A PHYSIO’S THOUGHTS ON RUNNING INJURIES

A massive thank you to Aaron Babb from Aevum Physiotherapy for this blog post

About 90% of running injuries are overuse related and for runners their biggest enemy is often their own energy and enthusiasm. A common mistake that even myself as a running Physio has made is leaving training too late. I know there will be a lot of runners out there that will resonate with this. You booked an event 10 months ago, its now 8 months since and you haven’t been training enough, so what do you do? Quickly ramp up your training and boom, something starts hurting. I have been a running Physio for over 10 years and over that time I have held soooo many runners together with the wonders of sports tape, to the point where they could be misconstrued to be doing the event in a mummy’s costume.

There are a couple of basic rules that have been proven over time to largely prevent those injuries leading upto your first or hundredth running event and we’ll discuss them in this article.

We see a lot of muscle injuries in runners, but by far the most common presentation are tendon injuries and for this reason its important to further explain the tendon. The tendon is the connective tissue that attaches muscle to bone. It’s the junction point the muscle tissue uses to exert load through your skeletal system. See the image below indicating the achilles tendon which is the attachment of the calf muscle group to the heel bone.

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There has been some excellent research indicating that tendons are less likely to get injured, the stronger the actual muscle is. But when we look closer it’s not exactly the strength adaptation in the muscle that is a deterrent to injury, it’s the adaptation that occurs to the tendon. Just as a muscle becomes bigger and stronger with exercise so does the tendon. The tendon needs to become thicker and be able to sustain the increased load that the newly stronger muscle can now generate, and this structural thickening is what can help to protect the tendon.

STRENGTH TRAINING AS A RUNNER

A quote I often reproduce is that running is a single legged sport. At any time during the gait cycle one leg is driving you forward and because it is a repetitive movement the same tissue is constantly loaded. So with that in mind we need to ensure that the specific structures coming under load are well prepared to firstly tolerate and secondly produce the forces required. For this reason there are some excellent running specific strengthening exercises out there. At Aevum Physiotherapy we are often updating our social media with great suggestions. These exercises will not only help to create muscle and tendon adaptations to help ward off injury but also improve performance. Many runners are surprised when we show them how weak they are in specific areas to running. Even experienced runners that are doing 100km + per week but frequently getting injured. This is because their cardiovascular fitness is excellent, that is they can run a certain distance without feeling exhausted from a heart a lung perspective, but fail to realise that their muscles started to really struggle 10km back and their form went out the window, which biomechanically is a leading cause for injury - and the thing that makes us Physio’s pull worried faces.

GRADED PROGRESSION IN RUNNING LOAD

There is a rough rule that running Physio’s and coaches frequently apply called the 10% rule. Although this hasn’t been strongly validated with research it has been well tested through time to be an excellent starting point. The rule stipulates that a runner should avoid increasing their weekly load by more than 10% above the following week i.e. If your total running load was 2km last week then try upto 2.2km this week. The beauty of this simple rule is it gives the muscles and most importantly the tendons, time to adapt to the increased load gradually, significantly reducing the chance of injury. The key here is to program well leading unto your event and make sure your not rushing to get your training in last minute before the event.

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STOP GRUMPY NIGGLES TURNING INTO ANGRY INJURIES

Lastly niggles. Every runner gets them and they can’t be avoided. But what can be avoided is the potential for that grumpy little niggle to become a daily abusive reminder that something isn’t happy on your body. A lot of my runners have learnt this one over the time they have been seeing me. Due to the repetitive nature of running a small injury can quickly become a big one, particularly when preparing for a long event or doing significant total km’s in the week. 

Most Physiotherapist’s experienced with treating runners will not think you are waisting their time or think you are a hypochondriac. More often than not a niggle is a sign that the tissue is beginning to break down under the current load it is under. Small changes in footwear, running surface or minor technique alterations can often be employed to reduce the load on a particular tissue enabling you to keep up with your training and prevent that niggle getting angry. The trick however is to get into see a running specialist Physio sooner rather than later so it can be a simple fix without requiring time off training.

Stay injury free so you can continue to love your running :)

Aaron Babb M.A.P.A

MAppSc (Physiotherapy)

BAppSc (Exercise Physiology)

Running Specialist Physiotherapist



Meet Helen - A BOTR Run Leader

This is Helen - she joined the BOTR team as a Run Leader this January....her journey through running has been a long and incredibly emotional one. I think her Dad is a legend! If you are on a weight loss goal, this is an incredibly inspiring story, and just look at the results...

