Posted on February 07, 2018 by Jenny Cromack
Running Injury Management
Having recently attended an extremely valuable talk on running injury, the following article to ‘bulletproof your running’ provides my reflections and the useful concepts that were shared. The talk was given by a very knowledgeable, experienced, and research driven guy called Peter Francis, who is based at Leeds Beckett and heads up the Musculo-skeletal Research group. I would recommend following him @peterfrancis_ie on twitter.
What are the key predictors of running injuries?
The following two risk factors appear simple, but are driven and supported by research. The first common predictor is load, or more specifically the rate of change in load. Our bodies respond to loading and adapt themselves to become stronger and cope with any load put on them. The rate at which we load our bodies, and specifically the tissues associated with running (e.g., achilles tendon, patella, tibial shaft), however, is important. The body needs time to aclimatise to the loads, and it needs to be drip fed these loads, otherwise we fail to recover an optimal state within the tissues.
Many runners are focused on “weekly mileage” increases, “PB’s”, or “10k times”. Some pick their goals – marathon races – and ramp up their training week-on-week and then fall short to injury. These weekly increases in load simply exceed the “normal load range” for the tissues, and they have not had sufficient time to adapt. A key concept discussed by Peter was the idea of consistency. Finding your “normal”, “injury free”, range or weekly mileage and sitting with that consistently for a prolonged period of time, let the tissues get used to the 40miles a week stress, and then consider sensibly progressing. Progression is also key and needs to be drip fed not ramped up 10 miles every week. The tissues will adapt, be more bulletproof, and more efficient in dealing with that load before you gently increase it.
The second key predictor is previous injury. Being subject to past injuries puts us at more risk of future issues. So either don’t get injured, or when injured sensibly work with your load, regress where necessary and bulletproof those tissues before pounding 40 miles of tarmac a week. The tissues need to re-learn, re-adapt, and start again in terms of coping with the running loads.
Bulletproof Your Running
Use Your Muscles!
The most common running injuries do not occur to muscular tissue, they in fact occur in the non-contractile tissues, and include patellar femoral pain, Achilles tendon issues, medial tibial stress syndrome (shin splints), plantar fasciitis, and ITB issues. A possible reason for this is the gait patterns often seen with running; the extended knee, foot far ahead of center of mass, and a raised foot (heel strike). This “locked” and stiff limb position leaves the absorption of impact down to these non-contractile tissues, and involves very little muscle action and control.
One way to tackle this is to allow for some bend in the knee on impact, shortening the stride slightly, and allowing the center of mass to lowered under control during landing. One way that could potentially aid the natural adjustment of these running characteristics is to include some barefoot running (on grass) into you training schedule. The reduced support stimulates more proprioceptive and sensory feedback and, along with the reduced cushioning of a shoe, encourages shorted and more controlled foot strikes.
Additionally, to help “wake up” and train the muscles to help unload this impact phase, engaging in a focused strength and conditioning plan is advised. Train the appropriate muscles in isolation to wake them up, choose exercises that mimic the functional patterns of running (e.g., weighted lunges), and include some dynamic and powerful movements (e.g., bounding, plyometrics) that work these muscles. Common key muscles to focus on are the gluteals, quadriceps, and hamstrings. Training these muscles in an eccentric fashion – where they lengthen under load – which will help control the impact phase during your run.
Take Home Messages
This article barely scrapes the surface of Peter’s talk, I only allude to some of the stand out concepts of load and muscle involvement. If I have learned anything from the workshop, it is that progression does not need to be week-on-week. We need to allow adaptation time for the tissues, so why not stick with a weekly mileage, or weight load (for resistance training), until we feel comfortable, efficient, and “bulletproof”? Let’s not get hung up on running harder, further, and achieving PB’s every week. Manage your load better, find a range that you know you are comfortable and injury free at, and stick with it for several weeks, then slowly progress. Add variability to your training; use strength work, include plyometrics, and add that yoga session in. To be a runner we don’t just need to run, all these different training modes ultimately improve our efficiency and resilience in running.
Be patient, be consistent, be sensible, and they will come naturally.
For the whole talk visit https://replay.leedsbeckett.ac.uk/Panopto/Pages/Viewer.aspx?id=33ae2915-5556-4b98-b0e2-b53d73b0066f