We’ve had our first London marathon runner of the year – we seem to get a handful every year, usually about this time as they start to increase the intensity of their training. The good news is that we can deal with most problems fairly effectively and get people through their race, especially if we get to see them at this stage when there are still a few weeks to go.
Most runners pick up injuries from time to time but marathons, half marathons and extreme 10km events are becoming increasingly popular and a significant number of the runners we see are part time occasional runners and most of their injuries are preventable.
A typical case for us at the clinic is a 35 year old man who comes in with Achilles pain. He’s training for the London marathon and has had a niggly pain for the week or two which is worse in the mornings and after a couple of miles into his run. He used to a good runner but hasn’t done as much over the last few years. He didn’t do much training pre Christmas as he felt that he had a “good base level of fitness and knew what he was doing”. He had a bit of a panic after Christmas though as the marathon was suddenly imminent, dug out his old running shoes and went out for an hour’s run.
He has managed to build up to the 10 mile distance over the last 3-4 weeks but is now getting increasingly concerned by his discomfort. He’s taken ibuprofen for the pain and continued to run but it’s not getting any better. Please help.
The good news with this case study is that with a few weeks to go, these cases can be dealt with and he’ll run his marathon. We’d give him some advice about his training programme, get him stretching properly, and treat his pain with massage, ultrasound or acupuncture. Most physiotherapists hate having to tell people to avoid exercising so we won’t ban you from running for any longer than is necessary (if at all). Even when seeing someone at the last minute, we can usually get people through the event with a bit of help.
But, prevention is always better than cure so these are our top tips for injury prevention:
Wear good shoes
It’s impossible to overstate how important your shoes are. Like tyres on a car, they are your only source of contact with the ground. You will run a lot of miles in the build up to and during your event. Buy good shoes from a reputable shop. A sole should be fairly stiff to support your foot but well cushioned to protect you from the impact. Most people should avoid a “flared” heel. Old, worn trainers should be replaced gradually with a new pair but not immediately before a race – break them in slowly.
Many sports shops now offer biomechanical assessment so that your shoes are the right ones for you. Special shoes, such as anti pronatory shoes, can be really useful but only if your feet are pronated. If your feet are neutral, they’ll just make things worse. If in doubt, consult a podiatrist who can advise you regarding what sort of shoe is good for you.
Build up gradually
Increase your distances and speeds slowly – make sure, for example, that you are comfortable running two to three miles before you start running five. Increase a mile or two at a time and avoid big jumps in distance. The same rule should be followed with speed. If you are used to running 8 minute miles and you want to increase you pace, try dropping to a shorter distance to ease the strain on your body. There are many books and computer apps available that will give you good guidelines for training.
Let your body recover between runs. Your body will cope with daily runs if you do short distances at slower speeds but for most people, running every other day is sensible. Injuries are far more likely when your body is tired and many overuse injuries such as tendonitis can be avoided with regular rest days.
Don’t leave your training too late – it puts you under pressure to train at too high an intensity, too quickly. You will try and skip the early shorter distance training runs and avoid resting as you have too much to do. It may be possible to train for a marathon in six weeks but it’s not recommended.
Manage Injuries and Niggles
Deal with problems as they arise. If you are running 50 miles per week, that niggly tendon probably won’t get better. Get some treatment or take a few days off. You need to weigh up which is going to have a greater effect on your performance – a week off training or running the event with your heels in agony. Generally, all other things being equal, a fit runner will beat an injured runner every time.
Remember that if you manage your training well, you are far less likely to get injured. There’s loads of information out there in books, on the internet and in magazines like Runners World (who put quite a lot of good tips on their twitter feed @runnersworld). Sift through it and use it.
If you do get injured, please get help. A good physiotherapist will be able to help you, as will a good podiatrist . They can give you advice and treatment that is right for you as an individual, whatever you level.
Simon Eason is a Chartered, HPC registered Physiotherapist and runs Garstang Physiotherapy clinic in Lancashire