Run less, improve your running results?
One of the biggest hurdles the Physiotherapists and Osteopaths encounter at the Injury Rehab Centre in Cheltenham is convincing our patients with running injuries such as plantar fasciitis, achilles tendinopathy,
One of the biggest hurdles the Physiotherapists and Osteopaths encounter at the Injury Rehab Centre in Cheltenham is convincing our patients with running injuries such as plantar fasciitis, achilles tendinopathy, knee pain or ITB syndrome is that the way for them to reduce their rate of injury AND improve their performance is to run less and do more weights in the gym.
A lot of runners have difficulty making time for the weight room or even hear the misconception that lifting weights will only hurt their performance with running. This however is proven to be untrue and there are plenty of options and routes for strength training programs such as traditional weight lifting, HIIT, and plyometric programs however it can be confusing to know which style of training is most suitable for you.
Mo Farah one of the greatest runners of all time didn’t get there by only running. He also adopts a consistent strength program
Let’s convince you why strength training is important for runners by informing you with a few studies findings:
Decreased strength/control around the hip that controls hip drop, adduction, and internal rotation are associated with increased incidence of anterior knee pain (Patellofemoral pain syndrome).
Individuals with decreased hip abduction, knee extension, knee flexion strength over a cross country season had increase in anterior knee pain and achilles tendinopathy.
Systematic review has found that hip abduction strength had correlation with ITB pathology (limited evidence for knee/lower leg injuries)
Running injuries such asplantar fasciitis, achilles tendinopathy, knee pain or ITB syndrome are pretty complex and there are MULTIPLE factors that have been associated with increased risk of running injuries. There does seem to be a general agreement that runners with decreased strength are predisposed to some injuries!
But… I’m an avid runner, and go to the gym 2-3x a week and still have pain?
One study looked at a hip strength-training program in pain-free individuals and the effects that it had on their running mechanics. The program lasted 6 weeks, 3x a week, and incorporated movement education with weight bearing exercises. They analysed their running mechanics before and after the program.
OUTCOMES:
Hip Abduction strength: INCREASED 42%
Hip External rotation strength: INCREASED 20%
NO SIGNIFICANT CHANGE IN RUNNING FORM
Improved single leg squat mechanics
Running is a very complex movement! This study demonstrated the notion that with pain-free individuals: Strength-training program won’t significantly change running mechanics. The runner that is in pain only while running may benefit from running retraining on top of a strength training program to get optimal benefits from your rehab!
Check out some of the top strength exercises for runners below.
The Solution!
Until you are assessed by one of the therapists at the Injury Rehab Centre using the latest technology to put a number on your flexibility, strength, balance and running technique you won’t know exactly why your running injury has occurred nor the best course of treatment to get you running pain free faster!
Take Home Messages:
Decreased strength may predispose individuals for running injuries
Solely strength training won’t change form
Runners in pain may benefit from component of retraining running
If you are a runner increasing their mileage and base for training or having pain while running then you should seek consultation from one of our Physiotherapists/Osteopaths at the Injury Rehab Centre in Cheltenham.
We will perform a comprehensive running analysis covering all components of movement to help you identify what needs to be addressed as part of your rehab program. This includes:
M.A.T Assessment created by the therapists of the Injury Rehab Centre to laser focus on areas of flexibility, balance and movement that identify whether your are at risk to sustain an injury.
Slow Motion Running Gait Video Analysis to IDENTIFY YOUR BAD RUNNING HABITS that stop you from progressing that next step in your running.
Strength Testing to identify any strength discrepancies that have a huge role in increasing your injury risk.
Force Plate Technology to put a number on differences in the power you can generate through each leg that can lead to compensations and can cause repetitive stress injuries.
Traditional Physiotherapy and Osteopathy examinations to identify dysfunction.
We then tailor and individualised rehab program based on your presentation to get the best possible outcome and achieve our goals.
To learn more about the Injury Rehab Centre’s Return To Running program click here or contact our friendly reception on 95537024 to learn more.
