Dealing with an injury.
If you're a runner there is every chance, that at some point, you will have to learn to deal with an injury. In fact, the statistics tell us that up to 70% of recreational and competitive runners will sustain an overuse injury during any 12-month period. Overuse injuries are more common than an acute injury (think ankle sprain) and are generally a result of too much too soon. Increased running frequency, distance or speed are the likely culprits.
The most common overuse injuries are patellofemoral pain syndrome (runner’s knee), iliotibial band friction syndrome (outside of knee), plantar fasciitis (heel pain), medial tibial stress syndrome (shin splints) and patellar tendinopathy (knee cap tendon pain).
Overuse injuries also tend to follow a pattern.
Initially you might feel a little niggle during the first 5 - 10 minutes of running that disappears as you "warm up". You decide to ignore the pain because it "gets better" and you don't want to miss out on a run.
You keep following your running program.
Suddenly you notice that the pain is there at the start of the run, yes it improves as you “warm up” but you now have pain at the end of the run. “It’s all good” you think to yourself because there’s no pain the following day and figure you can keep running
"Must follow my training program!!"
“Can’t miss a run!”
“I’ll lose fitness if I don’t run”
“I’m meant to do a long run today, and I love my long run, so I’m running!”
“If I don’t run I will go MAD!”
So, you keep on running, following your program until eventually you can’t. See now the pain gets worse the more you run and you find yourself walking the last section home.
And if you keep ignoring the pain signals your body is sending you, continue to run, you reach the point of having pain or discomfort all the time – even when you’re not running.
So, what to do?
Listen to your body. Pain is a warning sign that something is wrong and needs to be addressed.
And please, don’t rely on Dr Google or Social Media to work out what the problem is. It is, absolutely, worth seeking out a professional opinion by your preferred choice of healthcare provider.
The sooner you know and address whatever the cause of the problem is the less time off running you will need and that’s the best possible outcome.
Are you legs starting to feel tired & heavy when your run? Getting niggles? Sore, hots spots in your feet that you didn't have before? Maybe it's time for some new shoes...
A general rule of thumb has always been when you’ve run in the vicinity of 800 k’s, it was time for some new shoes. The heavier the runner, or even the light runner with a heavy foot strike might only get 500k’s out of a pair of running shoes.
Usually it's the midsole of the shoe that fails first. The midsole, funnily enough, is the middle part of the shoe, the bit between the upper and the outsole and in most running shoes is made from a viscoelastic material called EVA (ethylene vinyl acetate) As the shoe ages, the air content of the EVA foam decreases. You can start to see wrinkles and collapses in the side walls of the EVA, the midsole becomes stiffer, thinner and loses its capacity to dissipate energy. This can lead to changes in the way you run with increase pressure on the heel, increasing vertical loading and potential increase risk of injuries. One study has suggested that you increase your risk of injury if your shoes are 4 months or older!
But things have changed - and not necessarily for the good.
There has been a recent trend towards softer midsoles in running shoes across many of the popular shoe manufacturers. Super, marshmallow soft. And yes, the first feel of a running shoe with a soft midsole is a pillow of cushioning goodness but unfortunately the softer material doesn’t have the same durability as a firmer midsole. The softer midsole absorbs 83% more energy initially but degrades 49% faster than a firmer midsole!!
How can you check the midsole of your shoes?
Look at them - If you see a crinkle cut patterns in the midsole material then they have started to compress. The dead shoe test is also quick and simple to do. Grab your shoe and see if you can bend the forefoot back down towards the heel of the shoe. If it feels firm and doesn’t shift, awesome. If it easily bends, then the midsole has deteriorated and you probably need new shoe.
So, if your shoes are older than 4 months or if you wear them for everything not just running and they fail the dead shoe test, then now is a perfect time to get yourself some new running shoes.
Here's a question for you
If you suffer from isolated quad fatigue or cramping when you ride - is it because
a) you haven't had enough electrolytes or magnesium
b) you're dehydrated
c) you're nickname is "Quadzilla"
d) you've got a lazy butt?
e) you saddle is either too low, too far forward or a combination of both
Let's run through those answers one by one
a) If you did have low serum electrolyte concentration you would have generalised skeletal muscle cramping not localised to one muscle
b) Exercise induced hyponatraemia ( dehydration) is associated with generalised skeletal muscle cramping not localised to one muscle
c) You may in fact have Quads that are so big they should have their own post code but this is not a reason for them to cramp
So my guess is either "d" or "e" and that you're what we call a "Quad dominant" Rider whose glutes maybe aren't firing properly. The poor old quads are doing all the power delivery to the pedals.... hence they are not happy by the end of the ride and may even cramp.
