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MARATHON MONDAY: KNOWING WHEN TO STOP AND ASK FOR HELP

September 4, 2017

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

So, leading on from last weeks post I thought we would look in a little more detail at some of the more common niggles and injuries that a runner may experience. I shall share some tried and tested tools and tricks of the trade to ensure you stay fit as a fiddle and there's not a limp in sight.   

 

Most running injuries are simply overuse ones and if caught early enough and given the appropriate preventive exercises, many of this issues may never hinder your running training plan. 

 

Just to give you a little idea of the base lines I use with each of my running clients. These are examples of what I expect them to achieve before starting out on an impact based training program. 

 

1: Touch their toes or 90' hip flexion passively tested

2: Prone quad stretch, achieving heel to buttock

3: Reach down the side of the thighs to touch the outside of the knee joint line

4: Single leg balance for 60 sec with eyes open and 30 sec with eyes closed

5: Single leg calf raises with the knee straight and bent = 30 reps each side 

6: Single leg press = 5 reps x body weight on each leg

7: Isometric plank testing, ranging from 1-2 mins depending on the sling tested. 

 

HOW ARE YOU DOING SO FAR?  

 

 

Common Runners Injuries  

 

Plantar Fasciitis

 

The plantar fascia is a band of fascia which is composed of three blended segments. The fascia provides static support and works as a dynamic shock absorber within the arch of the foot. Plantar fasciitis is an overuse condition of the plantar fascia and its insertional point on the heel bone. 

 

Causes and risk factors of Plantar Fascia 

- Low or high arches 

- Reduced range of movement in the toe joints

- Decreased eccentric strength at the ankle 

- Poor ankle control

- Hip strength imbalances

- Unsupportive footwear 

- Increased BMI or Body Fat levels. 

- Tightness in the calf, hamstrings & glutes

 

Signs & Symptoms 

- Gradual onset of pain on the medial aspect of the heel. 

- Morning Pain which decreases with activity. 

- Tightness in the sole of the foot. 

- Positive windlass test. 

 

Treatment suggestions

- Avoid aggravating activity

- Cryotherapy (ice) post activity

- Refrain from impact 

- Gentle stretching of the Plantar fascia and calf muscles

- Taping 

- Anti-inflammatory diet or medication*. *( Please seek GP advice for correct dosages and to check you have no pre existing conditions which mean you so=houldnt take this type of medication).

- Gel heel pads

 

Rehab suggestions

- Establish correct fascia/tissue length with gentle stretching and massage.

- Activate local muscle systems around the ankle, hip, and pelvis. 

- Strengthen the extensors & abductors of the hip.

- Strengthen the ankle inversion muscles. 

- Increase stability at the ankle and hip.

- Complete a personalised rehab program in full, minimum 4-6 weeks. 

 

 

 

Achilles Pain 

 

This can arise from a number of causes and some are more common than others. Most commonly seen are Midproportion Achilles tendonitis, Posterior impingement syndrome, Insertional Achilles tendinopathy and Haglund's disease. Less common are Achilles bursitis or referred pain from the neural structures and lumbar spine - If you have a niggle or pain in the lower back along side Achilles pain please seek help from a Chartered Physiotherapist. The sooner the better in resolving this type of injury presentation as no one likes an episode of full blown sciatica.  

 

Signs & Symptoms

- The onset of pain: Sudden, gradual or insidious to the tendon region at the insertion or upper 1/3. 

- Swelling located around the posterior and medial heel.

- Tender on palpation of the Achilles tendon structures. 

 

Treatment suggestions 

- Cryo therapy to reduce swelling.

- Refrain from impact activities. 

- Early treatment. Don't run through pain.

- Physiotherapy Assessment to determine which condition is causing the discomfort.

- Completion of an individually prescribed rehab program, one shoe does not fit all here.

- Tendon integrity screening. 

- Biomechanical screening for causative factors.   

 

Rehab suggestions

- Assess single leg strength 

- Examine glute and hamstring muscle patterning

- Check ankle propulsion muscles

- Screen balance and proprioception ability. 

 

 

 

 

ITB Syndrome

 

Iliotibial band friction syndrome (ITBFS) is a overuse injury commonly treated by Physiotherapy. It is due to poor training errors and abnormal biomechanical loading. Lateral knee pain may also be misdiagnosed as ITBFS when in fact it originates from either the hamstrings insertion on to the fibular bone or from the knee cap being misaligned though muscles imbalances. If you find that kicking or sprinting aggravated the symptoms, this would suggest that it may originate from the hamstrings rather that the ITB.  

 

Signs & Symptoms

- Tenderness over the lateral bony prominence of the knee just above the joint line

- Local swelling 

- Crepitus (grinding or popping noise when bending and straightening the knee)  

- Tightness on ITB Ober's test 

- Increasing discomfort and distance increases

- Pain increases going uphill or climbing up stairs

 

Treatment suggestions

- Address the biomechanical loading factors first

- Cryo therapy  and anti-inflammatory medication may be used to settle the localised symptoms.* *(Check with GP for suitable medication)

- Stretching of the quads, glutes, hamstrings and adductors

- Strengthen hip muscles

- Soft tissues release

- Improve balance and proprioception

- Assess running style

- Review running loading plan

 

As you can see, these are just a handful of the overuse injuries out there. Stay tuned to our weekly blog for our flexibility for runners download and our Run Strong Training Plan coming soon.

 

Stretch, strengthen, stabilise and stay safe out there! 

 

Nikki x 

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