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Running Injuries Loads Better

systematic review of 17 high quality studies showed that, at any time, 19-79% of runners are experiencing injury. If we assume injury incidence is somewhere in the middle of these wide ranges, the numbers are very high. No wonder running gets a bad rap.

Why do I always get injured?

Most running injuries are due to tissue overload. Each tissue; bone, muscle, joint, tendon or ligament, has a certain capacity to withstand force applied to it (load). Usually with running, we load our tissues within in a tolerable limit, rest, recover and run again uninjured.

Sometimes, however, we load a tissue too much or too frequently, without giving it adequate time to adapt. The result is overload and grumpy or injured tissue. A stoic runner can even develop bone stress fractures if they continue to run through symptoms and signs of bone stress reaction.

It is also important to consider overall load history. If someone has taken up running later in life and does not have much experience with sport and physical activity, their tissues and bones will not have developed the same capacity as the lifelong sportsperson. It may seem obvious, but these people will be more vulnerable to injury.

The good news is that the body is incredibly good at adapting, and, if done carefully and slowly, even the most sensitive person with complex injury history, can build up their running to surprisingly high loads and volumes.

The problem is that there is no one size fits all. Many people will find couch to 5km programs overload them. For many runners I advise taking double the recommended time. Rest and recovery are crucial. For someone with a sensitive system and complex pain/injury history (eg. a chronic fatigue individual), they may need to take much more time to adapt and even more care with a supportive, holistic approach. The key is that each running program needs to tailored to the individual and their story.

What can I do to better manage loads, adapt quicker and increase capacity?

Relative to other sports, running is not particularly high impact. This is especially true at low to moderate speeds. However, running is extremely repetitive. Particularly if we always run on the same surface, the same route at the same speed with the same technique again, and again.

If we are injured, or we just want to be smarter about training, it is clever to mix up these training variables to reduce overload. This might mean

  • running on different surfaces
  • introducing variation to your runs eg. interval training, hill training, long/slow runs, tempo runs and really easy recovery runs
  • try different routes, trail runs
  • get some running retraining or gait analysis to learn different running techniques
  • running in different styles of footwear

Aside from load management and load variability, we can influence a body’s capacity to withstand load with strength training. If we train the muscles best adapted for running, we can absorb running loads more efficiently with these muscles, thus taking loads off the passive structures like the joints, tendons and ligaments.

How important is running form?

There is no one ‘right’ way to run…

Priscah Jeptoo won the silver medal in the marathon at the London Olympics with funky running technique.

However, we have enough understanding of the gait cycle and biomechanics to appreciate how different running strategies and techniques will manipulate and shift loads around in the body. This is why running retraining and gait analysis can be very useful for the injured runner.

The answers are often simple.

The merits of running are huge. Countless studies cite its mental and physical health benefits and implications for increasing life expectancy. And no, it is not bad for the knees. A massive study, showed less arthritic development in runner’s knees compared to non-runner’s knees.

I often walk to work along a popular running track. It is a real pleasure to watch the myriad of different shapes, sizes and running techniques these people have. I think about changes I could make to their running and remind myself.. “if it ain’t broke, don’t fix it”! Nearly everyone can run if they wish to and the answers to staying healthy are surprisingly simple. The main message is avoid doing too much too soon. The body can adapt to running loads beautifully if given time.

I love when someone wanting to run tells me they are unable to run or have been advised to avoid running. It is satisfying to get them back on track and running with confidence. Running is not dangerous. We just need to be smart, patient and take a simple load management approach.

Frequently Asked Questions

Osteopaths are primary healthcare providers which means that no referral is necessary. If your treatment is being covered by WorkSafe, TAC or DVA, you will require a referral to ensure that your costs are covered.

We are able to treat WorkSafe, TAC, EPC and DVA patients, however you will require a referral from your GP. For TAC and WorkSafe patients we will also require your claim number and date of injury.

We are covered by private health funds via extras cover. Exact details will vary depending on the individual fund and level of cover. We do have a Hicaps machine which enables you to claim health fund payments on the spot.

For medicare rebates you must qualify for an EPC plan. You will need to discuss this with your GP, and a referral is necessary.

Yes, please bring in any X-ray, CT or MRI scan results you may have. If you have a report for these scans, make sure you bring this along as well.

During your first consultation your osteopath will ask questions about your problem and symptoms. They may also ask questions about your medical history, any medications you are taking or other factors that may not appear to be directly related to your problem. If your medical condition changes during the course of your osteopathic treatment, you should tell your osteopath.

Your osteopath may ask about any recent X-rays, scans or test results that you may have.

Depending on the area of your body requiring treatment, your osteopath may ask you to undress to your underwear. It’s important that you feel comfortable, so you may want to wear loose pants or bring a pair of shorts to change into.

Next, your osteopath will conduct a full osteopathic examination and if necessary, clinical tests. This may involve diagnostic, orthopaedic or neurological tests, postural assessments and activities or exercises, which will help determine how best to manage your condition.

The examination may include passive and active movements, such as the osteopath lifting your arms or legs. As part of the examination, you may also be asked to bend over or stand in your underwear. Be sure to wear comfortable, flexible and appropriate underwear.

As osteopathy takes a holistic approach to treatment, your practitioner may look at other parts of your body, as well as the area that is troubling you. For example, if you have a sore knee, your osteopath may also look at your ankle, pelvis and back.

Your osteopath may also provide education and advice to help you manage your condition between treatments. This may include giving you exercises to do at home or work.

Osteopathy is a form of manual therapy, so hands-on treatment may include massage, stretching, repetitive movements, mobilisation and/or manipulation. Most osteopathic treatment is gentle and should not cause undue discomfort. If your injuries do require hands-on treatment of painful and tender areas, your osteopath will exercise care to make you as comfortable as possible.

Some people experience mild soreness for a day or two after treatment, similar to that felt after mild exercise. If this soreness persists or increases significantly, call your osteopath to discuss your concerns.

Your initial consultation may last up to one hour. This will enable your osteopath to take a thorough history, examine and treat you. Follow-up treatments are usually shorter. Depending on your condition, they can take 30-40 minutes.

Generally you would expect to see some changes in your symptoms after one or two visits; however, some long-term or chronic conditions may require a longer course or more frequent treatment. If you have any concerns, your osteopath will be happy to discuss these with you.

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