Going for a run is as simple as putting your shoes on and heading out the door.
In this simplicity, it’s easy to miss the complexity of a single stride.
To run efficiently, you need almost perfectly synchronised movement in each leg with each landing, and between the left and right sides of your body.
And this is repeated thousands of times on each run!

Most running injuries are repetitive strain injuries, or alternatively these can be viewed as under-conditioning injuries. The highest percentage of injuries occur in the knee, calf (bones, muscles and tendons), and foot and ankle. The hip, pelvis and lower back can also be sites of overload, depending on your biomechanics. (1)

Novice runners (people new to running) need the most support. The statistics show the injury rate for novice runners is 30 percent in the first year. (2)

This runner with a calf injury will benefit from physiotherapy which will address the cause of the injury.

Treatment for a running injury

The first step in treating any running injury is to understand the context – your history, concerns, and goals.

After understanding the context, your physio will do a physical examination and movement analysis. This makes up the assessment part of your treatment.
The assessment gives us the information we need to plan our treatment, and to identify any contributing factors which we might need to address with rehab exercises.

We use of a variety of running-specific assessment tools:

  • Functional movement assessment, an online tool, which produces objective and accurate reports
  • EMG (electromyography) assessment to check muscle activity and strength
  • Video gait analysis to have a look at your running technique, on fresh legs or tired legs

We interpret the data that these tools provide to put your injury in context, prioritise your treatment and rehab program, and plan a running program for while your injury is healing.

We may use combination of treatment tools such as:

  • Strength training with EMG
  • Running technique drills, and possibly gait retraining
  • A cross training program to help you achieve the flexibility, endurance, technique, or strength that you need

How many treatments do I need for a running injury?

There is no one-size-fits-all answer for how many physio treatments you will need.

We want you back on the road running with confidence and comfort after not a single treatment more-or-less than you need.

It is worth remembering that muscle weakness and imbalance often outlasts pain, and if this isn’t addressed, you may be more likely to injure yourself again.

Rehabilitation for a running injury

Rehab is the key to recovering well from an injury and increasing your body’s resilience to help prevent future injury. So we usually introduce exercises in the first or second treatment.

We want you to see your rehab through to the point of successful change. We plan your program with you so that it fits well into your routine - minimum inconvenience and frustration, maximum gains!

To achieve this, we may make use of an app which we can use to:

  • Send you your exercise program in a series of short videos
  • Change your exercises based on comments you give us
  • Track your progress
  • Give you questionnaires that you complete to measure your progress

Running with an injury

We know that running is not just ‘a want to’, it’s ‘a need to’!
The good news is that complete rest isn’t often needed for optimal recovery.
Our anatomy and physiology work on a ‘use it or lose it’ basis.

Physiological changes happen in your body with training.
While injured, maintaining the cardiovascular fitness and physical strength that your running has brought to your bones, muscles and tendons, is very important.

Doing the right training, in the right dosage, facilitates your healing and helps keep a healthy state of mind.
After we have accurately diagnosed your injury, we can plan a safe running program.

How do I stay fit when I can't run?

Some injuries demand a time of complete rest from running, for example ‘shin splints’, a stress fracture, or irritable ITB friction syndrome.

A program of active rest will help to maintain your cardiovascular fitness.
Trail running, hiking, hill walking and various cardio options at gym, such as the stepper, watt bike, or pool, are ideal ways to give an excellent cardiovascular workout and challenge your body in a satisfying and fun way. Your physio will guide you as to which of these are a good fit for your injury

In combination with your rehab program, this active rest will see you through the initial rest phase, and the transition phase back to your full running load.

Doing new and varied exercise on different surfaces, in different directions, and at different intensities, improves your body’s resilience.
It’s excellent practice, even when injury free, as learning new movement patterns or sports has a positive effect on the brain. (3,4)

TTrail running can be excellent cross training for road running.

How do I recover best after a race? From the Comrades to a 5k?

Your recovery process after a big event determines whether the race will leave your body stronger or more likely to pick up injury.

A quality recovery process allows your body to heal well, strengthening the structures to cope better with the same loads next time…
giving you maximum benefit from all the training you’ve put in, and reducing risk of injury on your return to running!

Tips for recovering well:

  • Re-fuel to support muscle repair by eating a protein and carbohydrate snack immediately post-race (within 30 minutes).
  • Rehydrate with water for optimal collagen repair.
  • Sleep! Your body restores and regenerates when you rest
  • Active rest has been shown to be better than inactivity in aiding recovery. Walking, gentle cycling or swimming from the day after the race are great active rest strategies.
  • Time to return to running varies lots between people, but the rule is that your body needs to have repaired enough, so don’t force a quick return.
  • The mental stress and social strain from Comrades (or any event that you have put a lot of time and effort into training for) shouldn’t put you off running for more than a few weeks.
  • Plan to run the first race of the spring season and start to train at least 6 weeks before the event. This will keep your focus in the down time.

What is cross training for running, and why should I do it?

