Injury Prevention

Top tips

1.Avoid the “terrible too’s”.

Many injuries are a result of overtraining: too much intensity, too many miles, too soon. It’s important to go easy when adding mileage or intensity to your training. You can still push your limits, but you’ll have to take a gradual and patient approach. By building up slowly, you can save yourself pain and frustration, and still reach your goals. Let common sense and a smart training schedule determine how much you should be running.

2. Treat your feet right.
Be sure that your shoes aren’t worn out and that you have the right model for your feet and running style. The wrong shoe can actually aggravate existing problems, causing pain in your feet, legs, knees or hips. Wearing shoes that have lost their cushioning may also lead to injury. Go to a specialty running shop where you can be properly fitted for running shoes, and replace them every 350-500 miles. If you have a biomechanical problem with your feet, you may also look into getting fitted for heel lifts or orthotics.

3. Find the right surface.
Once you have the right shoes, you want to make sure you’re using them on the best surface. Ideally, you want the ground to absorb shock, rather than passing it along to your legs. Some advise avoiding concrete as much as possible: It’s about 10 times as hard as asphalt, and may be the worst possible surface for running. But if your marathon is all on road then you may have to do a significant amount of training on road. For others trying to find grass or dirt trails to run on, especially for your higher mileage runs, is a better option. Perhaps trying a mixture of both offers a best compromise. Consistency is important, too, because a sudden change to a new running surface can cause injuries. You’ll also want to avoid tight turns, so look for slow curves and straight paths.

4. Stay loose.
A regular stretching program can go a long way toward injury prevention. Be diligent about stretching after your runs — your body will make you pay if you get lazy about it.

5. Keep your balance.
Injuries sometimes pop up when you’re paying too much attention to your running muscles and forgetting about the others. For example, knee injuries sometimes occur because running strengthens the back of your legs more than the front of your legs. Your relatively weak quads aren’t strong enough to keep your kneecap moving in its proper groove, which causes pain. However, once you strengthen your quads, the pain will often go away.

6. Make sure you’re ready to return.
To prevent re-injury, ease back into training with water running, cycling, or using an elliptical trainer. Overtraining is the number one cause of injuries, so try to remember that progress takes time.

Rest Periods

Rest is an essential element in staying fit and healthy if engaging in exercise. It is during sleep and rest that the body rebuilds itself to prepare for an increased workload. If adequate rest periods are not introduced then the runner could weaken the body leaving it vulnerable to injury and infection.

Sometimes you get stuck at work, or you’re really tired, or you need to deal with another life issue and you just don’t have time to run. It’s OK. Don’t beat yourself up just because you don’t stick to the exact schedule. Your body won’t lose its muscle tone or fitness because you wait an extra 24 hours to run again. Accept that you will have bad days or missed days, and then get back on track. Don’t try to catch up you’ll only risk injury.

Tapering     

It may seem strange to suggest, but the three weeks prior to a marathon are best spent taking it easy. This period is called tapering and while it does involve some running, all athletes benefit from letting the body recover for the big day.

Put simply tapering is the phase in an athlete’s programme where the volume of training is reduced. Tapering is often done in preparation for a big event like a marathon so that the body is in prime condition.

Generally 2-4 weeks is needed, to give the body time to recover from training and to store energy for the race itself. Tapering for three weeks doesn’t mean you literally stop running for three weeks before a marathon.

If you are planning a three-week tapering period, the week before, you should be embarking on your longest training run.

If you’re longest run is going to be about three hours, then after the first week you should cut that in half.

Then the week after that I’d cut in half again, so you’d only be doing a quarter of your longest run.

If it’s been part of your training it is also important not to forget about your speed work during the last week of training.

For the two weeks prior to the race you want to cut down the quantity of your other sessions. Keep the quality. So take a threshold run for example, you’d still work at an uncomfortable pace, but you wouldn’t do it for as long.

It’s tempting to keep yourself ticking over in the final seven days before the marathon. But really it’s all for effect. You’ve done the training, the main thing is not to get injured now and ruin it all.

