Running is great for so many reasons. It has amazing health benefits, it can be a great stress release, a reason to compete or even just a way to socialise. Unfortunately, at any level it is not always smooth sailing. The word ‘injury’ is one that almost every runner in the world can relate with – certainly every runner I have ever met, including myself.
In this blog, we will discuss potential causes of injury, how to identify the signs and symptoms of the most common injuries and also provide you with the top tips for staying injury free. Within all this we will also talk about Physiotherapy’s role not only in injury management but also injury prevention.
What increases your risk of injury?
The reasons as to why someone sustains an injury are usually multifactorial. Especially with overuse-type injuries, which accounts for the majority of running injuries. Here are the three top contributors to injury that we see with runners who attend the clinic.
1.Recent change in running shoe – So often we see runners who have recently changed their shoe and are now experiencing pain. This is particularly relevant to runners who cover a lot of distance during a week. Even if the shoe is identical to the one you just swapped out of, it can still increase your injury risk. Timing of a shoe change is very important and do your best to wear them in before you go running!
2.Lack of strength – If we expose our body to a load it cannot tolerate, injury will occur. We can increase our body’s tolerance to the load it is exposed to by strengthening it! The stronger we are, the more resilient our muscles are, the more we protect our joints and the less likely we are to be injured. The art of strength training is in which exercises are going to benefit your running the most.
3.Poor load management – This is by far the biggest risk factor contributing to injury. Load refers to the amount of running you are doing – most commonly measured in kilometres per week. majority of runners that come to the clinic have what we call ‘overtrained’. Overtraining occurs when your body has not been able to adapt to the amount of running you are doing. Hence, because our bodies don’t respond well to change, injury occurs. This comes back to the load vs tolerance principle. You can build tolerance but you also have to manage load.
Signs and symptoms of common injuries
Runner’s Knee or ITB Friction Syndrome (ITBFS)
-thick, fascial band anchored to hip and ankle that runs along outside of thigh
-important role in stabilising the knee during running
-poor stretch/shortening properties (not like muscle) – susceptible to injury
·irritable type pain usually on outside of knee
·gets worse throughout the run
·usually sore afterwards
·pain particularly when going up or down stairs
Kneecap pain or Patellofemoral Pain Syndrome (PFPS)
-the knee joints absorb high amounts of force during running
-the kneecap (or patellar) is anchored by the quadriceps above and patella tendon below
-during running the combination of force and movement due to quadriceps pull can cause kneecap pain
·vague pain around the kneecap
·pain can move around/change positions
·gets worse throughout run, although can improve for some people
·usually quite sore after running and often sensitive to touch
-thick, fascial band on the under surface of the foot
-provides support the foot arch
-works hard to maintain stiffness and position of foot during running
·pain towards heel (can sometimes be along entire foot)
·gets worse throughout run
·sore afterwards – often sore to walk on when aggravated
Achilles, Patellar or Gluteal Tendinopathy
Tendinopathy, meaning pathology or injury to the tendon, occurs when the tendon is unable to tolerate the load it is exposed to. Tendons in particular to not like change, and if irritated enough and for a prolonged period of time they can change their structure for the worse.
· focal point of tenderness which can be pointed to with one finger
· pain often improves throughout the run – known as the ‘warm-up effect’
· will be sore after the run
· doesn’t respond well to rest/time-off running – pain will return once running is recommenced
Keys to staying injury free
1.Plan your sessions – planning your sessions will help with your load management and minimise the risk of overuse injuries. It doesn’t have to be complex either. Tracking your km’s covered each week and sticking by the 10% rule (no more than 10% change in overall load each week) can often be enough to avoid injury.
2.Incorporate regular strength training into your routine – You don’t have to be a gym buff or go to the gym most days to complement your running and help avoid injury. Simply going to the gym 2-3 times per week is enough to improve your strength and maintain its benefit.
3.Identify and act on the early signs of injury – The quicker you act and seek professional advice the quicker you will be back running. We see the speediest results at the clinic from people who come in within the first 1-2wks from onset of their pain. The longer you wait, the harder it is to get rid of.
What we do at Melbourne Sports Physiotherapy
Here at Melbourne Sports we go further than simply diagnosing your injury and providing you with rehab to complete. Following our detailed assessment, our main priority is to get you back to what you love doing as soon as possible. Our rehab process typically includes hands-on treatment to settle symptoms, a detailed rehab exercise program and a carefully mapped out return to running plan. Given load management is so important, once you are back running we will also help you plan your sessions so you can safely increase your running load.
What is often not realised is as Physiotherapists we don’t just see you once you are injured. We want to prevent injury from happening in the first place! We work hard in the injury prevention space and often see keen, healthy runners for a detailed running assessment to help them stay injury free.
If you are showing some signs of injury or simply want help staying injury-free then book in with one of our highly experienced Physiotherapists today!