Eliminating the Risks
The following article featured in Athletics Weekly edition of week begginning 20th Janaury 2011;
With 2011 just underway, January is heaving with new club members for Athletic clubs while usually February and March are heaving for physiotherapists with injuries caused by not been fit to run. This article will discuss how to prevent injury, identify the first signs of injury and provide some key fundamental exercises to improve running performance.
The most important aspect of improving performance while reducing injury is the ability to move correctly. If one cannot move correctly, then they cannot run with an energy efficient stride and produce strength, stability and power to their full potential.
If for instance an athlete’s hip is stiff, this can cause the lower back or knee to do excessive work to compensate. Remember the brain will always find a way to achieve a running pattern but it might not always be the correct one! It WILL only be a matter of time before an injury arrives if the brain is cheating regularly.
A good way to preventing injury is to do a warm up that addresses these issues and will allow an athlete to improve their running stride. A good warm up will consist of some foam rolling, some active stretching and some active specific mobility work to specific joints in the body. This will ensure that the tissue quality is improved and the joints have the required mobility to achieve a safe and effective running pattern. This may take 10 to 15 minutes yet can improve performance and save valuable money from physiotherapy bills.
Foam Rolling - Essential for all athletes
Why is an efficient warm up important?
With most recreational athletes and runners, there is a good chance they will be sat at a desk or in a car for 6 + hours a day. To top this off, usually the person will be sat in a slouched rounded shoulders posture. Unfortunately this is the price we have to pay for technology! Is it any wonder that certain joints are prone to stiffness and restrictions? To top this off, when joints get stiff, they can also affect how certain muscles around those joints operate! The gluteal muscles are essential for running efficiently and unfortunately due to sitting and getting stiff hips, these muscles can usually be switched off pretty easily. This can lead to injuries in the back and pretty much any injury in the lower limb.
Avoid Sit Ups for Core Training!
This is a bold statement and somewhat controversial however if we look at the sit up and then combine this with the 6+ hours of sitting in poor postures, we can see that the sit up just adds to poor posture and hence poor running mechanics. When we crunch over, we tend to avoid using our diaphragm and instead use a poor breathing pattern. If we do not use our diaphragm correctly then we cannot use our core correctly! The lungs and an efficient breathing pattern are essential for distance running. Sit Ups also can place excessive strain on the hip flexors and lower back which can result in injury or poor running patterns.
Hip Mobility Exercise
A good hip mobility drill to avoid the above compensations is a stride position in which we can mobilise the hips while also activating the gluteal muscles. This drill is also useful for the brain to recognise prior to running as one hip is flexed (bent) while the opposite side is extended (straight) which is a fundamental pattern for running.
- The athlete gets in a press up position.
- The right foot is brought up beside the right hand while keeping the left leg straight.
- The athlete needs to keep the chest up and squeeze the straight legs gluteal throughout. This will ensure that the mid back is opened up while activating the gluteal muscles prior to running.
- This movement is held for 1 deep breath and then the legs switch positions.
- By using deep breathing instead of holds for seconds, this allows the athlete to reinforce correct breathing patterns and diaphragm activation which will ensure the core is given the best possible chance to function correctly.
Hip Mobility - Stride Position
Core Exercises
The front plank is a great exercise to train the core correctly but it is often done incorrectly.
- The athlete ensures that the elbows are directly under the shoulders and the feet are together in the starting position.
- The athlete must ensure that the bum is kept in line with the mid back and neck.
- The lower back MUST NOT BE ALLOWED TO ARCH at any point. Once the lower back begins to sag, the exercise should stop.
- A good way to avoid this is to actively squeeze the gluteal muscles throughout the hold.
- Holds for deep breathing rather than time will allow you to truly train the core to the best of its ability. E.g Hold for 3 deep breaths x 5 repetitions
Correct Front Plank
Identifying Signs of Injury
Identifying an injury early is essential to ensure damage limitation. Pain is a signal to the brain that something is wrong and should be treated very seriously. There is a big difference between severe muscle fatigue and build up of lactic acid versus pain caused by pathology!! The golden rule with most injuries is that the longer you run through an injury or leave it for months before getting help the longer it will take to heal and correct. A general rule of thumb for chronic injuries is that the length of time an athlete puts up with an injury is the time in half to get it correct. E.g an athlete carrying an Achilles injury for 3 months will usually take 6 weeks to get it right with the help of a medical professional. This is not always the case but a good guide and therefore it is a good idea to get advice before a niggle turns into something more serious.
Exercises that cause pain
If pain is a signal from the brain telling us something is wrong then it makes sense that we should never do any exercises that causes pain. NO PAIN NO GAIN is old fashioned and should not be used when dealing with injuries. All exercises to help correct particular issues should be pain free with the exception of Achilles tendonosis heel drops which have been proven to be acceptable to have some discomfort during the exercise.
Stop chasing the Pain!
In 99% of cases I treat, the site of the pain is never the true cause of the problem. If an athlete only focuses on the site of injury then usually progress will be minimal and the problem will return eventually. This is the equivalent of getting a finger stuck in the doorway and putting a bandage over the finger. By looking elsewhere in the body we actually remove the thumb from the doorway and give it a chance to heal correctly and significantly reduce chances of reoccurrence. At Pro Sport Physiotherapy we use a series of tests with every patient which will show us how certain movements can affect other joints in the body.
Two key stretches usually missed out
Two key stretches that athletes can miss are the long adductors stretch and the piriformis muscles.
Why stretch the adductors?
The adductors are essential to stretch before running as these muscles are on throughout the whole gait cycle. These muscles help flex and extend the hip and this is their true role. For athletes with weak hip flexors or glutes then the adductors can become overused and tight leading to injury. The sciatic nerve also has to pass through adductors and hamstring therefore any adhesion between these two can have detrimental effects on performance.
1) Long Adductors
Adductor Stretch
- Start on the back and keep the foot pointed up to the ceiling throughout. Don’t let the foot drop to the side as this will put more emphasis onto the hamstrings.
- Initiate movement with the side of the hip bring the leg as far apart from the midline as possible. As the end of the movement, give gentle assistance with the rope ensuring to exhale as the rope exerts 2 pounds worth of overpressure. Hold for 2 seconds and repeat 10 times.
1) Piriformis/hip rotator stretch
The sciatic nerve has to pass through this muscle in the vast majority of runners therefore if this muscle gets tight then it can lead to a whole host of problems both up and down the body.
Bring the knee to the opposite arm pit without rotating the rest of the body.
- Hold the knee with the same side’s hand.
- Initiate movement by brining the foot to the arm pit. Give 2 pounds worth of overpressure with the opposite sides hand or rope and hold for 2 seconds. Always exhale during the stretch. Repeat 10 times.
Wrap Up
These are just a few tips to reducing risk of injury while improving running performance. The proof should be in the pudding and by doing these warm ups and following the information above, the athlete should be able to feel a more efficient running pattern while clearing up niggling injuries in weeks rather than lingering on for months.
