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RAD BLOG

RUNNING AND OVERUSE INJURIES

RUNNING AND OVERUSE INJURIES:

Not uncommon scenes at the lake in recent weeks.

With COVID-19 impacting our lives in so many ways now, it is so important that we keep some form of routine. For so many of us routine would mean doing some form of organised sport most if not all days. However, with all group gatherings diminished to only two people it has meant much of our beloved sport has been postponed or cancelled. In trying to stick to our routine many of us have turned to other forms of exercise such as running, cycling and body weight circuits. This is great to see that so many people are still getting out there and doing something to maintain their health and fitness or to continue working towards their goals even if they may have been postponed.

Running seems to be one form of exercise that so many of us have taken up, it requires minimal equipment and not a great deal of prior training to do (….so it seems). However, with running as with all sport and activity it doesn’t come without its risks and potential for injury, with 37-56% of runners sustaining some form of overuse injury (). So, while all of us go gun hoe on our fitness routines with all this spare time we have on our hands let’s take a minute to take a step back and just assess what we are doing.

You want to do some running to stay fit and healthy however you haven’t done too much continuous running before. Living in Ballarat you might think well a lap of the lake seems simple let’s start there; you feel alright afterward so the next day you think well I might do that again or maybe Vic Park. The only thing is you have never run on consecutive days before, nor have you done so many kilometres in a week. The first week goes by and you’re doing ok, but then part way through the second week you start to get some niggles, in the Achilles, hamstrings, knee or shin. You don’t think too much of it because you think “I have to keep exercising and this seems to be all I can do now” so out you go again the next day. Two days later you are limping out of bed with horrible pains in your legs, you can’t explain why but you concede that you cannot run for a while.

What can you do or where could you have changed things? To start with if you have already come across an injury yourself initially it is best to rest and seek further advice from a professional as to what exactly it may be. Most importantly however, what could we have done to prevent this from happening at the start?

Firstly, let’s look at some of the common injuries that a runner may sustain. These include Achilles tendon pain (tendonitis/tendinosis), medial tibial stress syndrome (known as shin splints – Check out out video on this), lateral or medial knee pain (ITB syndrome), or high hamstring pain (proximal/distal hamstring tendinopathy) (2, 3). There are a few common causes that all these injuries have:

  • when we increase our load too quickly or rapidly change the type of training we are doing.
  • Wearing out dated shoes increasing impact loading on the body, commonly seen through the doors at the Running Company Ballarat (https://www.therunningcompany.com.au/ballarat/) (2, 3).
  • Another cause of injury within running especially those that are new to running, is technique with a few common faults among us that can lead to greater strain being placed on different muscle groups leading to an injury.

Load Management

So, then what are some things that we can do to avoid this happening to ourselves? Firstly, it is important to monitor how much you are doing and how quickly you are increasing that load, for this we use the overload principle whereby we never increase our load by more than 10% (2). For example, if you have never really done too much running before then starting off with 3 runs a week giving yourself plenty of rest between each is a good start. Then when you are feeling comfortable you can increase the amount you are doing; keeping in mind that we don’t increase by any more than 10%. Therefore, if you are running 15km a week to begin with then your first increase would only be to run and extra 1.5km for the week. Hence, you might add an extra 500m to each run, rather than adding an extra 5km run for the week. It is also important that at the end of each 4 week block of training we reduce the volume of training we are doing, this allows for the body to recover and adapt to the new stimulus before reintroducing a higher volume again (2).

An illustration of how load increase may look over a 4 week block.

We also need to look at the type of surfaces that we are running on, as running on hard surfaces frequently increases the impact forces placed on the body, resulting in an increased injury risk (2, 3). Therefore it is important that we are running on a variety of surfaces including grass, gravel and pavement or road (2, 3). This allows for our body to adapt to the different stressors placed on the body associated with the different surfaces (2, 3).  While running around your block on the pavement each day may seem the easiest, it will be well worth your while going to an oval or park lands once a week and running on the grass, as it reduces the impact loading on your body.