There’s absolutely nothing you can do in that last week which will make you run better. During the last week I’d go out for a light run on the Tuesday and Thursday but it’s more of a psychological thing. You might feel a bit sluggish during the last week because your body’s become used to running. A couple of runs will get rid of that feeling.

Building Slowly    

The body will improve when it is gradually introduced to a little extra work with rest in between to recover and rebuild. Some stress followed by rest stimulates the body to rebuild better and stronger to cope with the additional workload. Runners should build to a platform and stay there until it becomes comfortable and then increase the workload by a little. This way the body is pushed beyond what it is used to and the runner will see improvements. However this more cautious approach will not expose the body to the risk of injury associated with rapid increases in duration and speed over a short space of time. This can in turn lead to a potential hazard if the injury occurred whilst on a training run.

Injury & Recovery    

Most running injuries affect soft tissue structures especially those in major groups.

Muscle tears fall into two categories; acute and chronic. The acute muscle tear is a classic muscle injury of explosive sports such as sprinting, squash, tennis and soccer. The symptoms will be a severe pain to the area of the affected muscle and a loss of function. The muscle will be in spasm (a protective mechanism), is tender and be prone to swelling quickly after the injury has occurred. The skin overlying the injured area may also show signs of bruising. This type of injury is normally caused by a muscle imbalance between opposing muscle groups, inadequate warm up and muscle fatigue.

For the long distance runner such as you, the members of this club, the chronic muscle tear is much more common. Unlike the acute tear, the pain occurs following exercise. When it first occurs it is possible to run through it, but the pain will grow progressively worse. Running at any sort of pace will become impossible. The pain is usually found in the larger muscle groups and can be deep seated. This pain will pass off with rest and can be treated, but may leave the area weak and prone to future injury.

The risk of getting these types of muscle injury can be minimised or reduced by a few simple steps. Stretching and strengthening exercises may help reduce the risks of injury by introducing more flexibility and correcting imbalances and weaker areas. It may also help prevent the re-occurance of a similar injury once the current injury has healed. The appropriate shoe is also important to help correct biomechanical imbalances and reduce injury. When undertaking dynamic and explosive sports, a full and comprehensive warm up is recommended to help minimise the risk of injury. It is equally important to warm up after recovering to prevent further similar tears.

If treating the injury seek medical advice. Sports physios, sports massage therapists and osteopaths may well offer better advice than you GP.
The usual RICE (rest, ice, compression, elevation) principle may apply. However some injuries will respond well to cross-friction massage of the affected area.

There are a variety of injuries that can affect the knee. Many give rise to similar symptoms and so it is difficult for the ordinary runner to self diagnose with any degree of confidence. Expert advice should always be sought.

Some knee injuries originate from earlier incidents in other sports. If the ligaments have been damaged, for example, and have not been fully rehabilitated the uptake of a new sport which involves repetitive load bearing through the region can bring about new problems.

Other knee problems can arise with muscle weaknesses or imbalances usually in the quads.  Runners Knee (Patellofemoral Pain Syndrome) produces localised pain around the kneecap usually after a predicable distance.  It becomes gradually worse and is exacerbated by running long distances.  Walking up and down stairs as is squatting causes discomfort.

Bursitis is also common in the knee joint. This is a condition where the bursae (fluid sacs positioned around the joints to reduce friction) become inflamed. This condition will give rise to pain and restrict movement in the knee joint. The condition is difficult to diagnose and the symptoms are similar to those for tendonitis.

Tendonitis is a sprain to the ligament which holds the bones together. The ligament can be prone to sprains of varying degrees of intensity from a small stretch to a complete tear and recovery can take several weeks or months. The joint will become painful and will swell. RICE and medical advice is recommended to aid recovery.

Another common injury to affect the knee and cause pain is illiotibial band (ITB) friction syndrome. The illiotibial band is a thick strip of tendon that extends from the hip to the tibia immediately below the line of the knee joint. When the knee is bent the tendon may make contact with the femoral epicondyle and it is this which it is believed causes the pain. The pain will increase during exercise as the two rub together but will stop during rest. Again this can be helped by a combination of shoes, changes to training, surfaces and specific stretching exercises. Ice and anti-inflamatories can also help.