Training equals rehab, rehab equals training is a phrase that was coined by the American physio Charlie Weingroff. For me, the phrase means that rehab and training do not stand separately from one another. They are a continuum that blends seamlessly together. Parts of the rehab process sit at one end of the spectrum and parts of standard training are at the other the rest sits in the middle being neither one nor the other. Properly progressed rehab should resemble basic strength training and properly performed strength training has an injury preventative aspect. Continue reading “Training equals Rehab”
Stress and injury are related and today’s blog is about why. Stress is part of life, it is something that is impossible to avoid. How we deal with stress is the same regardless of the type. The body reacts to both physical or psychological stressors in exactly the same way. By pushing our nervous system towards a sympathetic state or, more simply, a flight or fight response. In the sympathetic state, we are ready for action, to run away from the lion if you will. The opposite of this is the parasympathetic state where we recover from the time spent in the sympathetic state.
Plyometrics are an often misunderstood and misused form of training, think box jumps in a Crossfit WOD. We make use of them in the mid to late stages of our lower body rehab. But why do we use them? Their main purpose is to teach you to be more explosive or to create faster ground reaction times. That is to hit the ground and come off it again as fast as possible. This is essential in any sport that requires you to run or jump.
“Please help, I get back pain when running and it’s stopping me from enjoying it” We tend not to think of back pain as a running injury but it is more common than you might think. Back pain when running is definitely in the group of common complaints that I deal with. So why do you get back pain when you run?
Your running warm-up is a great chance to prime yourself for a better quality run. Warming up for exercise will always improve performance as it allows you to prepare for the harder work to come. Anything that raises your temperature and heart rate is a good thing but getting your warm up for running right is even better. A well-used form of warm up is the RAMP style warm up. RAMP stands for
- Raise temperature and heart rate
- Activate the muscles to be used
- Mobilise the joints
- Potentiate or prime the body for the forces/intensities to be used
What are the most common causes of knee pain in runners?
There are 3 conditions that are likely to cause knee pain in runners; patella tendinopathy, ITB syndrome and patellafemoral pain. How do you know which one you have?
Whilst they all cause knee pain where the pain is lets you know which one it is that is that you are suffering from.
Illiotibial Band Syndrome
ITB syndrome is a complaint that runners will often talk about but describe a pain in a different area. The true site of pain from illiotibial band syndrome is on the outside of the knee. The pain will be felt at and above the condyle of the femur. One of the common held thoughts is that it is caused by your ITB being tight but the problem here is it is supposed to be. The ITB is part ligament part tendon so should be pretty stiff so that it can do it’s job properly.
The pain that is felt when people talk about having tight ITB’s is generally more to do with tight quads. The pain coming from the illiotibial band syndrome isn’t from the ITB itslef but from tissue underlying it. Another name for it is ITB friction syndrome because of how it rubs the underlying tissue.
When dealing with ITB syndrome we want to first calm things down. Playing with running frequency, duration or intensity are all useful to find the combination that helps. Increasing your stride frequency can also help. Increasing your stride frequency to between 160-180 spm reduces both the time spent in the air and the force you hit the ground with. Both of these reduce the chances of being in the zone that causes the irritation that creates the pain in ITB
In this post I expand more on illiotibial band syndrome
2. Patellofemoral Pain
Patellafemoral pain or PFP is where the pain exists on the front of the knee and can be along the edges or under neath the knee cap, patella. the pain will often present itself when sitting for long periods or on ascending hills/stairs. PFP is a particularly frustrating problem as the there hasn’t been any one biomechanical or physiological factor that accounts for it. PFP is more of a general overload of the tissue surrounding the knee rather than a specific biomechanical fault. This overload can be from one sudden incident such as a fall or repeated micro-trauma for an extended period.
For runners the problem is often more one of repeated micro trauma. In this situation the tissue becomes reactive because it never really gets a chance to recover from the previous bout of exercise. This is where load management becomes important. When looking to increase mileage or other variables it is better to make small regular increases rather than larger ones. Perhaps starting at 10% per week and gradually reducing this to 5%, then even 2.5%. In doing this you are allowing time for the tissues to adapt and get stronger and more robust by not exceeding the ability to adapt.
3. Patellar Tendinopathy
Patellar tendinopathy differs from PFP in that the location, whilst still on the front of the knee, is much more specific in location. Sufferers of PFP will feel pain below the knee cap in the patellar tendon itself. This is good news as having an exact location makes it much easier to treat.
The great thing about tendinopathy injuries is that we can treat them following some basic guidelines.
- Reduce pain.
- Build Strength.
- Increase power
- Improve movement
This doesn’t mean that you have to stop running but rather alter the fequency, intensity or distance. It might be that you run less frequently and keep the distances the same or that more frequently but shorter runs each time. Each individual will react differently to the demands of exercise which is why various strategies often need to be tried before finding the one that suits you. To reduce the pain and fit in with the clients schedule it may be that it is a case of running every 48 hours but in a run/walk manner. Sufficient training stimulus must be maintained and by performing the run walk we never exceed tissue tolerance.
When building strength the progression will go from static, isometric, work to slow movements to faster movements. The isometric movements also help in reducing the pain as well as building strength and flow into pure strength development. The heavy strength work allows for sufficient demand to force adaptation in the tendon. The power development work sets you up for transitioning into more running specific work that finishes off the rehab.
All 3 examples of knee pain should follow a graded approach to the rehab process. The final phase of the rehab process should incorporate drills that better reflect the demands of running. This is the case in all of the 3 of the problems above where the ultimate focus needs to be on returning you to running better than before.
Last week I had a quick look at the benefits to runners of including strength training in their program. This week we’ll look at when to schedule strength training in a running program. Where should you fit it in so that you get the benefit of having it in there but not have an adverse effect on your main activity, that is to say running?
Strength and conditioning in sport are more common place over time. The role of the strength and conditioning specialist becoming more important as athletes look to maximise their potential. This makes a lot of sense from when we considier the benefits of being a stronger athlete. A stronger athlete will, in most cases, never be anywhere tapping out their strength in a game situation. The conditioning side is about what is the appropriate type of work to be done. There is a lot to be gained from training the different energy systems but what ones are important. Knowing what aspects to train and where to place them are very important. There is no point in a marathon runner doing a Tabata session or a sprinter running for an hour. Plyometric drills that can of great benefit when used correctly for runners of all distances. Continue reading “STRENGTH training for runners”
This isn’t an uncommon thing to hear from anyone unfortunate enough to suffer regular ankle injuries. The likely hood that you have weak ankles is very low even if you are spraining one or both of them regularly. The cause of the problem is more likely one of poor communication between the brain and the muscles surrounding your ankle which results in a loss of what we call proprioception. Continue reading “I keep spraining my ankle, it must be weak”
Having stronger calf muscles is a great way to help reduce the chances of injury. The lower leg and feet take something of a pasting when you run. The peak load that occur when you are running start at around 3 times your body weight. In the lower leg the peak loads on soleus are 7 times body weight at normal running speeds. Wse types of loads it is easy to see the benefits of stronger calf muscles. The 2.5 figure is at slower running speeds and not sprinting. When sprinting the overall peak load is 7 or 8 times your body weight. From this it is easy to see how any interval session is going to be even more stressful. Continue reading “Strengthening your calf muscles for running”