By Joanna Tan
The life of a runner is one in which the balance between improving fitness and avoiding injury is a constant battle. Many of us run for fun, some for stress relief and some for weight loss. The figures around participation in the activity of running are staggering, with over 64 million people in the USA, 11 million in the UK and 1.3 million people in Australia (Statista, 2017) participating in running as a form of exercise. Of these figures, over 70% of runners participate in an organised running event every year! (Statista, 2017). Indeed reports suggest running has doubled in popularity over the last 10 years.
With such a high number of us out there pounding the pavements, ovals and running tracks it is no wonder that injuries associated with running are a large part of a physiotherapists caseload.
Here are some interesting facts about running related injuries:
• At least 75% of distance runners land on their heels (Hasewaga et al (2007))
• 19-79% of runners injured in a given year
• 50% runners get injured yearly
• 25% injured at any given time
• 60% due to training errors
• 55% one or more injuries in year leading to marathon event (Van Middlekoop et al (2008))
• Knee most common site 7-50% of all injuries
– Lower leg 9-32%
– Foot 5-39%,
– Upper leg 3-38%
• Most common injuries include:
– PFPS, ITB syndrome, tibial stress syndrome/fractures, plantar fasciitis, and Achilles tendinopathy (Bring et al (2017), Yeung et al (2011))
So this leads to the obvious question many of our patients ask – “How can I avoid injury and keep enjoying the great benefits of running?”
The answer to this is multifactorial:
1) Correct running form.
Many various beliefs have been presented as to what the correct running form is. We have had the barefoot revolution, pose running, mid-foot strike, heel strike and many more. In essence the best running form is that which places the least load on to the joints and associated soft tissue structures of the body. The challenge with this is that it requires great awareness of body position and a good balance within the various muscle systems of the body in order to achieve this. Therefore, non-running based training needs to be considered as key part of achieving the correct running form.
2) Running load.
A common mistake we see clinically is that recreational runners do not manage load increases very well. If you increase your running from 1km easy per week to 10km at a moderate intensity 3- 4 times per week then the multitude of systems in the body that are being asked to increase their load so suddenly will inevitably lead to a breakdown of one or more systems that will lead to injury. The general rule of thumb here is a 20% week on week increase to allow the body’s natural adaptive systems to learn how to correctly handle this load that is being placed on it.
3) Imbalances in the bodies muscle system.
A very common issue we see daily that leads to running injuries is that our clients do not spend enough time stretching, releasing, mobilising and re-training the muscles that are used in running. A tight calf muscle can lead to a reduced movement at the ankle, this can lead to an athlete picking up the foot earlier in the running cycle which requires the hip flexor to work more than the hip extensor and leading to a tightening of the hip flexor. This leads to reduced hip extension and eventually amalgamating in a decreased activation pattern of the important hip/buttock muscles that are crucial in the running gait.
Therefore, the use of various forms of non-run based training in the development of a runners training program is becoming more and more prevalent. Clinical Pilates is one such form of complementary training that is gaining in popularity in the running world.
A good Clinical Pilates program can target all aspects of running from standing functional exercises, to specific hip strengthening exercises tailored for running mechanics, flexibility exercises to ease the pressure on the common areas of tightness that lead to injury, and a series of run specific core strengthening exercises that can lead to significant gains in running form and function.
Physiotherapists at Pinnacle Health Group can assess and assist in developing a Pilates Program suited to your individual running requirements. Please come see me and have a chat. Happy Running!