Running from injury
I've suffered with 'medial tibial stress syndrome' (aka shin splints) for the last few years and have tried a range of treatments and strategies including physio, sports massage, stretching, taping, acupuncture, rest, expensive insoles, expensive trainers, compression sleeves, gait analysis, altering (trying to alter) technique. I've taken all the advice from experts and professionals and still struggle with the familiar niggle as soon as my training passes the 5k zone. I'm told my ankle doesn't flex well, I have a build up of scar tissue on my shin from a mystery previous injury and my balance and core muscles are non-existent. So I've started strength exercises and yoga to improve balance and core and flexibility and to stretch myself in all kinds of wondrous positions my body doesn't want to go into.
My other half spotted the advert for a talk at Leeds Beckett University entitled 'Why do runners get injured and how do we stop it?'. It sounded right up my street and so, on 31st January 2018 at 6pm I found myself sat in a lecture theatre at my old uni, surrounded by people of all ages, fitness levels, genders, scope of interest (professional, personal, educational).
Peter Francis PhD of the Musculoskeletal Research Group of the School of Clinical and Applied Science at Leeds Beckett University is well qualified to speak on the subject, not just through years of education, research and work experience but also on a personal level as someone who has been injured thanks to the pastime that is supposed to be good for you. A show of hands in the packed room showed that he and I were not alone. A room full of runners and most were suffering from or had suffered from a running injury.
A handout of an article about barefoot running and the display of research outside the lecture theatre alluded to Peter's specialism. Barefoot running?! Who does that? All I can think of is the dirt.
Peter started by talking about the biggest predictors of injury in runners.
Load. Not the amount of running but the rate of change. Doing too much too soon.
Previous injury. We get injured, stop running and rest then restart at the same pace > injured again >rest > restart at the same pace > injured again. And repeat until defeated and thinking running is not for us.
The loads a runner is exposed to is anything that loads all or part of the tissue differently to how it was before. So we blame our new trainers for the pain we're experiencing but did we actually just run that bit harder to try out the new trainers and therefore the blame lies with the load. It's a tricky thing to get your head around, I kept thinking of weight of the body but it's not that so much.
The most common running injuries are to the knee, ankle/foot and shin; all lower leg. They are not muscular injuries, they are structural, to the passive tissue.
75% of runners have a rear foot strike which jars the tissue. I was told by the experts that this was my issue, hence the technique change. Changing technique is hard! Technique was Peter's issue too. To reduce injury we need an even spread of contact. It could be that we run this way because the glute muscles are not being used. Glutes work for the legs like the bicep does for the arm. We don't use the muscles and so we load up the structural tissue. Work those glutes. I've been doing glute bridges, on exercise I'm surprisingly good at.
Peter compared runners to footballers. Footballers injuries are generally strains, far more muscular than structural. This is because they tend to sprint and have a much more varies movement pattern. Runners run in a straight line, footballers go in all directions. Therefore runners use muscles less adequately while running.
So these are the three challenges for runners:
Load Management
New runners are relatively injury free because they are well behaved and follow a plan, build up gradually, mixture of walking and running, not too much load. More experienced runners are the ones with issues. Chasing that PB, being competitive with yourself and others, knowledge about pace etc and wanting to improve.
Peter's advice is to accept what you are capable of. Find your perfect load and work with it. He keeps an Excel spreadsheet to keep his load the same or with a very slight increase. Consistently delivering the same level of performance. This in itself is enough to improve stamina, speed and all that good stuff without hurting yourself. A graph showed that Peter generally did around the same level of activity each week with only slight variations.
Load is a mental problem too. It can be related to stress. If you are stressed you feel pain more. You need to be relaxed, you need headspace, you need to enjoy the activity. ABC - Anticipation Breeds Consistency. If you know you have a stressful day ahead of you, fit your run in at the start of the the da instead of later when you're exhausted. If something happens and you miss a scheduled session, don't beat yourself up about it, ignore the session and don't try to catch up.
Muscle Use
As kids we do activity better. We run better. It all comes naturally. How we hold our bodyweight gets worse as adults.
Peter recommends isolated, functional, dynamic strength into muscles. So, running uphill, running fast, lifting weights, work on the flexion in hips and knees (yoga is good). Change your perception of what your body is capable of.
Increase Variability
Run barefoot on grass (or use barefoot trainers or cheap/light trainers for the cold weather! Don't just run, do other exercise too.
So, the recommendations...
Peter does not necessarily recommend halting training if you are injured because it leads to that whole hiatus/starting over thing with the risk of injury. Modify, modify, modify. Manage the pain, do what you are capable of. He does not advocate expensive running shoes. Cheaper ones have thinner, more flexible soles closer to barefoot running than the pricier ones. He doesn't have much faith in insoles and anything fancy to mess with your foot and your bank balance.
Everything made perfect sense and there were a few lightbulb moments. I'm starting to put the advice in place in the hope that I can run injury free. I really want to try barefoot running too! Maybe when it's a bit warmer...
The following links have been kindly provided by Peter as examples of studies and published works related to injury and barefoot running.
https://www.ncbi.nlm.nih.gov/
https://journals.
http://bmjopensem.bmj.com/
http://bjsm.bmj.com/content/
http://bjsm.bmj.com/content/
Peter's blog is here https://peterfrancis.blog/ including a recording of the talk.
