Running

--What are the benefits of running?

Running can:

• help to build strong bones, as it is a weight bearing exercise
• strengthen muscles
• improve cardiovascular fitness
• reduce some chronic health diseases
• help maintain a healthy weight by burning plenty of kilojoules
• be a great way of managing stress and mental health.

--What muscle groups should I focus on strengthening to help my running?

The most common running injuries reported are knee pain, shin pain and Achilles tendon pain. There is evidence that strong thigh and buttock muscles can help reduce knee pain. It’s important to have strong calf muscles as they provide 30 per cent of your running power and can help with Achilles tendon pain.

Wall squats, lunges and calf raises are a good start to strengthen these muscle groups. Jogging before trying faster running will condition these muscles. Your physiotherapist can tailor an exercise program that is right for you to help you strengthen your muscles.

--What are the best surfaces to run on to protect my knees and ankles?

The link between running surfaces and injury risk is complex. When running, a person will alter their leg stiffness on different surfaces. Runners need to be careful when they are changing running surfaces. Swapping from a treadmill to the ground may increase bone strain rate and running on very compliant surfaces such as sand will alter muscle related risk factors. Downhill running decreases shock.

Hard surfaces place higher load on the knees and hips. Choosing paved footpaths, dirt tracks and grassed ovals can reduce these forces and provide varying stability around the ankles to improve balance and prevent overuse.

Ankle sprains are common amongst runners, so if you have a history of sprains, some balance exercises prescribed by your physiotherapist may reduce your risk.

The running shoes you choose may be important in preventing injury. The running shoe should bend easily, feel comfortable and have a wedge of shock-absorbing material in the heel. The fit should not be too snug. However, this should be assessed when you have your shoes professionally fitted. When buying the shoes, wear the socks you intend to wear while running.

--I want to train for a long-distance run. What is the best way to start increasing the distance I run without causing injury? 

Longer distance running requires planning. Goal setting for distances and time to run the distance is important. There are several running apps that can assist. Keep in mind the below points:

• before running, see a professional to identify potential musculoskeletal and health problems that may contribute to injury
• include lower leg strength and flexibility exercises in your training program to reduce your risk of injury
• always warm up and cool down by jogging slowly for 5-10 minutes
• hydrate prior to running and consider taking water on longer runs. Drink water or a sports drink before, during and after running
• good technique and practices will help prevent injury. Consider joining a running club to learn good skills
• avoid doing too much too soon. Establish a graduated training program. Allow 24-48 hours rest and recovery between running sessions. Cross training, cycling or swimming can be done on ‘rest’ days to increase cardiovascular fitness
• start slowly at a pace where you can have a conversation without breathlessness
• gradually build up running speed and distance (no more than 10 per cent per week)
• cut down if you experience pain. Pain is a sign that the body is not adapting to the exercise load
• avoid running when you are tired and during the hottest part of the day and run in the shade, if possible.

Check running surface

• Avoid long runs on uneven surfaces, sand and concrete.
• Gradually introduce surface changes and slopes or hills.

Wear the right protective equipment

• Wear shoes specifically designed for running that match your foot type, particularly for long distance running.
• Wear lightweight and coloured clothing, sunscreen and a hat to protect against sunburn.
• Wear reflective clothing so you are visible to motorists.
• Use a head torch when running at night and where there are no streetlights.

--How can a physiotherapist help me with my running?

Strength is an important aspect of injury risk reduction and management. Sports physiotherapists are able to provide specific strength training prior to commencing a running program to reduce the risk of running related injury. They can also help you with your rehabilitation if you suffer from an injury as a result of training errors. Your physiotherapist will look at your running technique to ensure you perform at your optimum and reduce your risk of injury.

--What are common injuries associated with running?

Running causes few acute injuries, however can be associated with overuse injuries, particularly of muscle and tendons. Overuse injuries result from training errors (running frequency, duration, distance, speed, lack of leg strength and flexibility) and inappropriate surfaces, terrain and poor footwear.

42 per cent of all running injuries are to the knee, followed by 17 per cent to the foot and ankle, 13 per cent to the lower leg and 11 per cent to the hip and pelvis.

The most common overuse injuries are patellofemoral pain syndrome (pain around the kneecap), iliotibial friction syndrome (pain at the side of the knee), plantar fasciopathy (heel foot pain), tibial stress syndrome (shin pain) and gluteal tendinopathy (pain at the side of the hip).

Reducing the distance, frequency and duration of your run can prevent injury.

--What is the long-term impact of running on my joints?

Running does not wear out your joints. In fact, it is good for your bones. Runners have increased bone strength in the lower limb bones and healthier joint cartilage. If running is gradually increased, the body has time to adapt to the new activity. Long-term studies on runners have found no increase in joint symptoms in those who ran, unless there was previous joint injury or faulty biomechanics. As with all forms of exercise, too much too soon may cause overload on the body and you can risk joint injury.

If an injury occurs

• Rest or modify your activity to allow overuse injuries to heal and inflammation to go down. Consult your physiotherapist to diagnose, understand and manage your problem. A sports physiotherapist can help you to identify the cause of your injury and help to develop a strategy to manage and prevent the injury recurring.
• If you suffer severe or continuing pain, swelling or loss of motion, seek medical attention from a sports medicine professional. A sports physiotherapist is a great start.

Gradually return to running (10 per cent increase in distance per week) once your flexibility, strength and endurance has returned.

--Is there any reason I should avoid running?

Running is not an appropriate form of exercise for those who are heavily overweight, have significant skeletal misalignment, unstable hips, spinal stress fractures or knee cartilage damage.

Before running, see your GP to identify any risk factors that may predispose you to injury or health problems. If you have a known health condition, talking to your physiotherapist can assist planning your running or identify more suitable forms of exercise such as supervised gym work, swimming or bike riding.