Brad McIntosh

Running With Injury – Is It Time For A Rest?

Running With Injury – Is It Time For A Rest?

If you’re a runner, chances are you’ve asked yourself this question. Up to 80% of runners will sustain a running-related injury at some point. If we include running with a cold or flu, then the number jumps to 100%. The question is, do you rest, modify your training or continue on as if nothing’s wrong!

running-rest-day-myths

running-rest-day-myths

Whilst we’re all different and each of our circumstances unique, here’s what I suggest you think about as you contemplate whether to strap the shoes on or stay in bed:

  1. Is it acute? If you suffered an injury significant enough to cut a training session short, you should take 48-72 hours off, give it a chance to settle and throw some ice on it. If it’s still troubling you after this rest period, get it seen to.
  2. Is the injury bad enough to affect your running style? If you can’t run with your normal gait, continuing to train will lead to a worsening of the injury or a secondary injury somewhere else. We see this all the time. Take some time off, cross-train, and/or see a professional.
  3. Is this a recurrence of an old injury? Keep an eye on these ones. It may just be that your brain (and your genes) have some ‘memory’ of the old injury, but always better to get on to managing these injuries quickly. If you do, you can usually stop them from progressing.
  4. Is the injury getting worse? In most cases, if you record a worsening of an injury over the previous week of training, it’s not going in the direction you want! Take some time off and consider getting someone in the know to have a look at it.
  5. Is your ‘cold’ more than just a ‘cold’? If your symptoms are typical for an upper respiratory tract infection (sore throat, sniffles and other things above the neck) then you’re probably ok. Research suggests that training in this situation wont make you worse or slow your recovery. However, if you have symptoms of a fever or cough (i.e. anything below the neck) then you need to rest, or there’s a good chance you’ll regret it!

I hope these tips help, but regardless of your answers, as you start to feel better and make your way back into training, back off a little and build your training up slowly. Taking some time off and then jumping straight back in is one (if not the most-likely) reason for problems to occur.

Most injuries are simple to manage with a common-sense approach. Be wary of reading too much on the net, as there’s an awful lot out there and a lot of it is…not prudent advice! If you’re unsure whether you need to see someone, set up a Skype appointment with one of the expert Sydney Physio Solutions Physiotherapists. They’ll ask you a series of questions and help you wade through the plethora of information available to advise you how best to tackle it.

Simple Ways to Reduce Neck Pain

We all know that basic workplace ergonomics can support a healthy neck. If we keep our desk at elbow height, our computer screen at eye-level and our feet flat on the floor we should be fine, right? Unfortunately, it’s not always the case. In fact, Australians suffer from high levels of neck pain and it’s consistently rated as one of the top five causes of disability. So what can be done to reduce work-related neck issues?

1. Get up and move

Research shows that a sedentary lifestyle is bad for your health. Even when you have the correct posture, sitting for prolonged periods of time can increase your risk of heart disease, diabetes and even mortality. It should come as no surprise that it can also be detrimental to your neck.

Sit-to-stand desks encourage movement and are a great place to start if the option is available. Try to alternate between sitting and standing every hour throughout the day. If you don’t have access to a sit-to-stand desk, set a reminder to stand up every 45 minutes and have a short stretch or walk.

2. Stay fit

Engaging in regular exercise and physical activities outside of the office has been shown to decrease neck pain and headaches. You don’t need to spend hours exercising. If you’re short on time, high intensity interval training is a great way to get results quickly.

3. Manage work stress

Many of us are aware that stress can lead to neck pain and tension headaches. When we stress our shoulder and neck muscles tighten, resulting in discomfort. Everyone gets stressed from time to time, but if it’s causing problems it’s important to resolve it before it gets out of control. Exercise, meditation and breathing are all great techniques for reducing stress.

4. Breathe

Take two minutes and try this… as you sit there reading, feel how much tension there is in your neck and shoulder muscles. Now concentrate on breathing deep down into your stomach so it moves in and out with each breath. How’s the tension in your neck and shoulder muscles now? Can you feel the difference?

These muscles aren’t meant to work all day to do your breathing for you, but we get stuck in a negative pattern and forget what’s actually meant to happen. Practice diaphragmatic breathing and you’ll find that a lot of your neck tension will disappear.

5. Don’t look down

Research suggests that looking down for extended periods of time increases the forces passing through your neck by 600%. The more you look down, the more likely you are to have neck problems. Keep this in mind when you’re reading a book or looking at your smartphone and aim to keep your ears in line with your shoulders.

How to Avoid Overuse Running Injuries

With all the marketing hype around, you might be forgiven for thinking that footwear is the key to preventing running injuries. Especially now, with most runners at least aware of the “barefoot” craze, it’s becoming harder to know what is the right shoe. The “old” advice around finding the right shoe for a particular foot-type is slowly being tested, and the trend is towards a more lightweight, minimalistic running shoe.

