In my experience as a physiotherapist and a runner I have come to the conclusion that in any serious engagement in a sporting activity, injuries are inevitable. We all have to learn to deal with our own physical idiosyncrasies. Fortunately, the human body has an amazing ability to respond and adapt to the demands we place upon it. The secret to becoming resilient and enjoying longevity in a sport is learning to train ‘smarter’.
For me, ‘smarter’ means following a principle I learnt many years ago when studying exercise physiology – the SAID principle (specific adaptation to imposed demand). This basically means stressing the body in a manner that creates positive adaptive responses rather than negative ones.
The more common injuries runners experience include (but are not limited to):
- Calf muscle strains – especially in the older individual taking up running for the first time.
- Achilles tendinopathy – this can affect any runner at any age but the incidence does increase with age.
- Iliotibial Band Friction Syndrome (ITBS) – often related to suboptimal hip stability at any age – The ITB is the very long tendon (the longest in the body) that runs from a muscle that crosses the side of the hip – down the outside of the thigh to below the knee. It often gets very tight in an effort to stabilise this region.|
- Medial tibial stress syndrome (shin splints) – often associated with technical errors such as overstriding.
- Hamstring injuries – often associated with inadequate gluteal activation and overstriding.
- Plantar fasciitis – possibly related to repetitive degenerative changes.
Less common but often more devastating than the injuries mentioned above are stress reactions which can result in stress fractures of the lower limb.
- More often than not these injuries can be attributed to three primary training errors that create the negative responses to stress we should be seeking to avoid.
- Trying to build up mileage too quickly without the body having adequate time to adjust to the increase in load. For example, aiming to run a marathon with less than 12 – 16 weeks of training and having no base running fitness to start with.
- A sudden increase in the intensity of training that tends to be associated with speed and hill training. Speed and hill training are both important aspects of a well rounded running program but need to be incorporated judiciously with appropriate recovery between sessions.
- Inadequate rest between intense training sessions and after racing.
I have not included ‘poor flexibility’ as a contributing factor in running injuries as it has been a contentious issue for years and research has been inconsistent. I plan to address this at some point in a seperate blog.
There is no doubt that poor technique can be a significant factor in running injuries and in many cases this can often be attributed to lack of strength and endurance.
Interestingly, there is another less considered factor in developing injuries and this is ‘undertraining’.
In an article that was published in the British Journal of Sports Medicine in 2016 the question of undertraining was explored. One of the conclusions in this article was that,
‘…..while there is a relationship between high training loads and injury… well developed physical properties that develop with hard (and appropriate) training actually protect against injury’
Research suggests that older runners tend to be more susceptible to injury as a result of the training errors (I have to say I found it a little depressing that ‘older athletes’ were considered to be those over 25!). There is no doubt that as we age muscle mass and bone density diminish. However, specific strength training and progressive loading of the musculoskeletal system not only minimises these changes but in many cases these changes can, to an extent, be reversed.
Over the past four years I have worked hard at strength training that has included weights and Pilates. I have no doubt at all that this background training has been a significant factor in my running achievements at this stage of my life. I have certainly had injuries, in fact many of those mentioned earlier.
Fortunately, with my knowledge as a physiotherapist and previous study in exercise physiology, I have been able to quickly identify where I lack specific strength and worked to overcome weak areas that have contributed to these injuries. This, and some excellent mentoring, has helped me to become a better and stronger runner.
The one significant thing I have learned in my journey so far is the old traditional cure-for-all-things, ‘rest’, is not the answer to recovering from an injury. Complete rest only leads to overall loss of strength and condition and does nothing to create resilience in the part that is injured. This also is such an important subject that I hope to deal with it in more detail in the future.
Gabbett TJ. Br J Sports Med 2016;50:273–280. doi:10.1136/bjsports-2015-095788 [Available here]
ISSN: 1543-8627 (Print) 1543-8635 (Online) Journal homepage [Available here]