Your Physio Derry
In association with Your Physio, Greysteel, Derry.

Running injuries are very specific due to the repetitive nature of the sport. Injuries are caused either by the body’s own intrinsic factors or by extrinsic factors.

The body works on a closed chain system when running i.e. when the foot is in contact with the ground, the forces and mechanics are transmitted along the leg to the spine. This is repeated every step and means if anywhere along this chain is out of line then potential injuries can happen.

Intrinsic factors

Intrinsic factors relate to the body itself. They are factors from inside the body rather than outside injury risk factors. Everybody has their own individual mechanics, some better than others. Some break down more than others. Everyone has their own unique threshold of injury.

What can go wrong?

If there is a biomechanical abnormality anywhere along the chain from the feet up, then injuries can occur. The most common problem is feet that collapse and overpronate causing the leg to turn in and pressure on the achilles, shin, knee, hip and spine. If you over pronate then you need stability trainers or running shoes to support the foot. In extreme cases where the runner is injury prone, orthotics may be prescribed.

Most specialist running shops will be able to look at your feet and tell you what foot type you are. Squinting patella and hips and knees that turn in are also common problems especially in women. Again this means these areas and those above and below are placed under extra strain, leading to injuries.

A lot of biomechanical problems can be corrected using a rehabilitation program. For example, knees that fall in (giving a knock-kneed appearance) are usually the result of weak hip abductor muscles which would usually act to pull the thigh and so knee outwards. Tight hip flexors are also a very common problem with runners as the hip flexors are repeatedly contracted and shortened. I would advise all runners to include a simple hip flexor stretch in their warm up:

Hip flexor stretch

On one knee, other foot rested in front, tighten the stomach muscles and lean forwards. If this is painful on the knee then try standing , pull one heel to the bum and pull knee backwards, keeping the spine still.

Hold both stretches for 30 sec’s.

Tightness in the calf muscles can lead to over pronation due to lack of range and then shin pain. It is important to stretch the 3 layers of calf muscles.

Calf stretch

Standing on a step initially let the heels drop and stretch the large superficial muscles. Then repeat this stretch with the knee slightly bent to stretch the Soleus muscles which runs deep to the larger Gastrocnemius. This muscle is often forgotten!

Tightness in the spine is a very common cause of all the running injuries I treat. It is good to do some basic spinal mobility exercises to try and get the spinal joints moving before running. These can include pulling the knees to the chest, then lying on your front pushing up on the arms, and then you can rotate the spine lying on your back with the knees bent.

Extrinsic factors

Before training for any running event and even throughout your training (especially if you feel a niggly injury building), you should be asking yourself the following questions:

Running shoes

  • Have they worn out?
  • Are they the correct type?
  • Are you wearing racing shoes for slow mileage?
  • Do you pronate and have you stable trainers?
  • If you have rigid foot then you need a pair with good cushioning.

All these factors need addressing. To tell if a shoe has worn initially look at its sole, if this is worn out then you definitely need a new pair as the upper body wears first! Twisting too easily is another sign they may be worn.

Training

Do you perform a warm-up prior to training? (The answer should be yes!) Have you been increasing your training too quickly? The rule of thumb is a 10% increase in mileage per week. Are you running on a different surface to usual? Concrete pavements and roads offer very little shock absorption Are you doing a more hilly route than usual? running up and down hills alters your biomechanics Its a good idea to keep a training diary so you can look back and see what may have changed in your training.

Warm-up

Some people swear by a warm-up, others don’t bother. However, while the jury is still out on the effectiveness of stretching in preventing injuries, I am firmly in the camp which is singing the virtues of stretching before and after exercise.

A warm-up should ideally consist of a gentle pulse raiser, such as fast walking, cycling or skipping. After 5-10 minutes of this, you should commence your stretches. The most important areas to stretch for runners are the calf, hamstrings, groin, quadriceps and buttocks. Hold your stretches for 20-30 seconds each.

More recently, active stretches have been introduced as the warm-up technique of choice. These involve stretching the muscles through movement, rather than holding a static position. For example, walking lunges, heels to bums jogging and cariocas can be used.

Core strength

If the central part of the body is not strong then you will be more susceptible to injuries especially when you become tired at the end of a run. Make sure you do some abdominal exercises and glut strengthening. Try and get your club to organise a circuit session, include all the basic exercises like squats, lunges and calf raises. You can find examples of core training exercises, from beginners to advanced…here.

Nutrition

The old adage that you are what you eat is still true. You wouldn’t put diesel in a petrol car! Eat a balanced diet with lots of fresh fruit and vegetables and plenty of carbs following training and protein to repair muscle. It is also vitally important to stay hydrated before and after training. Try an electrolyte drink after to replace lost salts.