Injuries….that dirty 8 letter word that all runners hate to experience. Well, any athlete or non athlete even for that matter. When you have to stop what you love to do such as running for any period of time related to injuries it can send some into a tailspin. That one activity that does so much good to so many also wreaks havoc with one’s physical and mental well being. The majority of runners will experience an injury at some point in their lives regardless of age, level, speed, distance or climate they run in. There are those few that are biomechanically blessed or so smart that they never slip up and will remain in the uninjured category.
Having experienced more than my fair share of injuries over my 19 years as a runner/triathlete requiring either no time off at all or those requiring months off I felt it my duty to offer advice on some of the key exercises you can do anywhere to help prevent and often treat a few common runners’ maladies. I’m also a Physiotherapist so I figure I’ve got a bit of professional credibility too!
- Runners Knee– this is characterized by pain behind the kneecap area which worsens running downhill, going downstairs and often sitting with the knees bent. There may also be pain along the inside of the kneecap. There are multiple causes of this injury so to say there is one way would be prudent. However there are a few things that you can do that may help. Strengthening your hips with a combination of hip abduction and hip extension exercises will help to control the rotation of the hip which in turns affects the tracking of the kneecap. These include: standing abduction with a cable pulley or a simple Theraband, single leg bridging ( or double leg bridging if you are not able to control pelvic shifting while balancing on a single leg), single leg lunging, squatting or step ups ( be cautious with these and if they increase pain than avoid until they don’t or reduce the depth of squat to be pain free), stretching of the ITB, quads, hip flexors and outer hips. These are just a few to get you started This injury can be multi factorial so if this does not help after a couple of months of regular work than seek out medical help for further assessment, treatment and ideas.
SINGLE LEG BRIDGING
- Plantarfascitis– pain in the arch, heel or both. It’s annoying, slow to heal cuz really who doesn’t spend so much time on their feet? For this injury, calf tightness can be a roadblock to recovery. Stretch and foam roll your calves. Stretch with both a straight knee and bent knee so you attack both heads of the muscle. Foot strengthening may help and the most common way prescribed seems to be scrunching up a towel under the toes. I don’t usually find this has helped. I prefer the stretch method, rolling the foot or self- massaging with hands or knobby ball (I.e. Acuball) plus protection temporarily by taping the foot so it can’t over pronate and therefore unloads the tissue to allow it to heal. Then it’s key to identify why it occurred and change that factor. This could be silly training practices :), worn out shoes, running mechanics, too much too soon etc.
CALF STRETCHING
- Achilles tendinitis – pain at the back of the leg down towards the ankle in the Achilles tendon. Three exercises specifically could help to prevent and treat this injury. All should be painfree as the Achilles is another stubborn one to heal primarily due to its poor blood supply and constant usage while running. And walking for that matter! Stretch the calf as above as long as there is NO pain in the tendon. Strengthening eccentrically (this is strength as the tendon lengthens not contracts to shorten is proven to be the most effective but less strenuous to a tendon). Stand on a step or level ground. Rise up on both feet to toes and then slowly lower down just on the affected side. Faster is not better in this exercise. Slow and steady is best. Repeat up to 20x for 2 sets. (Start without holding a weight). The prescription for eccentrics seems to be best at 2 x 20 reps twice a day. As tolerated of course. The final exercise I recommend is to strengthen the glute muscles. I have had more than one client with weak butt muscles have chronic Achilles issues. They are using their Achilles to push off when their butt should be doing more of the work. So to target this, single leg bridging, single leg squats, single leg anything that targets the Gluteus Maximus. Aka your butt :).
ECCENTRIC STRENGTHENING (ACHILLES)
- Iliotibial band syndrome– that pesky ITB. It runs from your hip bone at the side to the outside of your knee. It’s primary site of injury is outside the knee and it can feel like a knife is digging into you. Pain usually comes on about 1-2 km into your run and usually stays reducing some to a walk or crawl back home. As per runners knee, strengthening the hips has been proven to be more effective than stretching and/or foam rolling in most instances. I still recommend both just to cover the bases but to neglect hip strength totally would be a big mistake. See the exercises above for runners’ knee as targeting the outer hip muscles is key to controlling excessive inward rotation of the thigh, which creates friction of this tendon. In addition abdominal core work such as plank and side plank and variations on this can also work to control pelvis drops and rotations.
As with all injuries it is key to address the causative factors in healing the injury. Seeking out the help of a medical professional experienced in working with runners is very important for your recovery and often as a “prehab” to prevent them from occurring in the first place. These exercises are to be used as a guideline only and not taken as the only way to treat or prevent the injuries. With the new year upon us make it part of your routine (if you don’t already) to incorporate some key strength and flexibility exercises into your running program. A few short sessions a week may go a long way towards being in that small percentage of runners who remain healthy from one season to the next.
See you on the roads!
Elise Yanover
Elise is a long time competitive amateur triathlete and Physiotherapist with 20+ years experience treating runners and athletes of all kinds. She also has an online coaching business for runners and triathletes looking to reach that next distance goal or PB. She is very passionate about biomechanics in running and does gait analysis and shoe recommendations as part of her practice. Elise also has a self admitted running shoe and apparel fetish. She is mom to an active 10 year old girl and is married to a man who also runs and races. Follow me on twitter (@eliseyanover) or email me (elise.yanover@gmail.com) if you have any questions!