RUNNING IN THE RIGHT DIRECTION

These are the things to remember, consider, and watch out for when going for a run, according to Dr.Alan Cheung, Consultant Orthopaedic Surgeon and founder of the International Orthopaedic Clinic (IOC)

What are the most common injuries one gets from running?

I have seen an explosion in running injuries as so many people have taken up running since the circuit breaker a year ago. Running injuries can be divided into a) sudden injuries from a trip or a fall, or b) overuse injuries that occur and worsen gradually. Overuse injuries are the easier type of injury to prevent.

What are the parts of the body that are typically prone to injuries when running and why?

The commonest injuries for each region are as follows:

BELOW THE KNEE

• Plantar fasciitis – inflammation of a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes (plantar fascia). It may cause a stabbing heel pain that usually occurs with your first steps in the morning. As you get up and move, the pain normally decreases, but it might return after long periods of standing or when you stand up after sitting. • Ankle sprains – when you “roll” or invert your ankle by missing a step or kerb. Typically this results in injury to a stabilising ligament called the ATFL at the front and outside of your ankle. If the damage is bad enough you may end up with permanent instability of your ankle.

• Shin splints – pain and swelling along the inside of the shin bone (medial tibial stress syndrome). Common in runners who have increased the intensity and pattern of their training routine. If ignored, it may lead to a stress fracture which takes far longer to heal.

• Achilles tendon injury – occurs more often in runners who perform speed training, uphill running, or use a forefootstriking style.

AT THE KNEE

• Meniscal tears – tears of the rubbery disc that sits between the thigh and shin bone at the knee joint. This may result in a sharp pain along the side of the knee and a sensation of catching and locking. • Iliotibial band syndrome (ITBS) – pain along the outside of the knee joint. Caused by repetitive of rubbing of band of tissue (iliotibial band) against the side of the knee. • Ligament tears – usually caused by a fall. The collateral ligaments sit at the sides of the knee, the cruciate ligaments in the centre of the knee joint. Manifested by pain, swelling and inability to walk or continue running.

• Patellofemoral pain syndrome – pain at the front of the knee due to injury to kneecap cartilage, or inflammation of tendons/soft tissues.

AT THE HIP

• Femoro-acetabular impingement and labral tears – a sharp groin pain due the thighbone rubbing against the hip socket causing pain (impingement), and sometimes causing a tear in the sensitive lining of the hip (labrum).

• Greater trochanteric bursitis – pain at the side of the thigh due to repetitive rubbing of a band of tissue (iliotibial band) against a prominent part of the thigh bone (greater trochanter).

• Muscle/tendon strains and tears of of the adductors, hamstrings, and hip flexors.

What’s the best way to avoid such injuries?

All sport carries an inherent risk of injury, but the best way to avoid injury is to do the following:

• See a medical professional if you are new to sports or have an underlying health condition that needs treatment or assessment.

• Identify your running goals. If you are running for fitness or social reasons, you may be running at a faster pace and consider joining a running group. If you are running to lose weight you may be running for longer at a slower pace and should also consider consulting a dietician or nutritionist. If you have the resources, then hiring a running coach with a supervised training program may help you get the motivation, performance, and results that you want. I recommend Arthur Tong at Elevate Performance Coaching (@arthurtongtri) or Zoe McParlin at UFIT (@zoemcp1) for running training.

• If you are a novice, start with short distances and rest days in between. Build up slowly and gradually. Most of the injuries I see are from beginners who run every day at distances their bodies cannot sustain.

• Warm up for 5-10mins before you run at a slow to medium pace. After your run, cool down for 5-10 minutes at a slower pace and stretch. Stretching before your run is not thought to be beneficial.

• Wear the right shoes. Head to a running shop to get properly fitted rather than buying online. Getting a video gait analysis at a podiatrist such as MyFootDr or The Foot Practice may be helpful particularly if you have flat feet and tend to roll your ankle (overpronate) when you run.

Are people of a certain age more prone to running injuries? Depending on the age group, what should their approach to running be like?

No matter what your age is, running can be beneficial to your physical and mental health. As we age our aerobic capacity (efficiency at using oxygen) declines, recovery slows, and injuries may start to affect performance. This tends to affect sprint runners at an earlier stage than endurance runners. The good news for endurance runners is that their aerobic capacity may remain stable until their late fifties, which may explain some great marathon times for older runner.

In general terms as we age, we should be looking to switch to endurance running, incorporate strength training in our program, and allow more time for recovery. Mindset is important – a fit 50 year old runner is more capable than a 24 year old couch potato.

INTERNATIONAL ORTHOPAEDIC CLINIC

#05-24 Mount Elizabeth

Novena Specialist Centre,

38 Irrawaddy Road, Singapore 329563. T +65 6690 2985

WhatsApp +65 8838 7111 W ioc-ortho.com