Injury prevention for runners

Part 1: Runners just want to run!

From my experience, the world always seems like a better place after a run -thanks largely to the endorphins we produce when we run. On the flip side, when I am injured and can't run, I become a bit of a monster! As a former triathlete, I am well versed in multisport participation and, while I do love to swim, ride my bike or tick off a gym session, none of them is as time intensive, productive and satisfying as a run.

As a physiotherapist, I see the frustrating effects of recurrent running injuries when the body reaches its threshold and can no longer cope. It's either a repeat injury or what I call injury 'ping pong', when the biomechanical overload pings from one injury to another injury along the kinetic chain. Your body is simply making the best plan it can, and when it can't absorb the load anymore, it sends the message to you, using the pain of an injury to get your attention.

How can we enjoy running and minimise the risk of injuries? In this and the next articles, I'll discuss three types of errors that I feel are most important, and that cause many of the injuries I see in my clinic: training errors, strength deficits, and poor running form.

Training errors

Approximately 80% of running related injuries are due to training errors, including overuse.

There are many myths about running being bad for the body. It's not, but it is intentionally hard on the body due to the eccentric muscle action where the muscles are working while lengthening. The impact involved is also hard on the body, which is why it helps to strengthen bones and minimise the incidence of low bone density as we get older.

When we strike the ground while running, our legs experience a force equal to around two and a half to three times our bodyweight. So, an 80 kg runner who hits the ground 500 times a mile will experience around 100 000 kg of load a mile on each leg!

Now it becomes obvious why we need to consider our training schedule. This is not just about overtraining (excessive volume or frequency) but also about how fast we ramp up our training, doing too much too soon after a break. Other common errors include too much high intensity training, bunching sessions after a break (weekend warrior), or cramming in aggressive hill repeats and track sessions within a short time.

Inadequate rest is a real injury risk. Run training is catabolic - it breaks the body down. The single best anabolic (rebuilding) activity you can do is sleep. If you are also low on sleep due to a young baby or a deadline at work, you should factor this into your training and recovery plan.

My tips

• Plan your training or get a running coach to do this for you. Coming up with a proper schedule, and sticking to it, is important. You need to balance your training load and factor in things like training build, tapering, races and recovery.
• Avoid boom and bust - going all in and doing too much too soon as the wheels will come off! Placing excessive load on your body tissues will result in a reactive response that commonly includes pain. Give your body time to adapt to the training and you will see steady improvements while avoiding injury and niggles.
• The 10% per week rule - aim to increase training time or training distance by a maximum of 10% each week.
• Step up and step back - if you step up training, you must also step back to rest more. You should allow your body to absorb an increased training load with dedicated recovery periods. For example, if you spend three weeks building training intensity, you should follow this by one week of recovery, where you back off the volume and intensity. You must plan for recovery, it doesn't just happen, so schedule in recovery days and weeks. This should include an off season of cross training. This assists with mental recovery which is also important in maintaining motivation.
• 80:20 split of intensity. Work on an 80:20 split of low and high intensity sessions to balance the load on your body.
• Have one goal for each run - long runs are not quick, and you should not extend speed work to cover long distances. Balance fitness and fatigue.

Remember:

• Stress + Recovery = Growth
• Stress - Recovery = Fatigue
• By considering your stress recovery balance you will sidestep many avoidable injuries. Factor in psychological wellbeing and sleep. One study has shown that less than seven hours of sleep a night in the previous two weeks increases the risk of new injury by 51%. On the flip side, sleeping more than seven hours a night decreased injury risk by 37%.

In short, sleep is crucial for our health and injury prevention so don't think you are being lazy when you prioritise this. The more you train, the more you should sleep!

• Monitor your response - be aware of the aches and pains you are experiencing. For example, don't join a competitive track session with a very tight calf. Give back to the body by stretching, getting a sports massage, or spending some time on a foam roller.

In summary: While the act of running is a healthy stress, it requires being balanced by rest to allow the body to become fitter and stronger.

Next, strength issues ...

About the writer

Parys Edwards is a physiotherapist with a special interest in sports injuries. She is an athlete in her own right. After winning the Triathlon Age Group World championships multiple times, she raced professionally for Great Britain for five years. She has also competed at elite level in South Africa in hockey and road cycling. She has recently been appointed co-chair of the Wits Sport and Health (WiSH) Running Interest Group.

Website: www.parysedwards.com

Email: physio@parysedwards.com

Cellphone: 072 753 0013