It seems like yesterday London runners tied their laces to compete in the 2017 London Marathon. So, before this year’s London Marathon, we thought it might be helpful to (i) explain some of the common problems experienced by runners, (ii) characterise a 'niggle' versus a possible 'injury', (iii) give you some general 'runners' tips, and (iv) set out some exercises to help keep you injury-free between now and the big day.
What are some of the common problems experienced by runners?
Some examples of common problems experienced by some runners include:
- Ilio-tibial band friction syndrome (ITBFS): pain is usually felt on the outside of the knee, especially as the knee moves to and from knee extension. This is usually associated with tightness in the gluteal (buttock), quadriceps (front of thigh) and adjacent muscle groups, and delayed or reduced activation patterns in gluteal and inner quadriceps muscles.
- Calf strains and/ or Achilles tendonitis (inflammation of the Achilles tendon): may be caused by tightness and/ or recruitment problems in the calf muscles, and also muscles of the feet, thighs, buttocks and spine.
- Plantar Fasciitis: Tightness of the fascia (white connective tissue) and muscles within the feet and leg can cause pain under the foot (commonly just forward of the heel, but this can be anywhere along the underside of the foot).
- Low back pain: When associated with running, low back pain is often associated with excessive extension and/ or rotation through the lumbar segments. Stiffness in your upper back, hip and lower back may all contribute to your lower back doing ‘a bit more than its share’ of extension and rotation.
Do I have an injury?
It is important to recognise that not every niggle is an injury. Some niggles are natural as your body adapts to meet the new demands placed upon it. It is also important to remember that all people are of different shapes, sizes and alignments, and different things work for different people. Some people have never had a day of pain in their lives even though they have flat feet, carry a bit more weight, shuffle more than run etc. There is hope for us all!
However, pain that (i) lasts or even increases during runs, or (ii) does not disappear between training sessions, or (iii) is starkly different to usual muscle soreness following exercise may be associated with injury. If you have any of these, or you have any doubts, it is best to see your Chartered (State Registered) Physiotherapist to assist you in correcting the problem.
Handy tip 1:
Build up gradually.
- Not every single run needs to be longer or harder than the preceding one.
- Allow your body time to adapt following a longer run before you increase the distance further.
Handy tip 2:
Monitor your shoes…
- Rotating two pairs of training shoes can reduce the stress on your feet and legs.
- Also check your shoes for signs of wear more on one side than another, as this may provide a clue if you are experiencing problems.
- Good heel support and a shoe that shares the bend and twist throughout the forefoot and midfoot (rather than just at one point).
Handy tip 3:
Be flexible with your training program
- A flexible program within a structured framework allows you to deal with the normal ‘juggle’ of daily life, ill health etc; Unlike a strictly rigid program, this is more realistic.
- Pick out the ‘target runs’ in your program (ie, these might be your 10 mile run, half marathon race, 15 mile, 16 mile, 18 mile and two twenty mile runs). These are the ones that the runs in between are building you to do well in. Not every run is ‘make or break’.
- Flexibility allows you to adapt your program according to how your body feels. Rather than running 20 miles on a sore leg or when you’re very run down, re-tailoring your fortnight can help you stay fit and healthy.
What are some of the exercises I can do to keep myself up and running?
Below are a series of exercises which we believe are useful in helping prevent and manage common problems experienced by runners. These exercises are not intended to be an exhaustive list, and they may well be performed alongside other exercises which aim to increase strength and endurance in specific muscle groups. Also refer to our Dynamic Stretching article for more exercises to prevent and manage niggling injuries, both dynamic and static stretches have a role to play in keeping you on the road. If you have any concerns, consult your Chartered Physiotherapist.