References:
Mucha, MD, Caldwell, W, Schlueter, El, Walters, C, & Hassen, A. Hip abductor strength and lower extremity running related injury in distance runners: a systematic review. J Sci Med Sport. 2016, pii: S1440-2440.
Luedke, LE, Heiderscheit, BC, Blaise Williams, DS, & Rauh, MJ. Association of isometric strength of hip and knee muscles with injury risk in high school cross country runners. Int J Sports Phys Ther. 2015, (106): 868-876
Willy, RW, Davis, IS. Effect of a hip-strengthening program on mechanics during running and during a single-leg squat. JOSPT. 2011, 41(9): 625-632.
Why does your heel hurt? 2 factors that cause Plantar Fasciitis.
Plantar Fasciitis is one of the most common causes of symptoms for heel pain in runners and is usually categorised by a sharp pain particularly in the morning that warms up or reduces with walking or running. At the Injury Rehab Centre our Physiotherapists
Plantar Fasciitis is one of the most common causes of symptoms for heel pain in runners and is usually categorised by a sharp pain particularly in the morning that warms up or reduces with walking or running. At the Injury Rehab Centre our Physiotherapists and Osteopaths in Cheltenham see many presentations of Plantar Fasciitis every week. About 10% of Plantar Fasciitis cases are linked with running and incidence peaks for individuals between 40-60 years of age.
Why is it happening to me?
Plantar Fasciitis like many other repetitive stress injuries occurs when there is too much load for what the body can tolerate. This repetitive stress causes micro trauma in the Plantar Fascia that is constantly irritated from time spent walking or running in activities of daily living. The foot faces repetitive strain from deformation of the arch during running with landing forces up to three times body weight with every step and this may lead to the development of Plantar Fasciitis.
Am I at risk?
The following factors have been identified in the research as being major risk factors for Plantar Fasciitis.
Reduced ankle dorsiflexion range of motion
Obesity (BMI > 30 kg/m2)
On feet majority of workday
Amongst Runners:
Use of racing spikes
High Foot Arch/Varus Hindfoot
High frequency of running days per week
Increased running volume km’s/week
Years of running activity
Inefficiencies in running form
What are the common symptoms that I might get with plantar fasciitis?
Pain with first steps in morning or after inactivity
Throbbing, searing, or piercing pain located on arch / inferior heel
Walking on toes, barefoot, or upstairs may make you worse
Pain will often ease up after period, but may get worse with continued activity
Is there anything that I can do?
Therapeutic intervention should consist of consulting a Physiotherapist or Osteopath to assess, treat and train any underlying dysfunctions or discrepancies causing the Plantar Fasciitis.
Studies examining the foot’s musculature in individuals with Plantar Fasciitis tend to display a decrease in:
Toe Flexor Strength
Foot Intrinsic muscle strength
These muscles are important as they provide DYNAMIC arch support of the foot during propulsion of gait in running.
Exercises to help Plantar Fasciitis should focus on evening up the ledger between how much stress and strain is being put through the body whilst increasing the tolerance of the Plantar Fascia and the body as a whole to these stresses.
A simple exercise that you may want to try to increase the local capacity of the muscles of the foot is the Foot Shortening Exercise or “Arch Doming” exercise: (See figure)
Keep toes in neutral position and attempt to not bend or extend the toes of your foot while contracting the arch. This exercise will take PRACTICE in order to get good at and you may experience some cramping in your arch, which is a good sign that you are activating these intrinsic muscles.
Perform this exercise multiple times a day with sets of 10 repetitions.
What’s my prognosis if I already have it?
The odds are in your favor! 80% of individuals who have Plantar Fasciitis had resolution of their symptoms in 12 months. However to get the best possible outcomes with your recovery a strategic approach to addressing causative and maintaining factors needs to be implemented. Patients should expect a recovery time of 6-12 months to make full resolution with Physiotherapy and Osteopathy management.
What should I do if I start noticing heel pain sticking around after a week or two?
Don’t delay. The earlier you can begin management to address Plantar Fasciitis with a Physiotherapist or Osteopath the better your outcomes in treatment with be.
