Injury is the most common reason for runners ‘retiring’ from the sport, especially as far too many attempt to run through pain without thought for the consequences. Chronic injuries – that is, long-standing ones – are invariably more difficult to restore to full health, so it should go without saying that you need to take early active intervention.
Acute injury is associated with local bleeding and that the object of first aid is to minimise this bleeding and reduce its consequences. The acronym ‘RICE’ is commonly used as an acronym.
R is for Rest – common sense, really, but a runner in the middle of a race or training session may not heed the symptoms of a less severe injury and just carry on. There may be some excuse, as exercise-induced endorphins can reduce the brain’s ability to interpret symptoms of injury, though the more experienced you are as a runner, the more intuitive you should be in interpreting these. Continuing to run will force more blood to the site of the injury and maintain bleeding – more severe damage is the inevitable result. If you have no option but to carry on, try to cool the area with water and slow right down – walking is ideal.
I is for Ice – the application of which should be carefully controlled. Simply putting ice on the site of an injury is going to produce blistering and ice burn, so it should be wrapped in polythene, crushed and further wrapped in a damp tea towel. Time is an important factor. Fifteen minutes should be the upper limit for a single application, but this can be repeated hourly.
You can use ice in other ways during rehabilitation. Firstly, you should reapply it if you feel twinges as you gently stretch out the injury on the subsequent days, and it can also be used as a massage medium which can ease apart scarred, healing tissues while the cooling effect continues to provide capilliary contraction and prevent further bleeding. Ice is the most valuable, yet least used and understood, method of healing sports injuries.
C is for Compression, or at least counter-pressure to the bleeding capilliaries. The greater the pressure applied, the lower the amount of blood that can pass to the rest of the limb. We all apply tissues to an external cut – a bandage or Tubi-grip will have the same effect internally. However, this pressure should be less than your blood pressure – there is little point in stopping the bleeding but cutting off the blood supply to the extremity of a limb. Gangrene can still occur, so you should alternate compression with ice. If the limb goes numb, the bandaging should be released.
E is for Elevation Elevate the limb. Blood pressure reduces with height – it is lower in our brain than our toes – so the higher the limb is above the heart, the less force there is within the damaged blood vessel to cause bleeding and worsen the injury. While it may not always be practical to elevate the limb, any time doing so is well spent and will aid recovery.
The RICE method (combined with anti-inflammatory drugs if desired i.e ibuprofen) is the best immediate response to most injuries. Full rehabilitation requires considerable expertise,I would recommend seeking the services of a Chartered Physiotherapist who specializes in sports injuries.
As we all know from time to time we may pick up injuries as a result of our running activities-here are a few basic rules which should help you prevent picking up injuries and also some self help strategies to treat yourself should you be unlucky enough to become injured.
General Training Advice
1) Do start gradually-when you first start running,be careful to stay within your comfort zone,and not push yourself too hard-that can come later!!.
2) Don’t build the mileage up too quickly-Most running injuries occur because we’ve stressed our bodies too hard or too quickly-The general rule of thumb is to limit any increase in mileage to no more than 10% a week-something to bear in mind if you’re training for a long mileage event such as a marathon.
3) Don’t run too many hard training sessions too closely together-After a hard training session the body does need time to recover and repair any damaged muscle tissue.So if you’ve run a hard speed or hill session one day it’s better to have a low mileage,easy run or a rest day the following day,the same is true if you have run a long distance run/race too.
4) Do warm up before running-it’s much better to get the muscles up to a warmer temperature before stressing them too hard-you can incorporate this into your run,simply by starting your running session off initially at a very slow,easy pace before speeding up.Current research indicates that it isn’t necessary to do lots of stretching prior to running to avoid injury,but a decent warm up drastically reduces the amount of injuries sustained.
5) Do warm down after running,rather than just stopping totally,it is better to try a few gentle stretches after running or a very gentle jog or walk afterwards does the trick too!.
6) After a run,try and avoid soaking in a very hot bath afterwards-I know it feels nice!,but the heat dilates the blood vessels which if you have picked up an injury,could make it bleed more,actually making it worse-You are better to have either a short not too hot shower,a cool bath or for the really masochistic of us an ice bath!-The effect of cold is to constrict the blood vessels which will have the effect of reducing any bleeding to an injury,therefore minimizing any muscle damage.