After a long ride you should have a general feeling of tiredness in all your big leg muscles, not just the quads.
What if I told you there is a better way? And therefore you don't need electrolytes or magnesium to solve the problem?
The altered neuromuscular control theory of cramping goes like this
A repetitive exercise with a muscle working in a shortened position (quads on a bike) with decrease muscle energy leads to the development of muscle fatigue. Throw in some decrease golgi tendon action , increase motor neuron and muscle cell membrane activity and voila you've got yourself a quad cramp.
There are two main joint actions that happen during the power phase of the pedal stroke. The quads extend the knee and the butt/glutes extend the hip. And depending on what research you look at - the glutes can contribute between 30 and 50 % of the power to your pedals. That's a heap of power you're missing out on if you are only relying on your quads.
Priority one is to make check that your saddle height is not too low or too far forward as this increases load on the quads and is a sure fire way if developing quad pain when riding
Now if you spend all of your day sitting on your butt at work you have your glutes in an elongated position. And if the glutes are in an elongated position for 40 hours a week there's a fair chance by the time you jump on your bike you can't activate them- Say hello to quad pain!
Not only will you suffer from quad pain being quad dominant with no butt action on the bike but you're also a candidate for knee pain (patello-femoral joint pain) due to excessive tractioning on the knee cap (patella) and back pain because without the glutes you will struggle to maintain pelvic position on the saddle and create over reliance on the back extensors
Get your Glutes On
Give this a go
Lying face down on your stomach, put your hands on both butt cheeks and squeeze them together. See if you can contract only the buttock muscles without the hamstrings or ‘back passage’ muscles kicking in. Then see if you can contract one side separately from the other.
Hold each contraction for 3-5 seconds and do them often!
Train Smart , Ride Strong
Do you have calf pain when you run that gets worse the longer you run? The calf feels tight and might even stop you from running forcing you to walk home?
This is a fairly common problem we see in runners and usually is a not caused by an acute injury but often the result of fatigue of the muscle.
Other potential causes of calf pain are compartment syndrome or sciatic nerve impingement.
But lets save them for another post....in the mean time if you have any numbness , tingling or loss of muscle function - get thee to a doctor!
Which calf muscle is it?
There are a heap of muscles in the back of the lower leg. (feel free to glaze over as we go through the anatomy) The "calf" muscle is the medial and lateral head of the gastrocnemius and the lower portion of the "calf" is the soleus.
Lying deep beneath the gastrocnemius and the soleus are the toe flexors and the tibialis posterior muscle.
So which one is causing you pain? That's a tricky question - most commonly it is the medial head of the gastrocnemius but I have certainly seen calf pain that has been caused by the Flexor Hallucis Longus - which is latin for the muscle that pulls your big toe down. The Flexor Hallucis Longus can get overworked, fatigued and stressed if your big toe is stiff - result is pain in the "calf"
Ok - why does the calf fatigue?
Well that’s a great question! Is it a problem of the calf or is it a problem up or down stream of the calf?
Is your calf muscle "tight" or is it "weak" or is it trying to do the job of something else?
If you have weakness or inhibition in your gluteus maximus it’s tricky to get into hip extension at propulsion, which is an important part of running. The result is we either compensate by using our hamstrings as hip extensors (say hello to proximal hamstring issues) or by using an ankle strategy and end up overloading the calf.
The other potential cause is restriction at the ankle joint called an equinus ( latin for an ankle that functions like a horses) which makes the life of the calf muscle that much harder
Also a sudden change in volume, intensity or frequency of running can also stress out the calf muscle. Sprinting and hills repeats are often the culprits.
The other potential cause of calf strain is a changing to a lower profile running shoe, racing flat or “barefoot” shoe. This can change the foot strike pattern of running and increase the demands of the calf muscle.
Well my calf is sore. Maybe I should take some anti-inflammatories then?
Ah…. The answer would be whoah Nelly! . NSAIDs or anti-inflammatories aren't that flash when it comes to helping muscle injury. There has been a truck load of research over the last 20 years or so that shows anti inflammatories impair muscle healing. Recently the Journal of Applied Physiology published research in 2013 that showed Anti-inflammatories actually slow down repair of muscle after injury which will delay your return to running. This is the last thing we want to do!!
So what do I do?
Well if the calf pain is significant it might be worth having a few rest days and let the calf settle. I know that sucks, ideally we want to start strengthening the calf muscle but there is no point adding load to an already overloaded muscle.
Once the pain has settled isometric calf raises are a fantastic place to start a strengthening program. Double legged, heels slightly off the ground, toes pointing straight ahead and hold for 15-30 seconds. As muscle endurance improves you can progress to single leg, heavy slow repeats and then even some plyometrics. But start with calf raise and hold.