Abrupt changes in running type can also contribute to an increased risk of injury, hence it is important that we don’t rapidly change the type of running we are doing (2, 3). For example don’t decide one day that you are going to run up a hill 10 times when all you have been doing is running on flat ground. What you might do instead is gradually introduce hills to your runs, where you might start to run over a few rolling hills before tackling a hills session, where you would progressively increase the pace at which you run up the hill each session. This will give your body the opportunity to adapt to running hills in a slow, progressive manner.

Technique

Lastly, on the technique side of things, as much as running seems a very simple task, just put one foot in front of the other quickly…… There are some key technique aspects that we can look at to reduce the risk of injury as well as make you more efficient at running. These are just a few key mistakes that many of us make.

Over striding:

Over striding means that when our foot strikes the ground we are landing on our heel (1, 5). In doing this we are essentially putting on the breaks, we must then overcome this braking force before we can apply force to the ground, propelling us forwards (1, 5). Not only is this less efficient, but it also places greater stress on the hamstrings and the lower back (1, 5). This occurs as your hamstrings are placed on stretch whilst also applying force to overcome the breaking forces being applied, potentially leading to knee or hamstring injuries (1, 5).

Incorrect and correct technique.

Increased hip flexion on foot strike (sitting in a bucket):

This means that when our foot strikes the ground we have a greater flexion angle at the hips, increasing our chances of overstriding, decreasing performance and increasing injury risk (1, 4, 5). This type of running style is more likely to lead to knee injuries due to the greater load placed on the quadriceps throughout the running cycle (1, 4, 5). This increased force produced by the quadriceps places an increased load on the ligaments and tendons surrounding the knee leading to potential knee injuries, such as ITB syndrome (1, 4, 5).

Incorrect and correct technique.

Shoulder rotation rather than arm swing:

This is a common mistake many make as we don’t necessarily see the importance of the arms in the running cycle. The arms however create an opposing force, we move the opposite arm forward to the leg that is forward allowing us to keep our body in a straight line and move in a straight line (1, 5). If we are to allow our shoulders to rotate, we are forcing our lower body and pelvis (hips) to rotate in the opposing direction resulting in us not running with a straight trajectory (1, 5). This is a far less efficient way of running, leading to greater fatigue and a further breakdown in technique (1, 5).

Incorrect and correct technique.

Leaning back when running:

This could mean that we are tight through our erector spinae and/or potentially lack flexibility through the hip flexors (1, 5). This will ultimately result in a reduced stride length and/or over striding, forcing there to be a greater energy cost for every step (). This is a less efficient running technique causing us to use more energy to cover the same distance.  

Incorrect and correct technique.

These are just a few key technical running errors that many people make. You may be asking however how can I fix these? Below are a few key running drills that you can complete to help teach you correct running technique.  

A march/skip:

Ankling:

Seated Running Arms:

Bounding:

Conclusion

If you have any questions on anything please get in contact with us: info@radcentre.com.au.

Or if you are interested in our coaching services for either running technique or strength work to compliment your running get in contact.

REFERENCES:

  1. Folland, J. Allen, S. Black, M. Handsaker, J. Forrester, S. Running technique is an important component of running economy and performance. Medicine and Science in Sports and Exercise.17: 1412-1423, 2017.
  2. McGrath, A. Finch, C. Running the race against injuries: A review of the literature. Monash University Accident Research Centre. 104: 1-66, 1996.
  3. Mechelen, W. Running Injuries: A review of the epidemiological literature. Sports Medicine. 14: 320-335, 2012.
  4. Mizahi, J. Verbitsky, O. Isakov, E. Daily, D. Effect of fatigue on leg kinematics and impact acceleration in long distance running. Human Movement Science. 19: 139-151, 2000.
  5. Moore, I. Is there an economical running technique? A review of modifiable biomechanical factors affecting running economy. Sports Medicine. 46: 793-807, 2016.

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