This phenomenon is primarily due to Chris McDougall’s book, that I’m sure everyone has read or at least knows the context, and to a study published in the British Journal of Sports Medicine. There will likely many more studies popping up in the next couple of years to corroborate these findings, as this is a big shift in thinking around footwear and running.

The study, by Ryan et al., showed that matching the “correct” shoe to a foot type had no effect on injury rates in a group of 81 female runners. In fact, those that received the “correct” shoe were slightly more likely to get injured. I think it’s important not to take this conclusion too far, as this was a relatively small study and had some major limitations. It does, however, give some credence to the view that we need to reassess the way we professionals in sports medicine approach running footwear.

While a bit un-scientific, selecting a shoe based on comfort is probably our best bet at present. For example, a study on 206 military personnel, who were allowed to select a foot insert based on their feelings of comfort, showed a significant reduction in injury rates, even though the inserts often had no association with their “foot type” or what would normally have been considered the appropriate insert for their foot. If you have a specific injury, or history of injury, affecting your foot then a consultation with a good physiotherapist or sports podiatrist is probably appropriate.

Anyway, regardless of all this hype and innuendo, a far more important issue than footwear is how you manipulate your training variables. Some studies have suggested that up to 80% of overuse running injuries are attributable to training errors. How you build your training up—including mileage, terrain, speed, and frequency—is the most important single consideration in avoiding a running injury. Regardless of what shoes you wear, how you run, how tight your hamstrings are or how poor your core control, the body needs to adapt to new loads. If you haven’t run much before, or you’re ramping up in preparation for an event, how you choose to do this will be the major factor in determining success or injury.

The 3 keys to avoiding running injuries:

1) Plan your event preparation, including the training variables of mileage, terrain, speed, frequency and, of course, the rate of increase in these variables. Discuss your plan with a sports medicine professional as well as a coach.

2) If you’re unsure on the footwear issue, discuss it with a professional. At present, research evidence suggests that you select a shoe that is comfortable for you, rather than one that has been “prescribed”. The way I address this is to give you a few options and suggest you go for a run around the store and select the one that feels the most comfortable.

3) Have a good biomechanical assessment – it’s a small investment in the overall scheme of things and will allow you to deal with pre-existing issues and risks, and help to prevent further problems.

…and it really is preventing an injury that is the key. Once an overuse running injury has occurred, it’s much harder to fix the problem and get you back on track.

What should be covered at the 3-month check up? This is probably the most critical point in preparing for an event. Identifying problems at this stage gives us the time and opportunity to fix the issue before it takes you out of training or results in a serious injury.

The key elements are:

• Discuss previous history of injury and any current niggles
• Assess weaknesses and areas of potential overuse injury
• Discuss your training plan and current fitness level
• Discuss your footwear
• Assess running mechanics using video analysis
• Establish a plan to avoid any potential injuries

 

If you suffer from running injury why not contact the team at Sydney Physiotherapy Solutions to make an appointment at either of our Sydney CBD physiotherapy clinics or at our recently opened Chatswood Physiotherapy clinic.

Make the most of Marathon Training

If you are thinking of doing a marathon here are ten things to keep in mind in order to make your training and competition the best it can be…..

1) Variety is the spice of life

Vary your training, include slow runs, fast runs, interval sessions and incline (hill) training. Mix up your routes, and build your distances gradually.

2) Shoes!

You’ll be pounding the pavements and covering long distances during the build up for your marathon and with every running step your joints absorb 2.5 – 3 times your body weight. As a result a good running shoe is imperative. Visit a good quality running shop for an individual assessment and recommendation of the best running shoe for your foot type.

3) Slow and steady wins the race.

Preparation is the key – start training early, plan your sessions, set yourself attainable goals and achieve them! Consistency is essential. Regular, varied training sessions of good quality, not just quantity, will help prepare you for a better performance and prevent injury. A minimum of 12 weeks is required to build your training for a marathon. A last minute training sprint is not the answer!

4) Don’t forget the warm up and cool down

Too often we try to save time by skipping these key components to our workout. A thorough warm up and cool down are vital to prepare our muscles, tendons, ligaments and joints and aid recovery in order to prevent injuries. So if you want the chance to partake in next year’s marathon too, don’t forget these key components!

5) Your body knows best

Pain is your body’s protective mechanism to warn you something may be wrong. Don’t ignore it and blindly push through. If an unusual ache or pain doesn’t resolve with rest – address it early. Seek help from a professional. This will give you the best chance of a quick recovery and prevent further injury.

If you have experienced problems when running in the past it may be worth considering a physiotherapy assessment with use of our digital motion analysis to address any problems with your running technique such as overstriding or reduced forward lean.