Some gentle, slow foam rolling to improve mobility of the calf is useful too. Don't go deep into the pain cave when foam rolling, we don't want to further damage the calf muscle - we just want to give it some love. As Chrissie Amplett said
"There's a fine line between pleasure and pain" so don't overdo it!
Also address any glute strength and ankle mobility issues and make sure your shoes aren’t completely trashed.
Maybe I'm too heavy to be a runner?
I'd respond - what's too heavy?
There is a certain logic to think that heavier runners are more likely to get injured than their lighter friend. But some research actually shows this not to be the case! And you've got to admit that running would have to be one of the most effective weight loss exercises out there!
Fitness vs Fatness
Want to live longer? A recent paper in the Journal of Science and Sports Medicine looked at fitness vs fatness.They worked out that "Cardiorespiratory fitness (CRF) is a more powerful predictor of mortality than body mass index or adiposity, (how fat you are) and improving CRF is more important than losing body fat for reducing risk of cardiovascular disease!" They found that if overweight people wanted to live longer they were better off on focusing on improving fitness than losing weight.
"There is little downside to becoming more physically active, and the threshold for CRF necessary to yield significant health benefits is fairly modest and achievable by most adults. A focus on improving CRF through increased physical activity is a safer alternative for management of obesity and associated comorbidities."
Get Thee running!
But hang on - won't I get injured?
Not necessarily. In a study published in the British Journal of Sports Medicine the researchers looked at the incidence of running-related injuries in over two thousand runners. And the only relationship they found between weight and injury was in female runners with a BMI less than 21 . These lightweight female runners were more likely to have tibial stress fractures and spine injuries than their heavier counterparts! Maybe their too skinny to run! The other interesting thing they found was men with a BMI higher than 26 and in shoes 4-6 months old were less likely to get injured!
Get Thee Running!
Don't runners have more issues with their knees?
No. In a recent paper conveniently titled Running and Knee Osteoarthritis: A Systematic Review and Meta-analysis they reviewed 153 previously published papers and found enough evidence to suggest that there was no association with running and osteoarthritis of the knee, The cool bit was if you are a runner you are less likely to have knee surgery compared to your non running friend
Get Thee Running!
So what should I do?
How you run, as well as how often you run are important. And if you are new to running alternating between walking and running small distances is a great place to start. Running efficiently will put less stress on the body- so it's worth getting your run technique checked out by a running coach or health professional.
Also make sure your shoes aren't too old. If you are running regularly - change them every 6 months. Expensive? Yes, but it's better than getting injured.
Get Thee Running!
Proximal Hamstring Tendon issues are common to distance runners, trail runners, sprinters and hurdlers. It's not the classic , clutching the back of your leg hamstring injury that you might see on a football field but rather a chronic problem that has been niggling at runners for a while
It is a deep, localised buttock pain, right on your ischial tuberosity (think sit bone) People suffering it will often describe it as an intense ache.
Tendons don't like compression or tension and activities that require the hamstring to contract or lengthen whilst in hip flexion can result in too much tensile and compressive load at the tendon insertion - think sprinting, hill work , jumping lunges. The hamstring tendon can sometimes be irritated by too much sustained stretching (tensile stress) in hip flexion (warrior pose and the classic hamstring stretch) or compressed by excessive sitting on hard surfaces
Sometimes you might have lower back pain, sciatic pain or sacro-iliac joint pain as well - so it is always worth getting checked out by a professional
Why do we get it?
Keep an eye out for our videos for glute and hamstring strengthening
I've had a few runs in the Salomon Sense Pro 2 W now and it's a great shoe. The first thing you notice is how lightweight it is, it feels like a racing flat built for the trails. But even though it is light it is surprisingly comfortable. It has a low profile, 6mm drop from heel to forefoot and a firm yet cushioned ride which I love. The midsole has two densities of "EnergyCell+" , soft under the forefoot and firmer under your heel, perfect for trail running. And because it has 23mm of midsole at the heel and 17mm at the forefoot, it's low profile means you never feel like you are too far away from the trail. Good for ankle stability!!
The Salomon "QUICKLACE" one -pull tightening lace system takes a while to dial in ( I found myself slipping at the heel initially) but once you get the feel for them they make putting your shoes on a breeze! Underneath the midsole foam there's a thin, “Profeel Film” that Salomon suggests "engages during the transition phase to support the foot and improve the overall rolling of the shoes during toe off " . I reckon it gives some added protection from rocks on the trail, always handy especially on Magnetic Island! I also love the re-inforced toe bumper that the Sense Pro has, it just makes sense on a trail shoe and firm heel counter is a winner.