7) Don’t run if you are feeling ill or are unwell-you will generally become more ill afterwards,and end up missing more time running as a result-It is also potentially dangerous,running with particularly a chest infection can be a cause of cardiac problems,where the heart muscle is attacked by a virus causing irrepairable damage,and in some cases can be fatal.
8) Do listen to your body-if you have significant pain from a muscle or joint that doesn’t feel “right”,then you are better to miss that training session and have a rest day.
9) Do take rest days,part of the training process,is actually caused by micro-trauma to the muscle fibres,and then by the body repairing them,so taking rest days is important to allow this recovery to take place,rather than training 7 days a week-alternatively,you could try another activity such as cycling or swimming which works slightly different muscle groups.
10) Do change your running shoes regularly,the average running shoe lasts for approximately 400-500 miles.After this time the mid-sole of the running shoe becomes significantly compressed,and you then start getting more impact passed up into the body,which can be a significant factor in causing injury.Certainly worth looking at as it is easy to average 40 miles per week during a marathon training schedule,so in 10 weeks or so your shoes could easily be on their last legs!.
11) Do use good quality footwear,it is better to go to a specialist running shop and get advice on appropriate footwear,rather than going to a High Street chain store,where the sales assistants are not very knowledgeable about running shoes.
12) Do try and run off road where possible,as running on softer surfaces dramatically reduces the amount of impact that the body receives.
13) Don’t slavishly follow running schedules if you are feeling ill or are injured-Most running schedules,such as those in “Runners World” are generally very good,but everyone is individual,so I would use these more as a guideline.So if you are feeling ill or are injured,don’t feel guilty about missing a day in the schedule,as it’s better to do that than have to have a longer lay off as a result of pushing yourself to the point of breaking down.
14) Do seek advice if you have an ongoing injury,which hasn’t responded to rest,modified activity and home treatments,then do seek help.I would recommend seeing a Chartered Physiotherapist with an interest in sports injuries,as it is possible that you may have underlying bio-mechanical issues which require accurate assessment and treatment.
As running is a repetitive activity,there is a tendency for the larger muscle groups,particularly in the lower limbs to become very tight and overactive.When this happens,this increases the likelihood of upsetting the bodies natural bio-mechanics and then lead to injury.It is advisable to do some stretching exercises on a regular basis to help counteract this and hopefully avoid picking up any injuries.Here a few which I would recommend which address the main muscle groups which can be affected.
1)Don’t stretch cold muscles. It’s far better to stretch after a run than before.
2)Do stretch lightly before speedwork, after a 10-minute warm-up jog.
3)Ease into each stretch: don’t bounce or force it.
4)Before speedwork, hold each stretch for 10-15 seconds.
5)After a run, hold each stretch for 30 seconds; repeat once or twice on each leg.
Keep your upper body relaxed and both legs straight as you pull one leg towards you. A variation: lying as before, bend the upper knee in towards your chest. Holding the cord around the foot of the bent leg, push away with the foot, trying to straighten the leg against the tension of the cord. You should feel the stretch higher up the hamstring.
Keep the ankle of your front leg just below your knee and ensure that you’re close enough to the wall for your lower back to be off the floor. As gravity gently brings your lower back towards the floor, you’ll feel a stretch in the muscles around the side of your buttocks. Adjust the angle of your hips and front knee to intensify the stretch.
Hold your feet and gently use your leg muscles to move your knees towards the ground. Keeping a straight back and bringing your feet closer to your body intensifies the stretch.
Keep the back leg straight and push the back heel into the ground. Keeping a straight upper body and gently lifting up your hips helps. There shouldn’t be much pressure on the front foot.
Stand closer to the wall and bend one leg, keeping the foot flat on the floor. You should feel a stretch in your lower calf. Leaning towards the wall intensifies the stretch; there should be little pressure on the other foot.
Place one foot around the other, with both feet flat on the ground. Keeping both legs straight, lean your hips towards the side of your rearmost foot (so, if your right foot is rearmost, lean your hips to the right). You should feel the stretch down the outside of your leg and around your hip – if you are very stiff, it may take a few times before you feel anything.
Keep your hips squared forwards and your upper body vertical; slumping forwards reduces the stretch.
Flex your foot and keep your body straight to maximise the stretch through the front of your leg. You can put one hand on a wall if you need balance.