Running injuries – explained and prevented.
This is the most requested blog topics from my clients all through 2017.
I live in a town where people run, a lot. Consequently, I live in a town where many have some serious pain associated with their running habits.
Running is a fantastic, fun, efficient, effective cardio exercise that everybody can access at any time night or day. You don’t even necessarily need a pair of runners to run! Some might say it’s entirely free, or is it?
I feel running is the one exercise that everybody can access yet may take for granted, people assume they can just do it, and don’t require training to partake. This unfortunately, more times than not leads to poor technique, over loading of joints, ligaments and in some cases irreversible damage.
In my opinion, people don’t think about a) their body type and b) the importance of technique when it comes to running. They forget that poor technique can trigger old injuries, thus impacting on current training programmes, goals, dreams. In my experience, once the running addiction hits runners run through all kinds of injury and pain, just to reach their next PB.
Insane, right? Well, the endorphins, headspace, increased fitness level and weight control are very real reasons to continue, but at what expense?
Biomechanics of running
Consider me an expert in movement, a physio mind, a biomechanics nerd and a very contented people body watcher! I would like to make it clear from the start that my approach as a physiotherapist is one that is an educator and facilitator. I endeavour to teach you about your body in a way that is relevant for you as an individual and aim to empower you to recognise the source of your pain. I am not the therapist who wants to ‘fix’ you – by contrast I want you to fix yourself. I try to teach you in my workshops how you can be your own clinician.
Fig. 1 Body Image
Body image is not the same as body type. Body type (in physio land) all starts and ends with your pelvis. Visualising your pelvis as a bucket of water is a common analogy. In standing, we all assume our buckets are full and not leaking to the front or to the back, right?
If this assumption is true then ask yourself how come over 75% of runners suffer injury to interrupt their training for a minimum of 6 weeks in their lifetime.
As physiotherapists, we are experts at seeing movement patterns, so much of how we run comes down to body type, technique comes after that. It is widely accepted that ‘body type’ has a huge influence on HOW you run and WHAT exactly gets injured.
Where is your pelvis at?
For the purpose of explanation and education lets briefly discuss how the pelvis position affects over 45% of running injuries relate to the knee.
To explain the theory, take a look at figure 2 below, of the 3 most common pelvic positions or ‘body types’.
Fig. 2 Body Type
The third body type in the above image (posterior pelvic tilt) is a tail tucker who’s backward facing pelvis could potentially be affecting the low back muscles (long and weak) causing pain and instability, hamstrings (short and tight) and calf muscles (short). Prolonged, ignored tight calf muscles can lead to Achilles tendonitis.
The tail tuckers amongst us could realistically be compensating with an increased heel strike due to long and weak hip flexors. The increased heel strike, in either body type, opens up a whole world of other problems like shin splints, anterior knee pain, and back pain due to ground reaction force and over load of our weight bearing joints.
Without getting too heavy into bio anatomy and risking boring you to tears, Ill aim to keep it simple by explaining the tail tucker in more simpler detail.
When the low back muscles are in a lengthened position (flattened lumber curve) the low back is more susceptible to injury, in fact tail tuckers are more likely to experience low back pain than tail lifters.
There is significant reason to believe that the hamstring may have a large part to play here. The hamstrings are one of the largest muscle groups in our bodies. They attach directly to the ischial tuberosity’s (sit bones) located at the base of our pelvis. When your hamstrings get shortened and tight due to lack of stretching and increased loading, then can potentially draw their attachment to the sit bones down ward – ultimately effecting the pelvic position without you ever noticing!
Biomechanically, as I’ve already explained this can have a domino effect.
Your supporting muscles of the pelvis get short and tight, unable to align knee position thus creating pain in the buttocks, potentially over loading the inside of the knee (kinetic chain load). This tail tucker may experience no back pain or buttock pain and just complain of medial knee pain. Highlighting, this is the symptom of a whole chain of events but is not the cause of the problem.
So, if you are serious about upping your distance and staying injury free, you need to get an handle on your techinique. In my Running rehab clinics you will spend 4 hours getting reacquainted with your body, identifying YOUR body type, YOUR weak points, YOUR strengths and specific injury prevention plan. There are common identifiable markers or ‘weak links’ which you will identify, to enable the runner in YOU to overcome with correct lengthening and strengthening. Learn them all in my clinic. Run faster for longer.