It’s half marathon season, and many runners, including me, are stepping up their distances and commitment to exercise. Unfortunately, it can mean more niggles and injuries too, as the body copes with the increase in force and load going through muscles and joints. In May this year, I gave a talk at the excellent Runfest, an evening designed by runners, for runners. There were informative discussions and inspirational stories from coaches and active people from varied backgrounds. I was asked to share my top tips for preventing and managing injuries while increasing distance.
3 key points from my talk
1. Moving well and staying strong are essential for smooth, efficient running and minimising pain. You to be strong, both in your postural muscles which support the spine and pelvis, such as the abdominals and erector spinae, and in the explosive hip and leg muscles, such as the quads and calf. While running helps develop this, ‘just running’ isn't enough. If increasing distance, e.g. stepping up from a 10k to half marathon distance, strengthening twice a week for a minimum of 20-30 mins is recommended. Starting strength work early in your training helps, but it’s never too late to start. One review in the British Journal of Sports Medicine looked at 25 studies, with data from over 25 000 injured and uninjured runners to determine if strengthening, stretching, balance, dynamic stability work and combinations of these help prevent and manage injuries. Strengthening benefits were highly significant, reducing overall injuries by a third. It's suggested that overuse injuries, like 'shin spints' (medial tibial stress syndrome), could be halved. Proprioception training (position, balance and dynamic movement training) also reduced injury. Static stretching alone had no benefit – something that’s been noted in other studies too. If you are going to stretch, make sure you are strengthening too, as it’s the strength work that makes the real difference.
2. Eating well, timing energy intake and staying hydrated, as my colleague Nutritionist and Dietitician Sue Baic says at our workshops, is one of, if not the key thing you can do to improve running performance and manage injury. We all know this – but what does that mean? I’d encourage all runners to learn more about the balance of protein, carbohydrates and fats they need, and get their information from Registered Nutritionists and Dieticians with sports specific knowledge (they are easy to find online or on social media, but check their qualifications). Consider your diet during training, not just ‘carb loading’ the night before an event! ‘Refuelling’ within 30-40 mins of a run aids recovery, and if you are running for more than an hour you need to think about taking energy on board during exercise.
3. Well planned training and a balanced lifestyle underpin performance and help prevent injury. Have a training plan and have some flexibility when you need it. There are no hard rules, but increasing your time, distance or intensity by no more than 10% a week is often recommended for novice to intermediate runners. Often patients come to physio not stretching enough or old shoes caused their injury, but more often I find it’s the steep hills that they’ve done (after doing flat running for ages) or huge increases in distance over a week or two that are the problem. Higher intensity helps you improve, but monitor and graduate it. Mood, stress level, energy, overall health and sleep, alongside general aches are markers of your well-being. Managing these elements and you’ll feel and perform better, enjoy your running more and are less likely to be injured.
Increasing distance may make you more injury prone, and managing injuries can be difficult, time consuming and expensive. Your time is valuable. Planning your running and exercise, combining strength and balance training running on different surfaces, eating well at the right times and sleeping well will save you time, improve your running and help prevent injuries. Seek help if niggles persist and enjoy your running.
References:
Lauersen, JB, Bertelsen, DM, Andersen, LB.The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials
Br J Sports Med 2014;48:871–877.
Gabbett TJ. Br J Sports Med 2016;50:273–280.