Cross training means strength training, agility drills, proprioceptive exercise, and running technique training.
It can also include other forms of cardio fitness such as spinning or swimming.
Cross training is very useful for training when injured and can help to improve your running performance.

Common injuries such as ITB friction syndrome, Achilles tendonitis, tight hip flexors, runners’ knee, plantar fasciitis, repeated muscle strains and bone stress injuries (such as Medial Tibial Stress Syndrome, or ‘shin splints’) all benefit hugely from cross training in both fixing the injury and preventing recurrence.

How do I prevent running injuries?

There are a few facts (research-backed and undisputed) about successful injury prevention for runners. But what we do know, makes sense:

  • Following a training program significantly reduces risk of running injury.
  • Good running technique. A large study that followed serial uninjured runners showed that they have a softer landing than injured runners.

This says a lot for paying attention to your running technique and cross training program.

Even if you follow these guidelines, it’s not a guarantee that you’ll avoid injury.
Other factors contribute to injury risk such as such as sleep deprivation, stress, sickness…and sometimes plain bad luck.

Healthy running for all age categories – Juniors, Seniors and Masters

We firmly believe that running is about good health for the joy of it.
It shouldn’t be just for the next few years but for life.
Age is never an excuse to quit and no one is ‘too old’ to be relatively active.

Different phases of life may need different training consideration, for example returning to running after having had a baby and in menopause (5).

We aim to support a healthy, active lifestyle by helping you to return to training after an injury, no matter how gradual the process may be.

Good health is about keeping the balance in your body and life:

  • Intrinsically / within your body – training load and recovery, strength and flexibility, speed endurance and power, short term gains vs longevity, nutrition to nourish and for pleasure.
  • Extrinsically / within life ¬– balancing training with life’s stressors, training to improve mental health but not to the point that it is an obsession and distraction, balancing time demands to ensure your ‘me-time’.

A team approach to fixing a running injury

We can answer the question of “Who should I see for my injury” as we work with a network of professionals such as orthopaedic surgeons and sports physicians.
Allied professionals such as chiropractors, biokineticists, podiatrists, dieticians as well as massage therapists and a running coach are part of our referral base.

Combining our knowledge of your injury with their expertise can give you great results.

Running gait analysis can be done to address a running injury and improve performance.

Gait analysis and retraining for an injury – what’s it about and do I need it?

Every runner has a unique running style which may or may not look as good as it feels.
But looks don’t matter.
What matters is the efficiency of movement throughout your body, and the energy dissipation between the joints, tendons and muscles in your legs.

To achieve that efficiency there are certain ‘normal’ points in the way any human runs.
Gait analysis looks at the way that you run, and teases out what is your unique style, and what falls outside the ‘normal’.
The information from the analysis can be helpful in managing an injury, or to improve performance.

The primary reason we analyse gait is to see if there could be a link between your running style and your injury.

Often oddities in gait will be changes you have made subconsciously to work around existing limitations (like a stiff big toe or even midback).
Or they could be compensations that you made for a previous injury that have remained as habit.

Analysing gait helps to understand your problem better and prioritise your treatment plan.

Gait retraining isn’t necessary for everyone. A rehab program on its own may be enough to change your loading pattern and get you over an injury.
But when it’s not, that’s when gait retraining comes in.

It’s helpful to know from the outset that it’s not easy to change your natural style of movement. It takes patience and hours of practice to get comfortable with the change, not less than 3 months.

Using gait analysis and retraining to improve performance

Analysing your gait and doing gait retraining based on the findings can help to improve your running performance.

But it’s only one piece of the puzzle.

You will need to include input from a running coach to create an optimised training program. Technique drills, a specific plyometric program, and a strength-endurance program will be also be important components in your drive to improve your times.

References:
1.J Sports Sci Med. 2019 Feb 11;18(1):21-31. eCollection 2019 Mar.
The Proportion of Lower Limb Running Injuries by Gender, Anatomical Location and Specific Pathology: A Systematic Review.
Francis P1, Whatman C2, Sheerin K2,Hume P2,Johnson MI3.
2.Phys Sportsmed. 2018 Nov;46(4):485-491. doi: 10.1080/00913847.2018.1507410. Epub 2018 Aug 21.Differences in injury risk and characteristics of injuries between novice and experienced runners over a 4-year period. Kemler E1, Blokland D2, Backx F2, Huisstede B2.
3. Front Psychol. 2018; 9: 509.
Published online 2018 Apr 27. doi: 10.3389/fpsyg.2018.00509
PMCID: PMC5934999 PMID: 29755380
Effects of Physical Exercise on Cognitive Functioning and Wellbeing: Biological and Psychological Benefits Laura Mandoles,1,2,* Arianna Polverino,1,3 Simone Montuori,1 Francesca Foti,2,4 Giampaolo Ferraioli,5 Pierpaolo Sorrentino,6 and Giuseppe Sorrentino1,3,7
4. https://www.drweil.com/health-wellness/health-centers/aging-gracefully/learning-a-new-sport-good-for-the-brain/
5. https://www.running-physio.com/menopause/