Running a marathon? Tips for injury prevention and performance
Injury is usually caused by overuse or misuse, poor planning, scheduling and the wrong mindset, here are some tips to help avoid unnecessary setbacks:
- With the world of technology entering into the running world, it is easy to chart your run on apps or GPS watches. Make sure that you don’t increase your weekly distance or longest run by more than 10% per week to avoid overload. You not only need to consider distance (miles/ km) but type of terrain (on road/ off road), intensity (including speed and hills), frequency (number of times per week). If you are not a fan of technology, then use a good old bit of paper (and a pen!).
- Use injury prevention plans to put out the small fires (niggles) before they become a fully blown injury. Foam rolling and strengthening programmes are particularly effective for this, mostly focusing on the leg and hip areas. Getting a good sports massage and physical assessment will also help.
- Listen to your body, you may want to do slightly less on occasions, plans are not set in stone. If you feel fatigue, make sure you are taking a rest day to avoid overtraining.
- Depending on the distances, get the correct nutrition, focus on a balanced diet with plenty of carbs for energy and protein for tissue repair. A window of opportunity to consume carbohydrate is 30 mins after activity to make sure glycogen stores replenish optimally for the next days training.
- Mix it up. You don’t have to run every day (point 1), in fact some low impact exercise such as swimming, water running or cycling will help keep CV fitness without as much impact on joints.
- Set training goals and work at a maximum of a two week sprint. This will build confidence by looking back and seeing your achievements and progress. This will add fire and motivation. Looking any further into the future will build frustration, disappointment and despair.
- Keep hydrated, if you’re thirsty, its too late!
- A training partner can help motivation and commitment. Beware…train at your own pace, getting dragged along will not help you reach your goals!!
- Embrace setbacks, this is part of the process, enjoy them (deal with them as they arise, remember it wouldn’t be as much of a challenge without them).
- Prepare on the day!! Carb loading, mentally see yourself succeeding, imagine each section of the race being completed on your own terms. Enjoy the experience!
James Kirkpatrick, Sports Therapist (MSc), Sports Science (BSc), Lecturer in Sports Injury and Treatment, sports fan and psychological skills coach.
At The Recovery Room sports injury clinic, we see many different sportspeople with varying goals and reasons for taking part in their chosen sport. These goals can be to maintain or help change body shape, meet new friends, stress relief, improving your performance etc.
Here is some simple advice on how to reduce your risk of injury:
Rapidly increasing your training distance or intensity is a recipe for disaster. Remember to slowly increase your training times with the difficulty of your session in mind so your body can adapt, remember your resolution should last the year!
The same is true with the frequency that you run, remember to have rest days and slowly build up your training days.
Appropriate warm up, using dynamic stretches, your goal is to increase you heart rate, body temperature, elasticity and range of muscle movement especially on those cold winter days.
Cool down using static stretches.
If you are starting a new exercise programme it is wise to get checked out for any areas of weakness or tightness and regular sports massage can help relieve those aching muscles.
Thinking of Running, Cycling or Swimming?
Tips for staying active:
Build up your distances slowly and beware of a change of terrain, this will change the intensity of your exercise.
Warm up with dynamic stretches to raise the pulse, temperature of muscles and improve the mobility of your joints. Focus more on hips and shoulders for swimming and from the hip down for cycling and running.
Rotator cuff impingement:
Soreness and pain on overhead activity through repeated overuse in swimming strokes.
Mix up you swimming stroke in training sessions to avoid overuse. Always stretch the shoulder muscle after use to prevent tightness and compression of the tendons in the shoulder. This will decrease the friction, inflammation and pain. Focus on stretching the chest muscles to prevent the shoulder joint becoming imbalanced and pulled forwards.
Strengthen the rotator cuff, upper back and core muscles to help your body position in the water. Use your legs as they will give you a lot of power in the stroke (triathletes may wish to preserve the legs more for cycling and running).
Runners/ Cyclists knee:
Strengthen the glute medius muscle at the side of the hip to stabilise the knee. You should be able to do 35 reps x 2 sets of the side lying clam to protect yourself from knee injury.
Make sure your saddle height is correctly measured for you (see last newsletter).
Foam roller or get a sports massage directed to the ITB at the outside of the upper leg (yes this is really quite painful- but worth it!).
Avoid too many hills in training (slowly build up the number of hills).
For more details on the signs and symptoms: http://the-recovery-room.co.uk/runners-knee-the-itb/
Running injuries are very common especially to the lower extremity (from the lumbar spine downwards). This is partly to do with the repetitive movement of the legs, hips, knees and ankles. Some common training errors can lead to unnecessary injury, especially from overuse, increasing your run duration, or intensity too quickly. This can lead to imbalances in the system causing some muscles to become fatigued, tight or inactive.Common Running injuries include:
- Referred leg pain from the lumbar spine (main in the hamstring or calf)
- Hamstring tendonopothy
- Hip Bursitis (pain on the outside of the hip)
- ITB friction syndrome (Runners knee) see blog post http://the-recovery-room.co.uk/category/the-recovery-room-blog/
- Parellar tendonopothy (pain at the front of the knee)
- patellar femoral joint pain (pain at the front of the knee)
- Hamstring strain
- Calf strain
- Achilles Tendonopothy
- Plantar fascitis
As prevention is better than cure, keeping to the 10% rule (not increasing you run in intensity or duration of more than 10% per week) will reduce the risk of overload. A regular foam roller session or sports massage focusing on the leg muscles will improve recovery and take the pressure off joints. Strengthening the glute muscles will help to protect the knee and hip (as long as they are firing correctly- you may need to get this checked).
Stretching the leg muscles, especially the calf muscles , quads and ITB. Core strength can help improve running economy improving the integration of the lumbar pelvic muscles to the lower limbs.
Are you looking to go to a bare foot or minimalist running shoe?
- Increase duration slowly and start with shorter runs than your normal distance
- Stretch the calf muscles as the toe (forefoot) running style will put extra pressure on the Achilles tendon and calf muscle.
- Strengthen the calf by using calf raises or heel drops.
- Strengthen the toes and forefoot by using toe tapping or strumming techniques.
If you would like any more help or advice please feel free to get in touch on 02380 192677 and ask for James.
Pain at the outside of the knee ITB
I often hear people in running and cycling clubs talk about pain at the outside of the knee that gets worse with exercise. The talk of the dreaded ITB that attaches at the outside of the knee that causes friction that produces inflammation and then pain. Many people that present in The Recovery Room sports injury clinic after running or cycling through the pain until it eventually prevents them from exercising.
Signs and symptoms of ITB friction syndrome include:
Gradual onset of pain at the outside of the knee made worse with exercise, can get progressively sharper.
Pain that is worse when running up and down hills-due to a shorter stride pattern increasing the friction and irritation.
Poor mechanics while running as weak glute muscles allow the knee to fold inwards.
Poor saddle height causing increased irritation at the knee.
Tight hip abductors that increase tension of the ITB and pressure at the knee.
Over pronation (flat foot).
Sudden increase in duration and intensity of exercise.
Treatment and prevention:
Rest, Ice, Compression and Elevation
Soft tissue therapy into the glutes, TFL and ITB. OR use a foam roller on these muscles.
Correct faulty firing patterns of the glutes and strengthen using side lying clam or hip abduction exercises.
Correct saddle height.
Rest or modify running to reduce pain- walk up and down hills.
Correct poor foot mechanics using orthotics.