The reasoning for this is likely the repetitive nature of the sport where little issues can then cause more stress and strain becoming painful over time.
Particularly if you are a runner our Return To Running Program has a comprehensive history taking and assessment process going above and beyond what other clinics do, so we can identify the root cause of your running related injury. This process is equally applicable to non runners with Plantar Fasciitis and utilises the latest technology including:
M.A.T Assessment created by the therapists of the Injury Rehab Centre to laser focus on areas of flexibility, balance and movement that identify whether your are at risk to sustain an injury.
Slow Motion Running Gait Video Analysis to IDENTIFY YOUR BAD RUNNING HABITS that stop you from progressing that next step in your running.
Strength Testing to identify any strength discrepancies that have a huge role in increasing your injury risk.
Force Plate Technology to put a number on differences in the power you can generate through each leg that can lead to compensations and can cause repetitive stress injuries.
Traditional Physiotherapy and Osteopathy examinations to identify dysfunction.
Next our treatment process achieves pain relief in the shortest amount of time by using hands on Physiotherapy and Osteopathy techniques such as soft tissue massage, joint manipulation, articulation and stretching techniques including the use of the True Stretch system.
Finally your management plan will involve an individualised training plan to build your running/walking movement capacity (muscle and tendon strength, stamina, specific flexibility) as well as increasing your movement skill to make you more efficient out on the road, track or trail to bullet proof your body from injury and increase performance.
Don’t delay. Contact the Injury Rehab Centre to get back on track to resolving your heel pain today. Call our friendly reception on 95537024 or book your appointment online by clicking the link below!
References:
Buchbinder, R. Plantar Fasciitis. New England j med; 2004, 350;21: 2159-2166.
Cole, CC, Seto, CS, Gazewood, J. Plantar Fasciitis: Evidence-Based Review of Diagnosis and Therapy. American Family Physician; 2005, 72 (11): 2237-2242.
Di Caprio, F, Buda, R, Mosca, M, Calabro, A., Giannini, S. Foot and lower limb diseases in runners: assessment of risk factors. Journal of Sports Science and Medicine (2010) 9, 587-596.
McKeon PO, Hertel J, Bramble D, et al. The foot core system: a new paradigm for understanding intrinsic foot muscle function. Br J Sports Med 2015;49:290.
Riddle, DL, Pulisic, M, Pidcoe, P, Johnson, RE. Factors for plantar fasciitis: matched case-control study. The Journal of Bone and Joint Surgery; 2003, 85(5):872-877.
4 Habits of Injury Free Triathletes
As Physiotherapists and Osteopaths in Cheltenham and Bayside we see many triathletes coming through the doors of the Injury Rehab Centre. Much like other endurance sports, a high proportion of triathlete injuries can be linked to overuse (80-85% in fact!).
As Physiotherapists and Osteopaths in Cheltenham and Bayside we see many triathletes coming through the doors of the Injury Rehab Centre. Much like other endurance sports, a high proportion of triathlete injuries can be linked to overuse (80-85% in fact!). Triathletes do fairly better than pure endurance runners in injury rate, but are more prone to injury than swimmers and cyclers. As you can imagine, running has the most commonly cited association with injury followed by cycling and then swimming.
Common injuries triathletes present with include:
Runner’s knee. Experiencing a tender pain around or behind the kneecap is usually a sure sign of patellofemoral pain syndrome, a fancy term for runner’s knee
Achilles tendinitis
Plantar fasciitis
Shin splints
Iliotibial band syndrome
Stress fracture
Patellar tendinitis
Ankle sprains
Why is it happening?
Lack of stretching
Poor warm up
Intensive training
Insufficient care of muscles
High impact running style
Consider: The T2 transition (cycling to running transition):
Once of the most unique parts of Triathlon is the transition between the swim, bike and running components of the race. Of particular importance is the transition from the bike to running, as this seems to be an area of the race where individual are most predisposed to injury. This could be due to many reasons but most likely are.
The change in muscle actions and from an unloaded state (cycling) to a loaded one (running) during this transition provides a high-risk zone for injury to occur.
