BEAT ANY INJURY
USE THESE EXPERT STRATEGIES TO IDENTIFY INJURIES, MINIMISE DAMAGE AND SPEED UP HEALING, SO YOU CAN RECOVER QUICKLY AND GET BACK ON THE ROAD
NO MATTER HOW careful you are, running takes a toll on your body: a 10-minute mile involves around
1,700 steps, each one producing ground reaction forces two-and-a-half times your body weight, on average. That’s a huge load to absorb – and probably why 20 per cent of runners are likely to develop an injury while training for an event, according to research published in the journal
BMJ Open Sport & Exercise Medicine. Also, a recent survey of 1,147 runners, published in
PLoS ONE, suggests that during the pandemic, runners are running more but with less intensity and are still experiencing more injuries. Knee issues, IT-band syndrome, ankle instability and back pain are among the most common problems. If you’re feeling pain that falls at or above a six or seven on a scale of one to 10, interferes with your daily life or lingers for more than two weeks, see a doctor, says physiotherapist Cat Fitzgerald.
To troubleshoot aches and niggles at home, try these remedies from Fitzgerald, biomechanics researcher Jay Dicharry and sports medicine doctor Jordan Metzl.
1 SHIN SPLINTS AKA MEDIAL TIBIAL STRESS SYNDROME
WHAT IT FEELS LIKE /
A nagging pain concentrated in the front or outside of your leg along the shin bone (the tibia); it usually flares up during and after exercise, and when you press on the affected area.
WHY IT HAPPENS / Repetitive stress on the shin bone and the connective tissues causes microscopic tearing of the muscle away from the bone, generally as a result of activity load (eg upping your
mileage too quickly) and issues with body mechanics (especially overstriding).
THE FIX / Learn to control the eccentric deceleration of your foot to the ground: loop a mini exercise band around your feet and step them apart until you begin to feel resistance in the band; flex one foot so the toes lift off the ground, then slowly lower your toes back to the ground. Repeat. Do three sets of 10 reps on each foot.
2 PIRIFORMIS SYNDROME
WHAT IT FEELS LIKE / A literal pain in the backside – specifically, pain, cramping and tingling in the glute muscles that may extend down the back of the leg and into the foot.
WHY IT HAPPENS / Weak glutes (due to too much sitting) or repetitive movement (eg running) fatigue the piriformis muscle, which is responsible for external rotation of the hip joint and can result in compression of the nearby sciatic nerve.
THE FIX / Floss the sciatic nerve to relieve compression: sit on the left edge of a stool so that your left leg can move freely. Tilt your head back, bend your left leg back towards your glute and point your left foot. Hold. Then extend your left leg, flex the foot up and tilt your chin to your chest. Hold again. Then tilt your head back, bend your knee and point your foot again. Perform two sets of 10 on each side. •
3
BLISTERS
WHAT IT FEELS LIKE / A burning sensation, accompanied by pain, redness or itching.
WHY IT HAPPENS / Friction, usually caused by your shoes or socks rubbing against your skin, plus the shearing effect of different layers of your skin rubbing against each other. Anything that intensifies rubbing can start a blister, including a faster pace, poor-fitting or new shoes and foot abnormalities such as bunions, heel spurs and hammer toes. And the problem is worsened by moisture.
THE FIX / There are lots of conflicting theories on how best to treat blisters (see RW, March 2021 for the full, complex history of runners vs blisters), but if you have a blister that prevents you from running, the best strategy for getting you back out there is draining and covering. Drain the blister using a sterilised needle, then cover with a tight, clean bandage; try synthetic, moisture-wicking socks to avoid blisters in the future.
4 HAMSTRING STRAIN
WHAT IT FEELS LIKE / Pain on the run at the top of the hamstrings, near the glutes, especially when you’re running uphill or doing speedwork.
WHY IT HAPPENS /
Dominant quads tilt the pelvis forward, which overlengthens the hamstrings, and/ or weak hips and glutes that put too much load on the muscle; this can
cause microtears in the muscle that subsequently develop scar tissue, leading to chronic stiffness and discomfort.
THE FIX / Increase the load your hamstrings can handle by doing bridge walk-outs: Lie face up on a mat with your knees bent, feet flat on floor, arms resting at your sides. Press through your heels and engage your glutes to lift your hips up towards the ceiling, without overarching your back. Slowly walk your feet out until your knees are almost straight, or as far as you can while keeping your hips lifted; then walk your feet back in. Slowly lower your hips and repeat. Do three sets of eight reps.
5 ANKLE PA I N
WHAT IT FEELS LIKE / A sharp, shooting pain or a constant, dull ache along either side of your ankle.
WHY IT HAPPENS / Weakness anywhere up and down the kinetic chain (above or below the hip, and especially the gluteus medius muscle) can cause instability and vulnerability at the ankle as you repeatedly load the joint; rolling the ankle, usually inward, can lead to partially or fully torn ligaments.
THE FIX / Build your ankle stability with pass-backs: stand on the floor holding a 2.5kg to 7kg weight, and shift your weight onto one leg. Pass the weight back and forth from one hand to the other while aiming to keep stable at the ankle joint. The faster you go, the harder this gets. Aim for two minutes total on each foot, taking breaks as needed.
6 LOWER BACK PAIN
WHAT IT FEELS LIKE / Musclerelated pain on either side of the lower part of your spine; you may feel spasms or sharp pain on either side of your spine, especially when you twist or move. It can affect you during daily activities, as well as running.