6) You are what you eat

Don’t forget that nutrition and hydration are as important as your physical preparation. Be aware that it is also possible to over-hydrate, resulting in hyponatraemia. Go to http://www.ausport.gov.au/ais/nutrition/factsheets/sports/distance_running for advice on nutrition and exercise from the AIS.

7) Quality rather than quantity

Evidence has found a that high running mileage is the greatest predictor of running injuries. Whilst some long runs are a key part of your training save them for the peak season and don’t over do it. Remember your varied training sessions including shorter, faster runs and some conditioning training too.

8) Support

Never underestimate the motivation from training with others and having friends and family around to cheer you on and help you keep pace on the day.

9) Race day

Don’t try to suddenly up your pace or intensity at the last hurdle – race day. Be secure in your preparation and stick to your plan. Ensure you have a nutritious breakfast 2 hours before and stay faithful to your usual running clothes and most certainly your usual shoes!

Don’t forget to be liberal with the Vaseline and cover any potentially sensitive areas that may chafe!

10) Have fun! 

A good Physiotherapist is key to your marathon preparation. They are the experts at assessing and diagnosing biomechanical issues and and related symptoms.

Don’t forget you entered this for the personal challenge and to enjoy the experience so remember to do just that! Enjoy.

Avoid Overuse Running Injuries

With all the marketing hype around, you might be forgiven for thinking that footwear is the key to preventing running injuries. Especially now, with most runners at least aware of the “barefoot” craze, it’s becoming harder to know what is the right shoe. The “old” advice around finding the right shoe for a particular foot-type is slowly being tested, and the trend is towards a more lightweight, minimalistic running shoe.

This phenomenon is primarily due to Chris McDougall’s book, that I’m sure everyone has read or at least knows the context, and to a study published in the British Journal of Sports Medicine. There will likely many more studies popping up in the next couple of years to corroborate these findings, as this is a big shift in thinking around footwear and running.

The study, by Ryan et al., showed that matching the “correct” shoe to a foot type had no effect on injury rates in a group of 81 female runners. In fact, those that received the “correct” shoe were slightly more likely to get injured. I think it’s important not to take this conclusion too far, as this was a relatively small study and had some major limitations. It does, however, give some credence to the view that we need to reassess the way we professionals in sports medicine approach running footwear.

While a bit un-scientific, selecting a shoe based on comfort is probably our best bet at present. For example, a study on 206 military personnel, who were allowed to select a foot insert based on their feelings of comfort, showed a significant reduction in injury rates, even though the inserts often had no association with their “foot type” or what would normally have been considered the appropriate insert for their foot. If you have a specific injury, or history of injury, affecting your foot then a consultation with a good physiotherapist or sports podiatrist is probably appropriate.

Anyway, regardless of all this hype and innuendo, a far more important issue than footwear is how you manipulate your training variables. Some studies have suggested that up to 80% of overuse running injuries are attributable to training errors. How you build your training up—including mileage, terrain, speed, and frequency—is the most important single consideration in avoiding a running injury. Regardless of what shoes you wear, how you run, how tight your hamstrings are or how poor your core control, the body needs to adapt to new loads. If you haven’t run much before, or you’re ramping up in preparation for an event, how you choose to do this will be the major factor in determining success or injury.

The 3 keys to avoiding injuries:
1) Plan your event preparation, including the training variables of mileage, terrain, speed, frequency and, of course, the rate of increase in these variables. Discuss your plan with a sports medicine professional as well as a coach.

2) If you’re unsure on the footwear issue, discuss it with a professional. At present, research evidence suggests that you select a shoe that is comfortable for you, rather than one that has been “prescribed”. The way I address this is to give you a few options and suggest you go for a run around the store and select the one that feels the most comfortable.

3) Have a good biomechanical assessment – it’s a small investment in the overall scheme of things and will allow you to deal with pre-existing issues and risks, and help to prevent further problems.
…and it really is preventing an injury that is the key. Once an overuse running injury has occurred, it’s much harder to fix the problem and get you back on track.

What should be covered at the 3-month check up? This is probably the most critical point in preparing for an event. Identifying problems at this stage gives us the time and opportunity to fix the issue before it takes you out of training or results in a serious injury.

The key elements are:
• Discuss previous history of injury and any current niggles
• Assess weaknesses and areas of potential overuse injury
• Discuss your training plan and current fitness level
• Discuss your footwear
• Assess running mechanics using video analysis
• Establish a plan to avoid any potential injuries

At SSOP our expert physiotherapists can do a running analysis and provide advice & assessment for the very best outcome. Call us on 9252 5770 for more information, or visit our website www.sydneyphysiosolutions.com.au

Good Luck with the training.

Dr Brad McIntosh