Running AdviceAugust 22, 2017
With the Nottingham half marathon fast approaching, many of you I’m sure will be starting to ramp up your training over the coming weeks. I’ve had a few clients in of late who have been coming to see me with various ailments, and we’ve been discussing their plan for returning to their training programme. Off the back off this, I thought I would just write a little something about the importance of considerations such as load management during this transition back from injury, or as you start to step up your mileage. Nothing too scientific – just a few nuggets of information from my experience which may be worth your consideration.
Load management/Optimal loading/Load tolerance have become quite popular terms in the Physio and running worlds in the past few years, but what do they mean to you? And moreover, why do they matter?
Essentially it boils down to a simple question – Is your body conditioned to manage the demand that you are placing upon it. I use this simple question across my practise, and I find that it serves me pretty well. Your body is capable of far more than people probably realise, and I actually go as far as to believe that that doesn’t matter how deconditioned you are, or may have been in the past. The key to avoiding injury is how you go about achieving your goals.
There are a few key things to consider here, and these are a few common issues that emerge at my clinic that I feel are significant contributors to injury.
- Too much, too soon.
Whether you’re a once a week park runner, or a 3 x 4-6miles a week runner, it is important that you don’t ramp your mileage up too quickly. Tendons are particularly slow in adapting to change, and can react quite unfavourably if you add too much mileage too quickly. Let’s take a runner who regularly runs 3 x 4miles a week. She has decided to sign up to the half marathon, and wants to increase her mileage. She decides to change from her usual 3x4miles a week, to 2 x 4, and a 6-7mile run at the weekend. On the face of it, this doesn’t sound too bad. But what is worth considering is that her weekend run is now putting at least an additional 50% load through her tendons, which the seems like a slightly more significant increase. This can then result in the tendon being over loaded relative to its capabilities, and thus result in a painful tendon.
This has always been a bit of a contentious issue for me. Do you over pronate? Under pronate? In all honesty, I don’t think it matters quite as much as perhaps we have been lead to believe over the years. That’s not to say that it doesn’t play a part, and certainly I think we would like to be able to optimise the role of the foot and ankle in propelling us forwards. But from my experience, I find that runners who vary their footwear tend to pick up fewer injuries associated with overloading. In my view, this dissipates the load that goes through the joints, particularly the knee. I think the same can be said for people who vary the terrain on which they run.
A good, supportive trainer I think is important, but it’s important to consider what your joints and tendons have become accustomed to, and how much they may have already had to adapt to any increase in your mileage in your older trainers. I’ve had more than a handful of patients this year who have had issues as a result of switching from an older running trainer, to a shiny new, all singing, all supportive trainer that has been ‘essential to support their over pronating foot posture’ . Again, I think this is due to the pathway of the load absorption, perhaps tracking through areas that aren’t used to taking that load – particularly in the knee. If you do decide to buy a new and more supportive trainer, make sure you reduce your mileage in these in order to break them in, and try and maintain your longer runs in your older trainers until you have caught up. It’s also worth having a look at what is happening around the hip, as this may be contributing to where this new load is being absorbed.
I often get asked what trainers people should buy. This isn’t really a market in which I’m any sort of expert, but for me, trainers made by your more ‘Designer’ brands, aren’t as good as brands such as Asics, New Balance, Saucony etc. The more ‘designer’ brands are exactly that, and tend to sell based on their marketing and aesthetic appeal. The latter brand names tend not to be so well marketed, but are more reliant on actually being a good quality running trainer.
- Just keep running running, and running running….
This for me is the single most important issue, and the most common issue that I encounter with my runners.
I think it would be fair to say that Mo Farah is probably one of the most successful runners of all time, non? But Mo Farah hasn’t reached the dizzy heights of multiple Olympic Gold medal winning Athlete by just running, his body simply wouldn’t allow it. Now I fully appreciate that the stress his body is put under is far far greater than even the most dedicated of recreational runners, but I truly believe that the principles are the same when it comes to your ability to manage, and sustain that load tolerance. Yes, your joints and tendons will adapt to a progressive increase in your mileage. But it is absolutely essential that you compliment this with some strengthening exercises, and I honestly cannot stress this enough.
Essentially, what we are looking to do is marry up the progressive loading that we discussed earlier, with progressive conditioning of the muscles and tendons. This ultimately gives you what I believe is your load tolerance. For some people, it is very easy to see where this has gone wrong, mainly for more novice runners. For others, this can take a bit of unpicking, so a good physio will take time to really unpick what your current regime is, what your training history is, how quickly you’ve transitioned to get where you are… and so on and so forth.
- Not addressing those niggles
Niggles often come and go with runners – knees, Achilles, hips, backs etc etc…. For those that have been running for quite a long time, this becomes part and parcel of running. But it is really important to differentiate between what is a pain or discomfort that we would expect as part of running, and what is an injury, that needs managing and dealing with. This can sometimes be a bit more problematic in ‘charity runners’, who feel they just need to push through, as people have kindly donated to their cause. But this can often lead to frustration and disappointment later down the line, as they are forced to reduce their mileage/pace. The key is to get the right advice on how best to manage the injury. In my practice, it is very much my last resort to stop someone from running. These issues can often be dealt with by managing the load going through that structure effectively, and by using some basic strengthening exercises to help offload things.
I’ve specifically not over complicated things with this information, as often there is no need with these issues. But I hope this information has been of some use to people.
Please don’t hesitate to get in touch with us at Advance Physiotherapy if you are starting to develop some niggles. We are offering a 10% discount off your initial consultation with your confirmation of your half-marathon entry. Prevention is very much better than cure.
Best of luck to those of you in training, run with a smile on your face, and ENJOY IT
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