Over the last few decades the popularity of running as a recreational activity has grown exponentially with the introduction of the big city marathons and increased awareness of the health benefits associated with physical activity. Unfortunately with the increase in participation has come an increase in running-related injuries. Studies have shown that the yearly incidence of running injuries is between 37-56%. Between 70-80% of running injuries occur from the knee downwards, the knee itself being the most common site with an incidence rate of between 25 to 42%.
Patellofemoral pain syndrome (PFPS) is the most common injury in running. It is used to describe the complaint of diffuse anterior knee pain, which is exacerbated by running, stair climbing, prolonged sitting and squatting or kneeling. Further associated symptoms include clicking, feeling of giving way and occasionally a small swelling around the knee joint.
Whatever the type or site of the injury, the following points, which have been adapted from the Ten Laws of Running Injuries, described by Tim Noakes in his book The Lore of Running, 2001, are invaluable when working through your injury.
Running Injuries Are Not An Act Of God
Injuries that occur in sport fall into one of two groups, they are either caused by extrinsic or intrinsic forces. Extrinsic injuries result when an external force acts on the body, for example a strike from a boxer or a rugby tackle. Intrinsic injuries, on the other hand, result from factors inherent in the body itself and have nothing to do with external traumas. Intrinsic factors include a runner’s physical build along with the training environment (including shoes, training surfaces and training methods). The successful treatment of running injuries requires not only treatment of the injury but also identification of the cause of injury and interventions to reduce this cause going forward.
Each Injury Progresses Through Four Grades
The onset of intrinsic running-related injury is almost always gradual. The injury becomes gradually and progressively more debilitating, typically passing through four stages/grades:
- An injury that causes pain after exercise and is often only felt for some hours after exercise has ceased.
- An injury that causes discomfort, not yet pain, during exercise,
but which is insufficiently severe to reduce the athletes training or racing performance.
- An injury that causes more severe discomfort, now recognised as pain, that limits the athletes training and interferes with racing performance.
- An injury so severe that it prevents any attempt at running.
Understanding the distinction in the severity of the injury allows a more rational approach to treatment and for the doctor/therapist to define the athlete’s pain and anxiety appropriately.
Each Injury Indicates A Break Down Point
Once an injury has occurred, it is time to analyse why it happened. This is frequently because the athlete has reached his or her breakdown point usually because of overtraining and not giving the body sufficient time to adapt. It may also be due to a sudden change in training routine, intensity, terrain, or shoes (either new or worn out)
There are so many variables…
…that can dictate the type of experience and performance you have on race day, and as the day looms closer no matter how many times you’ve rehearsed it in your head, uncertainties still will come bursting to the surface. Nerves start jangling and doubts start popping up in places you never anticipated.
Do you know how much tapering you should do in the weeks before the race, have you worked out what pace you’re going run and calculated your split times to avoid burning out half way round, do you know your carbohydrate loading rates pre-race, are you mentally prepared for the fatigue you’ll experience, can you drive or cycle the course beforehand, have you got the right gear, how do you prepare for the race start…the questions are probably endless?
The 14 KEY Tips
The key to giving yourself the best experience possible at this stage is all about mental preparation, so for answers to the questions above and more, we’ve put together a newsletter of 14 key tips to make sure you’re primed and ready to go on your Marathon D-Day.
One thing’s for sure, it will be a unique journey for every single runner, so read our tips and make that experience that experience one of the best of your life so far.
We wish everyone participating in this year’s London Marathon the very best of luck.