All in all it is an awesome shoe that just makes me want to go for a run!!
Ready for some fun???
Here's a great 60 min paddle workout we did at our recent paddling camp with Clint Robinson
After a 10 min warm up you will do a pyramid ladder based around 5 min segments , with efforts every minute on the minute (EMOM)
1st 5 min effort is 30 sec hard 30 sec easy EMOM
2nd 5 min effort is 40 sec hard 20 sec easy EMOM
3rd 5 min effort is 45 sec hard 15 sec easy EMOM
4th 5 min effort is 40 sec hard 20 sec easy EMOM
5th 5 min effort is 30 sec hard 30 sec easy EMOM
Rest 3 mins between each 5 min effort
Cool down with a 10 min paddle
There you go - a session you can bust out in 60 mins that will get your heart rate pumping
When Mona joins us on the island in September he will be guiding us through his famous Mona's Fartlek.
Here is what we've got installed for you.
We will warm up with about 15 to 20 minutes of easy running followed by some strides, leg swings and calf pumps to make sure we are ready to roll before we start the fun stuff
2 x 90secs with 90secs recovery (float, jog or walk depending on your fitness level)
4 x 60secs with 60secs recovery (float, jog or walk depending on your fitness level)
4 x 30secs with 30secs recovery (float, jog or walk depending on your fitness level)
4 x 15secs with 30secs recovery (float, jog or walk depending on your fitness level)
The pace of the hard efforts and recoveries will depend on your running experience and usual speed.
" For elite runners the pace is just over threshold in the repetitions and just under for the recoveries.
Intermediate level runners would do the reps at their ten kilometre race pace and the recoveries at a comfortable jog (about seventy five percent of race pace).
Beginners should treat the twenty minute session as their introduction to quicker running so it would be a pace slightly quicker than the normal running speed for the repetitions and then at brisk walking pace in between to allow a good recovery."
The idea is to keep the hard efforts and the recoveries at a consistent pace if you can relative to your running ability.
Cool down for 15-20 minutes
It's a tough running workout but will pay massive dividends.
And we get to do it with the man himself!
Here at Destination Adventure Magnetic Island we've been fortunate enough to have had legendary triple Olympian Melinda Gainsford-Taylor with us sharing her insights on running. For the next couple of weeks we are going to share some of those training tips with you.
First up is the 30-20-10, it is easy to do (well sort of) and gives an incredible bang for buck. Run less often yet improve your run - sounds pretty awesome to me
Normal interval training is tough and requires a high level of commitment and determination to complete the sessions knowing the pain they likely will inflict. An aerobic high intensity training session of 4 x 4 mins with 3 mins of recovery at a working heart rate of around 95% max is not fun, in fact super hard! A speed endurance training session of 12 bouts of near maximal 30 second sprints, separated by 3-4 minutes of passive recovery before you sprint again is also tough. Now 30 seconds doesn’t sound like a long time but when you are sprinting that 30 seconds seems to go on forever.
All in all, these are incredibly hard sessions and not for the fainthearted or the uninitiated.
An easier program with similar results would be better for the every day runner to adhere to, that’s where Melinda's 30-20-10 training protocol comes in and the research backs her up.
In a paper published in October 2015, researchers from Denmark wanted to assess the effect of an easy to carry out interval training program on moderately trained runners. 166 runners were studied and during the 8 weeks of the study they reduced their weekly volume by 50%, keeping one moderate intensity run and added in two sessions of 30-20-10 running
The 30-20-10 training protocol consists of a standard warm up followed by 3 x 5 min running periods with a 2 min rest between efforts. Each 5 min running effort consisted of 5 consecutive 1 min intervals divided into 30 seconds jog, 20 seconds steady run, then 10 seconds at 100% intensity. Sounds easy but by the 5th effort of that last set your heart will be jumping out of your chest!
After 8 weeks the results were nothing short of amazing. Compared to the control group the 30-20-10 group improved their 5k run time by 38 seconds, improved their maximal oxygen uptake (VO2max), lowered their blood pressure and as an added bonus their waist circumference reduced by almost 2 cm. All with just the addition of what adds up to be 5 minutes of high speed running per week. Pretty impressive.
A great place to start if you're new to running is substitute the 30 second jog with walking, then jog for 20 seconds and sprint for 10 seconds and repeat that 4 more times.
All in all the 30-20-10 training protocol is quick, easy and surprisingly enjoyable; not to mention the physical benefits as described above.
Why don’t you give it a try, you’ve got nothing to lose except time off your run and less time on the training track.
Train Smart, Run Strong