Running Advice from Stuart Calnan, Wimbledon Osteopath
Avoiding running-related injuries
Maybe the lovely Spring weather has inspired you to take up running, or to train for an event/race? If so, this post is for you!
If it’s a been a while, then its best to take it easy initially and add-in some specific strengthening work between runs.
A recent study by Gothenburg University study (March 2021), ‘Running-related injuries among recreational runners’ drew some interesting conclusions.
The study builds on five previous papers, using data from 2016-2018, from 200 runners in the Gothenburg half marathon. The runners had all been injury free for past 6 months, aged between 18-55, and were running an average of 15km/wk for the previous year. Baseline tests were performed to assess the athletes – range of movement, flexibility, trigger points, running style and isometric strength. Runners were then monitored for training and injury status for one year, until injured or they left the study.
Study results
The cumulative proportion of new running related injuries over one year was 46%, i.e., almost half the runners sustained a new injury that year. The most common locations were the knee (27% of all injuries) and Achilles tendon/calf (25%). Unsurprisingly runners with previous injury were almost twice as likely to sustain a running related injury than runners with no previous injury.
Interestingly, the results show no associations at all between running related injury and excessive or restrictive joint range of motion, excessive or restrictive muscle flexibility, or having painful trigger points. None of these variables serve as a strong predictor of running related injury (nor did age, sex or years of running experience).
However, runners with ‘late timing of max eversion’ (a complex joint motion of the foot and ankle which occurs as we load bear) or a low ratio between hip abductor strength and hip adductor strength (i.e. relatively weak abductors) sustained 17% and 21% more injuries, respectively, than the reference groups.
So why do injuries occur?
The study could not answer this and found no strong causal relationship between changes in training load and injuries.
What can we learn from the study and other running experts?
Many experts believe overuse injuries can be avoiding by adjusting training plans…include strength work, and vary your running training.
Strength Work
Ankle and Feet
This area bears the load with every stride and are the first point of force transference. A Brazilian study found performing an 8 week training programme focused on foot and ankle strength reduced injury risk by almost 60%, compared with the control group.
What should you do?
- Single leg balancing (when brushing teeth)
- Toe scrunching exercises, e.g. picking up a sock with your toes helps build the smaller intrinsic muscles of the foot and support the frontal arch
- Bare foot balancing and walking along on a narrow beam of smoothed edged 2in wide wood.
Calf
Calf raises strengthens the calf muscles and Achille’s tendon. Steve Cram would do 500 of them daily during his running career!
But 3 sets of 20 repetitions will suffice for most people.
Perform them slowly (3 seconds up, 3 seconds down) with no bouncing.
Hip abductor
As the Swedish study found, weak abductors can contribute to injury risk.
Strengthen these muscles by performing clams or crab walks with an appropriately strong TheraBand around your knees. You should feel the muscle just under your back pocket working hard by the final few repetitions.
Try 2-3 sets of 12-15 reps for either exercise (no need to do both).
Single leg squats
These work the muscles of the hips, legs and glutes, plus highlight any differences between the legs requiring further attention.
Don’t try and go too low too soon, mini squats are fine. Have your hands on your hips for balance (or a hand on a wall to start with) and try to go a few centimetres lower each week as you build up power and control.
Look for 2-3 sets of 7-10 reps.
More general advice
The 25% rule
Increase the distance or intensity by a maximum of 25% per week. Build gradually (you wouldn’t jump from a 60kg to 100kg bench press in the gym).
Hill sprints
Add these into your routine for a challenge and to improve your power. Due to the slope of the ground the loading on the joints is less, but the load on muscles is greater. Be sure to be thoroughly warmed up, especially through your hamstrings, choose a steep hill (there are plenty in Wimbledon!) and aim to sprint up it for 15 seconds, building up to 30 seconds gradually. Admire the view, then walk back down and go again after a total rest of one minute. Five sprints should suffice!
Posture
Avoid leaning too far forward when you run. This has an impact on stride length (makes it shorter) and changes the ground reaction forces, leading to 29% increased loading and ground reaction force through the body, which increases the load on the lumber spine and knees due to the change in centre of gravity.
Trainers
Avoid trainers with too much or too little cushioning. Choose a light neutral shoe with medium cushioning.
Running variety
Vary the distances and speed in your training – sometimes do intervals and faster short runs, as well as longer steady paced runs.
And finally…
Remember the importance of good sleep, nutrition and rest. Listen to your body and allow sufficient time for recovery - 36 to 48 hours.
Happy running!
Interesting Fact...
How does the fastest marathon runner in the world structure his weekly training?
It's well known that Eliud Kipchoge runs a marathon at an incredible 2:50 minutes per km, or 21km/h. But how fast does he run in training?
Surprisingly to me, the world's fastest ever marathon runner doesn't blast his running sessions. 85% of his training is at low intensity 'zone 1', at a speed where he can hold a conversation. However, his training volume is very high (200-220km per week), and he's also training at 2000m altitude!!
Nonetheless, most of Kipchoge's weekly running is done at a leisurely 4-5 minutes per km.
The remaining 15% training is spent in more intense zones 2 & 3 during a track session and sprint intervals.
Why train like this?
To avoid injury and burnout, whilst maintaining aerobic fitness.
What can you learn from Kipchoge?
Plan your sessions and include a variety of training. And if you're meant to be on a steady tempo run, don't add a sprint finish just because you're feeling good that day - save it for the planned sprint session another day!