In a recent talk at the London Marathon Medicine Conference, Dr Rasmus Nielsen and Dr Andrew Mitchell discussed whether all running injuries are theoretically preventable. As someone who tends to get injured to some degree during each marathon training cycle, I was intrigued to say the least- could they give me the answers I’ve been looking for?
They theorised that developing a running injury is rooted in the act of running, and if you run too much, injury will occur. The likelihood of developing an injury is influenced by many factors which will be different for each person. If you listen to your body and know what to look out for, you could potentially never get injured. Sounds dreamy, right?
So, what causes injuries and how can we avoid them?
1.) A sudden change in running distance
This is something I’m definitely guilty of and probably the cause of a bulk of my injuries. I’ll sign up for a race with not enough time to prepare, or want to take advantage of a sudden burst of running enthusiasm, increasing my mileage significantly overnight. To avoid injury, the general guidance is to not increase your mileage by more than 10% per week, which really isn’t very much when you break it down and probably explains why many of us don’t stick to it.
2.) Running the same distance but with a sudden change in circumstances
It’s amazing how small changes that you may not even think about can significantly increase your risk of injury. Here are some examples of sudden change in circumstance that could increase your risk of injury:
- New shoes should be broken in gradually, alternating between your new and old trainers for several weeks before exclusively running in the new trainers. I’m guilty again- never, ever have I done this!
- New insoles- firstly you need to work out whether you actually need to wear insoles, as they can often cause more harm than good, especially if you just buy them off the shelf. If you think you need insoles, for example, if you have really low arches, then see a specialist podiatrist and make sure they fit properly before wearing them.
- Change in running surface- if you’re a trail runner and you’ve signed up for a road marathon or vice versa, don’t make a sudden change to the surface you’re training on as each will provide different stressors to the body, resulting in injury if you overdo it. It’s good to keep a mix of both trail and road runs in your training, but if you want to run exclusively on one type of surface, build up to it gradually.
- Wearing a backpack- running to or from work is a great way to get the miles in and save time, but if you suddenly start running with a heavy load on your back it adds a new dimension to your run, adding extra strain and, you got it, increasing your risk of injury.
- Change in speed- running at different speeds causes stress on different areas of the leg. Running slowly causes stress on the inside of the lower leg, the front of the knee and the outside part of the hip, causing injuries such as patellofemoral pain, whereas, fast running causes stress on the plantar fascia, achilles tendon, calf and hamstrings, causing injuries such as achilles tendonitis. A sudden increase in either slow or fast running increases your risk of injury in these areas, so either make gradual changes to your training plan, or maintain a good balance between fast and slow runs.
- What else you’re doing- how active you are the rest of the time can really influence how likely you are to get injured. Someone who has a sedentary lifestyle while not running will often be more rested with more time to recover than someone who’s job is physically very active.
3.) Pre-existing problems, or intrinsic factors
Each person will have their own unique problems which make them prone to injury. These could include body composition, muscle imbalances, leg length discrepancies, previous injuries and hyper- or hypomobility to name a few. An awareness of your own preexisting problems allows you to address them before they cause you problems, in something called pre-habilitation. Essentially, fixing a problem before it causes a problem.
So, are running injuries really avoidable? In theory they are, but the reality is very different! The overriding message is to not make sudden changes to your training and this is something I’ve definitely taken on board. Whether I’ll choose to ignore this advice (as usual) when it comes to my next training cycle, I don’t know. I really hope not, as perhaps this really is the key to my marathon success!
What do you think of this theory? Are you also guilty of ignoring advice in pursuit of your goals?!