Today, millions of individuals are running to keep fit but more than 50% will sustain an injury as a result. Some of these can be small sprains and strains, whilst others can be severe. What’s more, minor injuries which are left untreated can become chronic and present long term stress and discomfort. It is my responsibility as a therapist to not only identify and diagnose injuries, but also to educate the person about how to best prevent these types of conditions.
The knee is the most common site of injury in runners, followed by the Achilles, shins, hip, groin, foot/ankle then back. We are all aware of the benefits of running; we can increase cardiovascular fitness and enhance feelings of wellness and relaxation. However, pre-existing genetic issues can make it difficult for some folk to participate in running. Some examples include arthritis and cardiac problems.
Training errors can also predispose a runner to injury. These can include covering excessive mileage, hill running, hard surfaces and sudden increase in exercise frequency. Furthermore, an insufficient stretching programme without a warm up and cool down also has a negative effect. These factors can place undue strain on joints and soft tissues and the body cannot adapt… Injury then ensues.
Appropriate running surface is an important aspect to consider. The ideal running surface is a soft, level dirt path. Running on uneven surfaces or hard ground such as concrete increases the shock transmitted through the feet and lower extremity. Grass and sand can provide good cushioning for the feet, on the other hand, they can pose a risk as they are often uneven. In addition to this, running on hills or a banked surface can cause the foot to flatten (overpronate) and increase the stress on the Achilles especially.
Running posture is also an important element in the prevention of injury. Runners should maintain an upright position, where the torso remains perpendicular to the running surface. The upper body and arms should be relaxed with the elbows bent to approximately 90 degrees and the hands loose. Attempt to run with shorter steps; your strides shouldn’t be heavy.
Shoes. Footwear that is worn down or inappropriate to the individual’s foot shape can consequent in ailments of the lower limb and back. Unsuitable trainers do not provide adequate cushioning and stability that our feet in this day and age rely on, however this is contrary to the concept of barefoot exercise. Those that support barefoot running suggest that it can improve foot biomechanics and in fact reduce injury risk, although scientific evidence in this area is lacking. Due to years and years of wearing supportive footwear, the small intrinsic muscles in our feet have become weak and “lazy”. I therefore believe that strengthening these small muscles of the foot and leg is paramount to encourage optimal foot alignment and perhaps prepare us better to run bare foot. But when it comes down to it, a good shoe can help to provide rigidity and prevent over pronation (flat foot) or supination (high arch) which can put us at risk of injury.
Common running injuries include:
• ITB Friction syndrome (ITBFS) “Runner’s Knee”
• Anterior Compartment Syndrome (Shin Splints)
• Patellofemoral Pain
• Bone Stress Reaction/Fractures
• Achilles Tendinopathy
• Ankle Sprains