WHY IT HAPPENS /
Tightness in the hamstrings and in the front of the hips, as well as weakness in the muscles that surround your back – your core, hips, glutes and hamstrings – rotate your pelvis forward, making it impossible to engage and stabilise your core and putting the burden on
your lower back instead.
THE FIX / Foamroll your main running muscles to release the pressure on your lower back: roll your lower back, glutes, quads, IT bands, hamstrings and calves for 20 seconds each, then repeat that sequence three times for a total of 60 seconds of rolling on each body part. Yes, it is probably not going to be something you enjoy a great deal, but it’s worth it. If you’re looking to invest in a foam roller or are thinking of an upgrade, the Trigger Point GRID foam roller (£39.99, wiggle.co.uk) is an excellent option. •
7 STRESS FRACTURE
WHAT IT FEELS
LIKE / Aching or burning localised pain somewhere along a bone; the area will hurt if you press on it, and the pain will get progressively worse as you run on it.
WHY IT HAPPENS /
Too much loading
force on the bone, typically owing to overuse or ramping up your mileage too quickly.
THE FIX / Learn how to rest! Stress fractures can take four to eight weeks to heal, depending on the severity.
Continuing to run on one will only prolong the healing process or worsen the injury. Use this time to do low-impact cross-training, eg swimming or cycling. Get clearance from your doctor before you do anything.
8 IT-BAND SYNDROME
WHAT IT FEELS LIKE / An aching, burning pain on the outside of the knee (sometimes spreading up the thigh to the hip) that occurs five to seven minutes into every run.
WHY IT HAPPENS / Overuse, wearing worn-out shoes, pelvic imbalances and weak glutes can all cause the leg to turn in, irritating the iliotibial band, a thick band of connective tissue that runs from the outside of the hip to the outside of the knee and helps stabilise and move the knee joint.
THE FIX / Strengthen the gluteus medius muscles with hip hikes to keep the pelvis level: stand sideways on a step, hanging one leg off it. Keeping your core engaged and the standing leg straight, allow the hanging leg to drop toward the ground by lowering your pelvis on that side as far as possible. Use the hip muscles in the standing leg to raise your pelvis back up. Do three sets of 12 reps on each side.
9 BLACK TOENAIL
WHAT IT FEELS LIKE / Often you you’ll feel nothing, really; though sometimes it may be swollen and sore. Either way, you’ll know you have one: it looks ugly.
WHY IT HAPPENS / During the push-off phase of your running gait, the toes on your trailing foot extend up and hit the toebox of your shoe, causing repetitive microtrauma that adds up over your runs and can lead to bleeding under the nail.
THE FIX / In most cases, the best plan is to do nothing at all; nature will take its course and the nail will grow out. In more extreme cases, where the nail is causing constant pain, don’t treat it at home; see a doctor, who can drain it within the first few days. If the nail falls off, use an antibiotic ointment and a bandage to prevent infection.
10 PLANTAR FASCIITIS
WHAT IT FEELS LIKE /
A sharp stab or deep ache in the heel or along the arch of the foot, especially in the morning, after sitting for long periods of time, or during the pushoff phase of your gait.
WHY IT HAPPENS /
Drastic or sudden increases in mileage, tight calves, overpronation and inappropriate running shoes can overload the plantar fascia (the connective tissue that runs from your heel to the base of your toes). That stress can cause tiny tears in the plantar fascia, which, in turn, causes heel pain and inflammation.
THE FIX / Strengthen the foot muscles, specifically in the arch, with toe yoga: Remove your socks and shoes, and stand tall on both feet. Splay your toes and feet out so your weight is distributed evenly. While keeping toes two to five down, lift just your big toe. (It’s a lot harder than it sounds.) Hold for two seconds while keeping the small toes relaxed. Lower and repeat for a total of 20 lifts. Then switch and keep your big toe down while lifting toes two to five; make sure you do not let the foot pronate (roll inward). Hold for two seconds. Lower and repeat 20 times.
11 RUNNER’S KNEE AKA PATELLOFEMORAL PAIN SYNDROME
WHAT IT FEELS LIKE / Aching pain around or behind the kneecap, especially when running downstairs or on hill descents.
WHY IT HAPPENS / Often, it is the result of abnormal mechanics that develop owing to issues away from the knee, such as weak posterior hip muscles that rotate the leg inward, forcing the patella to bump against the femoral groove. This is, you will not be shocked to hear, exacerbated by overuse.
THE FIX / Activate your glutes and relearn hip extension with grasshopper exercises: lie on your stomach and rest your chin on your hands. Spread your knees apart as far as you can on the floor and bring your toes together in the air so that both sets of toes are pointing at the ceiling. Lift your thighs off the ground as high as you can (it will only be a few inches, at most) while keeping your torso flat on the ground. Lower back down. Do three sets of 15 reps.
12 PAIN ON TOP OF THE FOOT
WHAT IT FEELS LIKE / Irritation on the top of your foot, or a sharp pain that shoots up through your foot into your toes.
WHY IT HAPPENS / Shoes that are too small or too tight around the forefoot cause irritation on the top of the foot, or neuromas, inflamed or swollen nerves near the metatarsals.
THE FIX / Often the solution is simple; loosen your laces or look for shoes with a wide toebox for more room in the forefoot. During downtime, use Yoga Toes (£36.50, yogamatters.com) to stretch and separate your toes out of that crunched position.