There is also a period of time for running technique to become optimal after cycling that may increase the stress in the low back and knee as there may not be optimal ability to dissipate load.
Things that injury free Triathletes do:
A lot of self treatment/maintenance: Triathletes with cycling and running backgrounds tend to have increased tightness of the hip flexors, tensor fascia latae muscle, and iliotibial band (ITB). Use a foam roller with daily training to help maintain your range of motion for 5-10 minutes a day!
Intensive training: Be patient, and don’t do too much, too soon. Be considerate of your training and don’t increase the mileage of your running/swimming by greater than 10% between training weeks. If you have trouble with training regimens, seek a coach!
Don’t have a high impact running style: The different disciplines in triathlon can often mean athletes are not as technically proficient as they should be. Injury free triathletes are also very competent runners and transition well. A comprehensive running assessment may be of benefit.
Regular consults with their Physiotherapist or Osteopath: If you are training and competing close to your physical limit it’s naive to assume there won’t be aches and pains. Regular consultations with your Physiotherapist or Osteopath should be part of your routine to reduce the risk of injury and keep you training consistently.
The Injury Rehab Centre are experts in providing comprehensive running assessments to break down your biomechanics and identify regions that may be at risk of injury. Utilising the M.A.T (Movement Assessment Tool) and Strength Testing we can then help develop a plan to improve your form and minimise your risk of injury. Contact us today at the clinic on 95537024 or click here to book online!
References
Migliorini, S. Risk factors and injury mechanism in Triathlon. Journal of Human Sport & Exercise. 2011, 6(2): i-vi
Return to Running – How to beat running injuries with long term results.
It all begins with an idea.
Running is one of Australia’s favourite recreational activities due to convenience/affordability and we are lucky to have many great running tracks around the Cheltenham, Moorabin and Bayside areas. Unfortunately, the repetitive nature of the sport means that it is has one of the highest rates of injuries causing interruptions in training and leading to loss of conditioning.
According to Sports Medicine Australia:
Up to 70% of recreational and competitive runners sustain overuse injuries during any 12-month period.
42% of all running injuries are to the knee, followed by 17% to the foot/ankle, 13% to the lower leg and 11% to the hip/pelvis.
Overuse injuries can occur from training errors (running frequency, duration, distance, speed and lack of leg strength and flexibility) and inappropriate surfaces, terrain and footwear.
Overuse injuries, as a result of training errors, are more common than acute injuries such as ligament and muscle sprains and strains.
The most common overuse injuries are patellofemoral pain syndrome (runner’s knee), iliotibial band friction syndrome, plantar fasciitis, meniscal injuries, tibial stress syndrome and patellar tendinopathy.
At the Injury Rehab Centre we take a holistic approach to the treatment of running injuries such as plantar fasciitis etc in a way that not only aims to get symptomatic relief but also to create long standing change to reduce the risk of re-occurrence.
Fundamentally most overuse injuries occur because something is wrong with the way we run, causing too much stress and strain to an area resulting in pathology.
Our comprehensive history taking and assessment process means that we get to the bottom of what the issue might be. This process utilises slow motion running gait analysis, our very own Movement Assessment Tool (M.A.T) for measuring muscle and jint flexibility and control, as well as muscle strength testing using Force Plate technology and traditional Physiotherapy and Osteopathy examinations.
Next our treatment process aims to achieve symptomatic relief by using hands on Physiotherapy and Osteopathy techniques such as soft tissue massage, joint manipulation, articulation and stretching techniques including the use of the True Stretch system.
Finally your management plan will involve an individualised training plan to build your running movement capacity (muscle strength, stamina, specific flexibility) as well the competency in other directions of movement.
One of the biggest problems many runners face is that the sport is so repetitive in one direction of movement. This lack of variability can be a big factor in the origin of many overuse injuries such as patellofemoral pain syndrome, iliotibial band friction syndrome, plantar fasciitis. By creating competency in moving in other directions we give runners more movement options to utilise to offload these areas when running for extended periods of time.
If you or someone you know suffers from a running related injury book your appointment online to start your Return to Running journey today.