Running is an extremely high impact activity and therefore your body needs to be in optimal condition to deal with these forces, so that you don’t pick up any injuries secondary to repetitive forces through poorly aligned/ controlled joints or reduced strength and control. Secondly you need good neuromuscular control, which is the ability of our brain to effectively recruit and use the appropriate muscles to protect your joints from excessive strain.
I have seen many people in my clinic with running related injuries and similarly I have had first hand experience ranging from ankle, knee, hip to low back pain. Most or all of the injuries have been the result of poor technique, poor footwear, reduced overall strength and conditioning or a sudden increase in distance or time. Therefore before you dig your trainers out, here are my top five tips for preventing a running injury.
1. The Contentious Issue Of Stretching
There are lots of different reasons to stretch; for pain relief, to improve flexibility and to increase muscle extensibility, to prevent muscle soreness and reduce the risk of injury. The evidence out there doesn’t seem to reach any clear conclusions, and what is unclear is whether the increase in range of movement gained is due to an increase in the stretch tolerance of the muscle or an actual increase in the muscle length. Interestingly there also appears to be little evidence to show that it will make you perform better, in fact stretching before exercise could actually reduce your strength, power and endurance.
How long to stretch for is another confusing topic. I usually advise people to stretch statically for at least 15-30 seconds 3-5 times each side two times per week to maintain flexibility (American College of Sports Medicine). However if you have lost range of movement or are particularly stiff the advice is to stretch daily. What is even more interesting is that if you’re stretching to warm up before a race/ activity stretching for longer than 60 seconds could actually temporarily reduce your performance. So my advice would be to run for about five minutes before stopping to stretch the key muscle groups- quads, hamstrings, calf and hip flexor muscles for 30 seconds and then stretching once you have finished.
2. Pilates/Core stability
I am personally a big fan of Pilates and believe that it is a great compliment to running. We all know that it’s important to have a strong core, but why…
Regardless of how strong or conditioned your legs are you need a strong core to allow force to be effectively transmitted to your legs. If you don’t have a strong core then all those squats and lunges could be in vain.
There have been a lot of studies looking into the effect of Pilates on the strength and endurance of the deep abdominal and lumbar muscles and flexibility. And it appears that doing regular Pilates can improve the endurance of the deep abdominal and lumbar muscles, which can help protect the spine and reduce the risk of developing or managing existing low back pain. So if you want to protect your spine from the repetitive forces and loads that road running brings, I would advise you to try and join a Pilates class or incorporate some Pilates based exercises into your weekly fitness routine.
3. Appropriate Footwear
If you haven’t run for a while, I would recommend visiting a running shop that can analyse your gait and recommend specific trainers that can help reduce the risk of injury. You should also be aware that you should change your trainers every 300-500 miles, which is relatively easy to do by keeping track of your mileage using a training app.
The surface that you’re running on is also important, where possible try to run on softer surfaces such as gravel or grass which will reduce the forces and impact going through your joints.
Another tip which I picked up from watching a youtube video posted by ‘Illumiseen’ is the importance of the extra shoe-lace hole on your trainers.
For most people – myself included – it has served no purpose and has always been a mystery. I have struggled over the years with losing toe-nails, at last count I have lost a total of seven nails in the pursuit of health and fitness. But alas now some light has been shed on a solution to this problem, the frustrating thing is that it has always been there disguised as the ‘extra shoe-lace hole’ the technical term for which, is the ‘eyelet.’ I have been using the eyelets since watching the video and I have to say that I have not had any further losses or blisters, furthermore my foot feels more secure and stable whilst running.
As a practicing Physiotherapist, I see lots of people in my clinic with lower limb problems secondary to injuries or biomechanical abnormalities. Although this is not a solution to injury prevention, a more stable and secure fitting running shoe can obviously provide greater support for the foot and ankle as well as reducing the stresses transmitted further up the leg to the knee, hip and lower back.
4. Glute/ Hip Control
Hip and glute control is extremely important to reduce the risk of developing hip/knee and ankle injuries. If you have poor control around your hips it can cause excessive force to be transmitted to your knee or knee cap which can also be transmitted further down the kinematic chain to your ankle. This can lead to a catalogue of injuries such as ITB syndrome (lateral knee pain), patellofemoral joint dysfunction (pain around the knee cap), posterior tibial tendon dysfunction (pain around the medial aspect of the ankle) and plantarfascitis (pain in the sole of the foot) to name but a few.
When assessing someone, if I find that they have reduced glute control (particularly gluteus medius) which is the muscle responsible for keeping your pelvis level, I would recommend specific exercises, a few of my favourites are the double and single leg bridge and single leg squat. However it may be useful to see a Physiotherapist who can assess for any significant muscle weaknesses/ imbalances.
5. Slowly Increasing Time And Distance
If you’re new to running or a pro who is training for a longer distance run, increasing the time or distance too quickly can be a recipe for injury. Like most things in life training and preparation is the key and quality is far more important than quantity. If you start upping the distance or time too quickly your muscles may start to fatigue, which may put you at greater risk of injury. I would advise you to follow a training plan or start with some interval training (mixture of high and low intensity exercise- running/ jogging followed by walking).
Running is a great way to improve your cardiovascular fitness, but because of its high impact nature it carries the risk of injuries. If you follow the above advice it will not completely eliminate the risk of injury but it should reduce the risk. So grab your trainers and head out for a run with the knowledge that you are in the best possible shape.
By Ally Rosam (Chartered Physiotherapist and running enthusiast-sometimes)