Running season is well underway, with Brighton Marathon taking place last Sunday and the upcoming London Marathon this Sunday. So many of us seem to have contracted the running bug over the last few years (myself included!) and as a 'marathon widow' as well this year I thought I'd put together a few words for those of us who enjoy a run and are taking on (or thinking about taking on) exciting running challenges in the coming weeks and months.
From an osteopaths point of view, we love it when you move your bodies! I find myself telling people day in, day out 'you need to move more, your body is designed to move' and for the large majority of us who lead fairly sedentary lives, this is so true. When however, we are training for something specific and putting in lots of hours of repetitive movement, unfortunately injuries can occur or problems that we had long since forgotten about can raise their ugly heads. On the flip side, if we don't train enough the chances of a problem on the day become much greater and so balance (my favourite word!) is the key. Making sure you follow, as best you can, a good running plan that gradually takes you up to the distance of your event, I find is the best way to start. I use the free plans (and handy little app) from www.my.ascis.com but there are lots of other free plans that are just as good. Bear in mind that training for some events will take months in some instances so planning ahead is also important.
Unfortunately I can't write about every possible running injury as every runner is an individual. Different running techniques, fitness levels, body shapes and so on and so on can lead to totally different injury patterns. I've just picked a couple of the problems I see most often to give you a little information about.
The most common one I have personally seen amongst my running patients is Achilles tendonitis. The Achilles' tendon attaches the two big calf muscles, gastrocnemius and soleus, to the back of the heel. With repeated stress the tendon can become inflamed and therefore painful. A lot of up hill running, poor footwear and not stretching out properly are big players in causing this. In my experience I have found that a routine of icing and stretching, later followed by strengthening exercises helps reduce the inflammation. In clinic, I often use massage to release tensions in the muscles and I have had good results with dry needling (a form of acupuncture) and sports taping. As an osteopath, a lot of the treatment will also be to address any other imbalances in the lower limb, lower back etc that may be predisposing the calf to tensions.
Another problem high up the list for runners is 'ITB syndrome'. As soon as you mention those three letters you hear all the runners groaning! ITB or iliotibial band is a thick band of fibrous tissue that runs on the outside of the thigh from the hip to just below the knee, which it helps to stabilise. As the band approaches the knee it becomes narrower and runs over the bone, repetitive movement can cause it to rub here causing inflammation and pain on the outside of the knee. It often happens when the leg is repeatedly turned inwards so avoid running on the camber of the road if you can and check to see if the soles of your trainers are worn. (As a little aside, everyone knows the importance of correctly fitting and supportive trainers, they are well worth the investment. I always get mine from the outlet centre at Ashford, a lot cheaper as long as you don't mind last seasons styles!). Rest, ice and stretching are also important in this instance, knocking it on the head before it becomes chronic.
Finally, the last thing I see a lot of (not just in runners) is plantar fasciitis. The plantar fascia is a really tough membrane on the sole of the foot, running from underneath the heel bone to the ball of the foot. Its job is to maintain the arch of the foot however a lot of us turn our feet in (pronate) and flatten the arch, causing the membrane to stretch. Due to this it can get inflamed at its attachment points, normally where it attaches under the heel bone. This is where good supportive trainers are really important to help maintain the shape of your foot and prevent over-pronation as you run. A lot of my patients love the golf ball exercise, rolling a golf ball under your foot to massage the area, and also stretching the area by pulling the toes back. Again from an osteopathic viewpoint we can help stretch the fascia with massage but I really like to focus on the causative factors and biomechanics in the limb to help resolve this.
Rest, allowing time for inflammation to subside, is important in all of the above. However, and I totally get it, a lot of us will want to keep going and patch ourselves up to make it through the event and achieve our goals. Just be mindful of the potential for these problems to become chronic, especially if you have more than one event lined up, and bear in mind the long term. If you really are going to keep going then following advice about shoes, stretching etc becomes even more important.
Apart from all that, my best piece of advice is to enjoy it. Whatever challenge you are taking on, for whatever reason, you can do it! If you have never run before and are thinking of starting, or if you're an accomplished runner, I believe a challenge is always good for the mind and body. I now find my runs are a way to chill out and switch off, something I never thought I would say a few years ago!
I hope you have found this little oversight interesting and if you have any questions please ask. Finally, good luck and enjoy running!!