You can also follow him on Twitter @peterfrancis_ie.
My other half spotted the advert for a talk at Leeds Beckett University entitled 'Why do runners get injured and how do we stop it?'. It sounded right up my street and so, on 31st January 2018 at 6pm I found myself sat in a lecture theatre at my old uni, surrounded by people of all ages, fitness levels, genders, scope of interest (professional, personal, educational).
Peter Francis PhD of the Musculoskeletal Research Group of the School of Clinical and Applied Science at Leeds Beckett University is well qualified to speak on the subject, not just through years of education, research and work experience but also on a personal level as someone who has been injured thanks to the pastime that is supposed to be good for you. A show of hands in the packed room showed that he and I were not alone. A room full of runners and most were suffering from or had suffered from a running injury.
A handout of an article about barefoot running and the display of research outside the lecture theatre alluded to Peter's specialism. Barefoot running?! Who does that? All I can think of is the dirt.
Peter started by talking about the biggest predictors of injury in runners.
Load. Not the amount of running but the rate of change. Doing too much too soon.
Previous injury. We get injured, stop running and rest then restart at the same pace > injured again >rest > restart at the same pace > injured again. And repeat until defeated and thinking running is not for us.
The loads a runner is exposed to is anything that loads all or part of the tissue differently to how it was before. So we blame our new trainers for the pain we're experiencing but did we actually just run that bit harder to try out the new trainers and therefore the blame lies with the load. It's a tricky thing to get your head around, I kept thinking of weight of the body but it's not that so much.
The most common running injuries are to the knee, ankle/foot and shin; all lower leg. They are not muscular injuries, they are structural, to the passive tissue.
75% of runners have a rear foot strike which jars the tissue. I was told by the experts that this was my issue, hence the technique change. Changing technique is hard! Technique was Peter's issue too. To reduce injury we need an even spread of contact. It could be that we run this way because the glute muscles are not being used. Glutes work for the legs like the bicep does for the arm. We don't use the muscles and so we load up the structural tissue. Work those glutes. I've been doing glute bridges, on exercise I'm surprisingly good at.
Peter compared runners to footballers. Footballers injuries are generally strains, far more muscular than structural. This is because they tend to sprint and have a much more varies movement pattern. Runners run in a straight line, footballers go in all directions. Therefore runners use muscles less adequately while running.
So these are the three challenges for runners:
- Load management
- Muscle use
- Increase variability
Load Management
New runners are relatively injury free because they are well behaved and follow a plan, build up gradually, mixture of walking and running, not too much load. More experienced runners are the ones with issues. Chasing that PB, being competitive with yourself and others, knowledge about pace etc and wanting to improve.
Peter's advice is to accept what you are capable of. Find your perfect load and work with it. He keeps an Excel spreadsheet to keep his load the same or with a very slight increase. Consistently delivering the same level of performance. This in itself is enough to improve stamina, speed and all that good stuff without hurting yourself. A graph showed that Peter generally did around the same level of activity each week with only slight variations.
Load is a mental problem too. It can be related to stress. If you are stressed you feel pain more. You need to be relaxed, you need headspace, you need to enjoy the activity. ABC - Anticipation Breeds Consistency. If you know you have a stressful day ahead of you, fit your run in at the start of the the da instead of later when you're exhausted. If something happens and you miss a scheduled session, don't beat yourself up about it, ignore the session and don't try to catch up.
Muscle Use
As kids we do activity better. We run better. It all comes naturally. How we hold our bodyweight gets worse as adults.
Peter recommends isolated, functional, dynamic strength into muscles. So, running uphill, running fast, lifting weights, work on the flexion in hips and knees (yoga is good). Change your perception of what your body is capable of.
Increase Variability
Run barefoot on grass (or use barefoot trainers or cheap/light trainers for the cold weather! Don't just run, do other exercise too.
So, the recommendations...
- Variable programme, no two days the same each week.
- Find the volume of running you can do comfortably and do just that for 10 weeks. It should result in improvements even if you feel you're not getting further distance wise.
- Create a training spreadsheet.
- Strength and conditioning training to improve those muscles. Yoga, cross train, something other than running.
- Barefoot run on grass for 10-15 minutes each week.
- Once a week focus on running uphill or as fast as you can. This won't result in increased risk of injury because we naturally generally have a better running technique when we run uphill or fast.
- Get the headspace to run.
Peter does not necessarily recommend halting training if you are injured because it leads to that whole hiatus/starting over thing with the risk of injury. Modify, modify, modify. Manage the pain, do what you are capable of. He does not advocate expensive running shoes. Cheaper ones have thinner, more flexible soles closer to barefoot running than the pricier ones. He doesn't have much faith in insoles and anything fancy to mess with your foot and your bank balance.
Everything made perfect sense and there were a few lightbulb moments. I'm starting to put the advice in place in the hope that I can run injury free. I really want to try barefoot running too! Maybe when it's a bit warmer...
The following links have been kindly provided by Peter as examples of studies and published works related to injury and barefoot running.
https://www.ncbi.nlm.nih.gov/
https://journals.
http://bmjopensem.bmj.com/
http://bjsm.bmj.com/content/
http://bjsm.bmj.com/content/
Peter's blog is here https://peterfrancis.blog/ including a recording of the talk.
You can also follow him on Twitter @peterfrancis_ie.
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