I was never sporty.  I was always last to be picked at team sports at school.  I was more academic than anything. 

My family were active though.  My brother played for Wales at rugby.  My dad was a runner and had ran a number of marathons when I was younger and was still running at 60.

However, my problems probably began at school I went through some bullying and never really had any interests apart from films, TV and computer games.  With the bullying I started comfort eating and lost quite a bit of self-respect for myself.

My family moved when I was a teenager and I struggled to make friends at the new school.  The new friends I did make weren’t really a great bunch of girls and were more interested in boys and not being great students.

I did however go to university but that’s when my eating got out of control.  I put on a lot of weight, comfort ate, drank. Continued to sit at a computer and work.  I did however graduate but I also got into a relationship that didn’t do anything to motivate me in life.  I thought I was happy but I wasn’t.

At my biggest I was 146 kilograms

However, when I was 25 and 133kg my brother set his wedding date.  I knew I had a problem and knew I was morbidly obese.  I hated pictures of myself, hated shopping for clothes, hated social events.  However I knew that I would be in the pictures and wouldn’t avoid them. 

I was close to two of my cousins who encouraged me to go to a healthy eating group to monitor what I ate and monitor my weight.  I had absolutely no expectations but went anyway.  Who knew that healthy eating worked.  The weight started to come off.

Week after week I attended the group and saw that the scales were actually going down.  I decided I wanted to boost that by introducing some exercise in my life.

Of course that worked too.  I started small with exercise DVD’s.  I also attended some dance classes like zumba and aerobics as they were fun and I could do them with friends who were also getting active, who knew me and encouraged me and made me not feel embarrassed doing it.  But, despite living in the UK, the summer was coming and it was getting warmer.  I saw people running outside and I decided I wanted to join them.

Given my dad was a runner, I asked him for advice.  He was so proud of the weight I had lost that far and the active lifestyle I was taking on.  He asked me to go out with him the very next day.  He told me you can’t just run, you learn to run.  You build it up and you see how you go. 

The next day we went out.  I ran probably 300 metres before I had to walk again.  I walked for a bit and then ran a bit. I continued for about 2k.  I was proud of myself.  I’d actually been out on my first run and I enjoyed it.

I continued running with my dad who taught me all about posture and breathing and what to think about when I struggled.  I also started running on my own.  Within a few months I was running the whole course and my route became a regular 3k run.  I went out about 3 – 4 times a week. My eating was also under control and the weight was still coming off. The more the weight came off the better I was getting at running. 

There was a 10k event that took place every year and some friends were doing it.  I decided this was it. That was my challenge and I would enter it.

6 months later I did my first 10k run in a time of 1 hour and 3 minutes.  For me this was, and possibly will be, one of the happiest days of my life.  I remember that feeling of crossing the finish line and being so proud of myself. I knew I had changed and I knew that I never see that old, depressed, unhealthy me ever again.  I also found the confidence in getting out of the relationship I wasn’t happy in and became happier within myself.

Half Marathon - 2013

Half Marathon - 2013

The following year I did a half marathon in 1 hour and 56 minutes.

I laughed at the thought of a marathon.  That was too big for me.  I would only do one if it was a big one like London.... of course I got into the London Marathon and did it in 4 hours and 54 minutes.  When crossing that line I can’t even describe the feeling.  I was screaming at people around me to do it, to push it.  I will never forget that and get emotional even now thinking about it. That was the proudest day and I knew that my biggest goal had been achieved.  I had ran a marathon.  At that stage I had also lost 82 kilos.  Major life achievements had been accomplished in the space of just 3 years.

Running also restored my confidence in my life.  From the UK I moved to Australia where I met people who were even more  passionate about running. I joined running groups, went to Park Runs, competed in various other 10k’s, half marathons and, recently signed up to my next marathon; the Queenstown Marathon in November 2016.

I also understand how my story can inspire others.  I want to encourage others to do what I did.  In 2016 I became an accredited athletics coach and work with a great bunch of people at a running club called Boobs on the Run which inspires women to be active and healthy.  They teach people to run properly like I was taught by my dad.  It’s great to see people fall in love with running and watch it change their lives.

Running has literally saved my life. Without running I don’t know where I’d be.  I don’t think you can really put into words what running means to me.