Running Injury Prevention

Due to the repetitive nature of running, it is not surprising that injury within the sport is common. Over time, if the loads to the body are not managed effectively, changes in the body’s biomechanics can arise and in turn this re-occurring stress on specific tissues can create pain and injury.

The most common running injuries reported are Achilles’ tendinopathy, Medial tibial stress syndrome (MTSS), hamstring strains, plantar fasciitis, Patella tendinopathy, Patella femoral pain syndrome (PFPS), lateral hip pain and lower back pain.

 

But why are these injuries common in running?

As a brief example, Achilles’ tendinopathies are extremely common due to the impact that the foot must take when landing each stride. The load is transmitted through the Achilles tendon and into the calf where the load continues to dissipate throughout the lower extremity. As the calf muscle and Achilles’ tendon work together to generate the propulsion phase of the gait cycle (stride), it is good practice to ensure that the calf and lower limb are kept in good condition and not left to tighten as this may create increased stress upon the Achilles. In addition, repetitive stress from an over-pronated foot causing the planter fascia to shorten (tighten), may also lead to increased force and torsion being applied through the Achilles tendon and eventually lead to tendinopathy. Remembering that biomechanics involve the entire kinetic chain above and below this common injury site is useful when trying to avoid injury!

One of the strategies to reduce the risk of developing such an injury is stretching the calf and maintaining the flexibility throughout the posterior chain to prevent accumulative tissue tightening. Prevention of this injury not only involves maintaining good flexibility, but also strength of the ankle, calf muscle and surrounding tissues for them to better tolerate running loads. Both factors have been shown to be beneficial when trying to reduce the risk of tendinopathy development. A good example of an evidence-based strength program for Achilles tendinopathy prevention is eccentric loading. 

 

Risk factors for running injuries:  

• Age
• Gender
• Individual biomechanics
• Footwear
• Inefficient and poorly managed training programmes
• Poor or inefficient strength and conditioning for the sport
• Inadequate stretching routines
• Inadequate or absent warm up for exercise preparation 

Talking about load: 

It has previously been suggested that the Achilles tendon is able to withstand loads of up to 8x body weight whilst an individual is running. Although our bodies can tolerate amazing amounts of load, too much load in an inadequate amount of time to allow for tissue adaptation may lead to pain, dysfunction and subsequently injury. It is always advised to consider four principles of training such as frequency, intensity, time and the type of exercise when planning your training leading up to a particular event in order to stand the best chance of reducing your injury risk. 

One simple way to avoid such injuries is to implement a structured training program ensuring enough time is given between sessions to allow for tissue adaptations and appropriate rest between each session. In turn allowing for a steady and stable increase in load placed on the tissues therefore minimising the risk of injury. It has previously been shown that when a tissue is put under strain, increasing the stress by only 10% may reduce the risk of tissue failure by 50%. 

 

Strategies to help you avoid running injuries:

• Implementing a structured and efficient running programme
• Implementing a good sport specific strength and conditioning programme
• Make sure you are completing the correct type of stretches
• Warm up effectively
• Avoid static stretches pre-exercise
• Sports massage
• Good quality, individualised, and appropriate footwear
• Knowing and understanding your personal biomechanics

Remembering that load management is key in injury prevention, as people return to running especially marathon training post the COVID-19 pandemic, the clinic has seen a rise in some of the repetitive stress injuries (RSI) mentioned above. We hope this provides a little insight into injury prevention and management of those niggly injuries to help our patients and others that want to start or indeed adapt their current running training program. 

If you have any questions regarding injury prevention for your current training plan, have an existing injury that needs attention or simply just need some help and advice regarding anything mentioned within this blog, please do not hesitate to drop us a call 01843 867195 or email info@momentumhealthcare.co.uk! Our team are here to help!

 

Helpful Links: 

This is a great little article to help better understand the role that stretching has to play in injury prevention: https://www.co-kinetic.com/media/render/a26e8cb1201bee235b066b88feef9451/media.pdf

 

References: 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8329326/

https://www.co-kinetic.com/media/render/eb23ff7f848df3be0ac52b39a639e852/media.pdf

https://www.researchgate.net/profile/Thomas-Kernozek/publication/297676252_Effects_of_Foot_Strike_and_Step_Frequency_on_Achilles_Tendon_Stress_During_Running/links/5804f1c708aef87fbf3ba656/Effects-of-Foot-Strike-and-Step-Frequency-on-Achilles-Tendon-Stress-During-Running.pdf

https://www.researchgate.net/profile/Jonas-Rubenson/publication/51471418_Influence_of_Stretching_and_Warm-Up_on_Achilles_Tendon_Material_Properties/links/00b7d51b5dafe6b56f000000/Influence-of-Stretching-and-Warm-Up-on-Achilles-Tendon-Material-Properties.pdf?origin=publication_detail

https://www.mdpi.com/2673-4036/1/4/17

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