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Prevention of Injuries

Prevention of injuries

by: Phil Parle


Overuse injuries are the result of excessive or inefficient loading on body tissues such as tendon, muscle cartilage and bone.

The key to prevention lies in training efficiently and training smartly.
Training

Injuries are often associated with an increase in intensity of training or volume of training, or returning from a lay off.

Checklist

  1. Ensure your base training is adequate for your season's expectations. Injury occurs when these two are out of synchrony.
  2. Plan long term goals ahead. Keep short term goals achievable. Chip away at your PB in seconds, not in minutes.
  3. Keep schedule varied but consistent. Most training regimes advise ALTERNATE hard/easy days plus one for rest or cross training.
  4. Ensure part of your training is aimed at simply running well and efficiently.
  5. Warm up should include a jog, stretches for the back and ower limbs followed by some stride outs.
  6. Cool down should include jog down, a hot and cold shower and a light stretch.
  7. Recovery. Rehydrate and reload with nutritious carbohydrates.
  8. Pay attention to ensuring good body strength and flexibility.


Environment

Too much of the same surface or terrain may contribute to injury.

  • Run on a variety of surfaces and terrain.
  • Wear good shoes.
  • Keep well hydrated during training.


Shoes

Poor or old footwear contributes to excessive forces through the lower limb, and is a large contributor to calf soreness and lower limb injury

A good shoe provides more stability for those who need stability (the over pronators and heavy runners), and more cushioning for the higher arched and stiff feet that do not pronate enough and need assistance to absorb shock

New shoes are required:

  1. Every 6-9 months for the average runner running 50km a week (in the same shoes). The shoes' shock absorption properties have diminished.
  2. When there is excessive wear on the heels causing altered weight bearing forces.
Note: wet shoes may deteriorate faster.


Flexibility

Repetitive action in a given joint range causes tightening of muscles and renders the muscles, their attachments and the underlying joints, open to increased mechanical loading.

Stretching assists in:

  1. Maintaining the muscle length.
  2. Reducing delayed onset muscle soreness and enhancing recovery.
  3. Providing the muscles optimum length for force production and efficent running.

When to stretch?

Warm-up/cool-down and 2-3 times weekly pending your relative flexibility.

How to stretch?

  • Raise body temperature with light excercise.
  • Stretch spine first (see diagrams below). This helps mobilise the nerves as well. Follow with the proximal muscles (hamstrings, hip flexors and quads) and then the distal ones such as the calves.
  • Stabilise one end of the muscle and sustain the stretch for 20-30 seconds and repeat (maybe longer if advised by your physiotherapist for therapeutic reasons).
  • Sports massage can assist the general effects of stretching.


Stretch exercises

Spine

Proximal

Distal

Pictures and text from "Smart Sport" - De Castella and Clews 1996.


Stability

Low back, hip and lower limb injuries may occur as a result of excessive movement around the pelvis during running.

Pelvic stability

A stable pelvis (Diagram A below) means good, efficient posture whilst running. It means running with a good strong base of support, controlled largely by the abdominals, gluteal (buttock) muscles and shoulder girdle musculature. A stable base enables the lower limb forces to be distributed appropriately and protects the lower back and hips from injury. Secondly, a stable base allows the muscles of teh lower limb that attach to the pelvis to propel the body forward in an efficient manner.

Pelvic instability

Excessive movement (Diagrams B and C below) will alter the distribution of forces inappropriately, possible causing injury.

Optimising Pelvic stability

Pelvic stability can be enhanced by a good stretching program, as described above, accompanied by good abdominal and gluteal strength exercises (see Diagrams below). Practise in stride outs can also assist, however further instruction regarding running drills may be required for specific problems.

A Good PostureB Excessive forward Tilt
Poor Abdominal Function
C Excessive Lateral Tilt
Poor Gluteal Function


Strength exercises

Abdominals
Take your straight arms behind your head and breathe out, keeping back flat. Breathe in on return. Repeat 30 times. Progress to a slow sit up and return. Repeat 10 times.
hold back stable, extend bent leg to 6 inches off the ground and breathe out. Breathe in on return. Repeat 5-10 times each leg x3 sets. Progress to a cycling action.

Gluteals
Hold back stable and lift one leg up for 5 seconds and return. Repeat x10 for each leg.
Lower leg bent up, back stable and upper leg foot turned up. Lift to line of body and then backwards, then lower. Repeat 10 times.

Abdominals/lumbar extensors
Lie face down, forehead on floor, elbows at right angles to head. Hold abdominals tight. Lift elbows and forearms off the floor, squeezing shoulder blades together. PUsh forward with arms and back, then relax. Repeat 4 times then do a few half push ups - avoid back extension. Repeat total set 5 times.


Early recognition of injury

Pain after running, or during warm-up and near the end of your session is an early sign of minor to moderate overuse injury.

The good news is that if you identify your training error at that point, then you should be able to minimise your interruption to training

Checklist

Possible training errors:

  1. Any sudden increases in milage or intensity.
  2. Excessive hill running, particularly downhill.
  3. Surfaces: too much road, beach etc. than normal.
  4. Well prepared for racing? tired? too many? check diary!
  5. Shoes: old? new and stiff? worn? appropriate?
  6. Flexibility and stability: check for stiffness and tightness above and below the injury. Does this need attention?

Action

  • Correct training error.
  • Ice the injured part after your run.
  • Minimise the aggravating part of your training and cross train as an alternative if need be.
  • Monitor symptoms and seek advice if not responding.

If pain increases with running, a period of time is required to allow the tissues to heal.

Action

  • Seek advice from a Sports or Manipulative Physiotherapist or your GP.

For further information:

Phillip Parle M.A.P.A. M.M.P.A.A.

City Physiotherapy Centre
Shop 3 Simpson House
135-137 Crown Street
Wollongong

Telephone (042) 261015
Fax (042) 252260

Phillip Parle, Cool Running Australia, 05.07.97


This page last updated: Saturday 20 March 2010


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