The countdown to the Auckland marathon is on! Regardless of which race you are planning to participate in, nothing is worse than investing time, energy and money into an event and being taken out by injury before the big day. There is a lot of misinformation out there, so here is some insight into the different methods proposed to prevent injury come race day.
Training errors have been shown to account for up to 70% of running injuries. Training errors include excessive mileage, increasing mileage too quickly and sudden changes in routine. If you are relatively new to running, you probably do not need to increase your running each week. You may run the same kilometres / time for several weeks. Give yourself plenty of time to get comfortable with a training volume, before increasing by around 10%. Running more does not necessarily mean you will run better on the day! Some of my patients who could not train for several weeks leading up to the big day due to injury surprised themselves by running their personal best time after that significant rest.
If it ain’t broke, don’t fix it! So often I have patients come in with issues after changing their footwear because they think they will run better or safer with new shoes. Often this is when they are upping their training for an event and it is not an ideal time to be breaking in new footwear. There is very little evidence to suggest that the prescription of particular footwear prevents injury but anecdotal evidence suggests existing pain can be improved with new footwear. Recent evidence suggests that minimalist footwear may help runners with knee pain. So if you are having no problems, leave it be. You can upgrade your tatty trainers after the race when less is riding on it!
Research has suggested that a 10 minute warm up at 40-60% of your VO2 max can reduce injury by up to 50%. Because warm-up should be sport specific, in regards to running this may simply mean beginning your run at a light to moderate pace, allowing your body time to warm-up (increase blood flow, reduce stiffness, improve oxygen release in the blood, increase heart rate) before increasing the pace to your normal speed.
There is very little evidence to suggest that stretching before running reduces injury risk and some evidence to suggest that it may actually make you more likely to injure yourself! Stretching can be an excellent adjunct to running, but is best done afterwards when you are warm. Focus on areas that you know tend to be tight for you – calves, shins, quads, hamstrings and glutes are common.
Orthotics are inserts that you place inside your existing shoes to replace the stock insole and provide specific support to your foot. They tend to provide arch support or cushion the heel. Some of the evidence would suggest that with existing pain and problems, particularly in the lower limb, orthotics can provide great relief of symptoms. But in terms of injury prevention, there is limited evidence to suggest you are better off wearing them. There may be a relationship with reduced risk of stress fractures. If they are affordable and don’t create any pain, then it may be a safe and easy addition to your training to help prevent the development of injury. This is something you trial early in the piece – don’t chuck them in your shoes a few weeks before the marathon as they may create problems rather than help, leaving you minimal time to rectify the issues.
Musculoskeletal and running assessment
An assessment of your biomechanics and running style may reveal some issues that could predict injury down the track. We often find issues in patients with existing pain and injury, but learning of these problems before you start training may prevent pain from arising in the first place. An appointment with your physio can highlight some key areas to work on, and an exercise programme can be implemented to work around your training schedule to keep you injury free and race-day-ready.
As mentioned, strengthening exercises addressing some key areas that tend to affect runners may keep you on schedule and ready to go. Studies looking at strengthening the quads and glutes to help prevent injury showed changes in lower limb biomechanics that reduced loading, which could reduce injury risk. As long as it is not exhausting you or interfering with your training schedule, it is a safe addition to your training. Three or four exercises done three times per week can make all the difference.
We don’t tend to encourage the use of braces unless you have had previous injury. Unfortunately, previous injury is one of the risk factors for sustaining an injury or developing pain in running. Some studies showed that wearing a knee brace with a hole for the patella reduced knee pain in runners. Unless it is a very poor fit, braces don’t tend to have serious negative effects so may be a relatively safe thing to try if you are worried about an old injury flaring up. Chat to your physio if you want some advice about which one to get as there is a lot of junk out there.
If you are in doubt about your impending marathon, come in and chat to one of the physios at Healthzone Physiotherapy who can assess your training schedule, biomechanics, footwear and make any amendments necessary to ensure you turn up at the start line injury-free.