Physiotherapy advice from Nuffield Health
Did you know:
- 65% of regular runners are injured per year
- 11 injuries occur per 1000 running hours.
The most common running injuries are patellofemoral disorder (pain at the front of the knee), iliotibial band syndrome (pain on the outside of the knee and thigh) and plantar fasciitis (pain in the sole of the heel or foot).
However both of these statistics can be significantly reduced through injury prevention. There are a number of factors that can predispose to an injury occurring due to running, many of which can be minimised by knowledge of the potential problems and action to reduce risk factors.
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It is always best to seek some advice on training regimes if you are starting to run for the first time. As well as not getting the most benefit from your training, a poor schedule can often lead to injuries.
- Excessive running distance or intensity - injuries can occur from simply running too far or too hard.
- Frequency of runs - the body needs adequate rest between sessions - the amount of rest depending on the fitness of the athlete and the type of exercise.
- Surface - running on roads is very different to running on soft ground. Jarring forces from road running can create problems such as stress fractures and sprained ankles and are more likely when running on uneven ground. Frequent hill running can also create injuries - especially to knee tendons.
- Shoes - getting a good pair of running shoes is a sound investment as they can be a factor in injury prevention. Always try running shoes on before buying. It is best to have 2 pairs of shoes that you alternate for running. This allows them to dry out completely between runs and also allows you to break a new pair in gradually.
- Stretching - some research suggests that stretching before a run can actually make you more likely to have an injury. The best thing to do are some active stretches - things like rotating your body and kicking your legs side to side rather than holding the muscle on a long stretch.
- Rapid increases of running distance or intensity - sudden increases in training is a common cause of injury and often happens when someone takes up training. The initial rush of enthusiasm can lead to running too much before the body has had a chance to get used to it.
Unfortunately, your body shape is often beyond your control. But awareness of the risk factors can allow you to plan your training to minimise the risk of injuries. A physiotherapist or podiatrist can help you with this and it is probably worth getting an assessment before starting out.
- Knees - people with knock-knees or bowed-legs can sometimes have more problems - especially when running longer distances.
- Hips - some people have hip joints that are not normally aligned. This can produce problems if running long distances.
- Muscle control - poor muscle control around joints is a major cause of running injuries and can occur even in experienced runners. The runner may be completely unaware of the problem, with poor muscle control often only being identified by a physiotherapist. Specific exercises can then be performed to improve muscle control around joints.
- Feet - feet that have very low or high arches or feet that roll in when running can predispose to injury. Buying the correct shoes or using insoles (orthotics) in your running shoes may help.
Recognising an injury
The more you run, the more you will get to know when your body doesn't feel right. Sometimes the onset of an injury is sudden and very painful. But more often it is a gradual increase in an ache or a niggle. Something that is getting worse or not going away after a couple of sessions should be checked out before it develops into an injury that will stop your training.
Sometimes a simple modification in your schedule or some new shoes is all that is needed. Otherwise, treatment or specific exercises can get you back to where you want to be. If in doubt, seek the advice of an expert.
For an acute injury, follow the PRICE guidelines recommended by the Chartered Society of Physiotherapy:
P - Protect the injured area from further damage
R - Rest the injured area for 48 hours and then start to move it within pain limits
I - Ice the injured area for 20 minutes at a time using ice wrapped in a damp towel
C - Compression of the injured area to prevent swelling using an elastic bandage
E - Elevation of the injured part where possible for the first 48 hours.