With the upcoming City 2 Surf and other fun runs, it is tempting to leave training until the last minute, then throw on a pair of sneakers to head out for a run. This often leads to injury as the body is not prepared to sustain the loads that running can have on the body, nor have you given your body the tools it needs to complete the run in a healthy way. Many running-related injuries that I see in clinic are knee injuries that have culminated as a result of a number of factors. If you want to be a successful runner, it is important to remember that your feet and pelvis are the key foundations for running, and to prioritise safe running practices to ensure your joint longevity. In order to prevent knee injuries (or any lower limb injuries for that matter), I have included my top tips below!
- Anatomy and biomechanics of the knee
The knee joint joins the foot to the hip and low back via long lever bones and many muscles, tendons and ligaments. If you are getting knee pain only on one side then it usually indicates a bio-mechanical issue, highlighting an imbalance somewhere (usually in the lower body). If the knee pain is exactly the same on both sides then it is likely you are doing (or not doing) something to cause the pain, such as wearing ill-fitting footwear, running with poor technique, introducing training distances too quickly or running on a surface that is too hard. Most knee injuries I see in the clinic stem from either faulty pelvic or foot mechanics, and once these factors are fixed, the knee pain magically goes away!
- Have your feet assessed by a professional
Sports specific podiatrists, chiropractors or physiotherapists are great choices to have your feet assessed. If your feet roll in or out too much, or your arches are weak, then you may need to be fitted with an orthotic to support the foot. In my opinion, semi rigid orthotics are best as they are supportive but don’t lock your foot into a rigid structure. Rigid orthotics tend to lock the foot into a sub-talar-neutral position (a position where the foot neither rolls in nor out), which is great when the foot is standing, but not so good for runners who need the foot to naturally pronate (roll in) in order to absorb the ground reaction forces and distribute them as evenly as possible up the legs and spine. Rigid orthotics tend to move the problem from the foot up the body through the bio-mechanical chain (usually the shins, Achilles or lower back / sacro-iliac joints), not to mention are super uncomfortable!
- Get your footwear professionally fitted
Have your running shoes fitted by a professional EVERY time. Brands change their designs every six to twelve months, so just because a certain shoe suited your foot last time does not mean it will this time. It is hard not to go for the pretty colours but when it comes to preventing injuries, the correct foot wear will make your long term performance much prettier!
- Have at least a few training sessions with a technique specialist
Many people go for strength or extra training to overcome shortfalls in technique. At the end of the day, the better your technique, the better your chances of preventing common running injuries. Many runners over stride in an attempt to go faster instead of focusing on foot placement and using the ground reaction forces to create a longer stride naturally. Poor foot placement, over striding, excess pelvic rotation, lack of arm drive and so on all place more stress on the bio-mechanical system of the body and increase the chance of injury, especially in the knees and shins.
- Have your spine and joints checked
Regardless of whether you have pain, have your full spine and joints checked by a sports specific chiropractor, osteopath or manipulative physiotherapist who can take x-rays (or refer for them) and assess you for anything that may affect your running biomechanics. The best time to do this is BEFORE you start an intense period of training as it will identify any areas of muscle weakness, bio-mechanical breakdown, nervous system firing issues or potential injuries that can then be addressed with treatment or support such as strapping, stretching, massage, adjustments, technique advice, nutritional advice, supplements and activation exercises. Be proactive and don’t wait until you are injured!
- Service your body regularly
Just like you service your car before it breaks down, your body also works best when it is serviced regularly. Not only does it run better but there is less chance of it breaking down. Treatments that work well for maintenance care are massage, reflexology, chiropractic, osteopathy, Bowen therapy and physiotherapy to name a few.
- Strengthen your feet and avoid barefoot running unless you have properly prepared for it
In this day and age our feet are much weaker than they were designed to be as we are in shoes often before we even take our first steps. There is a movement back to barefoot running and although there are many benefits to being barefoot, the main issue I see is that people often don’t allow enough time to transition from shoes to barefoot. In my opinion, unless your lifestyle supports the transition to be predominantly barefoot then you are increasing your chance of injuries. Runners are even more at risk to injury as impact from running compared to walking can be up to ten fold if your feet are not strong enough to cope. Foot and arch strength exercises are essential to keep the feet strong, especially if you are wearing orthotics (which, although they support the feet and prevent injuries, they are actually doing the work for the foot and hence make them weaker over time).
- Progressively overload your training program and train on softer surfaces
We all know you can’t just train at high intensity all year round or throw yourself into full training after a rest or an injury. A well-planned and periodised program that includes progressive overload is another key in preventing injuries as it allows your body to adapt to the training load over time. Running on softer surfaces (like dirt or grass), rather than on the hard surfaces (like road or cement pathways) also gives the body more longevity as there is less impact on the joints and muscles.
- Ensure you have good core strength and implement exercises specific for your body
Many people don’t realise the importance of core strength in prevention of running injuries. Having a strong core protects your lower back and also gives you a strong base to pivot around when you run. If your core is strong, then the lower back is more stable, which allows the gluteals to fire better and in turn takes load off the hamstrings and knees. Have a professional prescribe specific exercises that will target your weaknesses, but a great, general exercise for strengthening your knees is to do wall sits.
- Stretch regularly
No matter how flexible you are, running tightens your muscles. A regular stretching program incorporated into your training will most likely prevent injuries and also assist performance and recovery. This can be teamed with massage, Epsom salt baths, saunas, heat, ice and hot/cold treatments as required. If you don’t like stretching think about joining a yoga or Pilates class to combine core activation and stretching together.
- Ensure you have good nutrition and hydration
If your body is dehydrated and/or nutrient deficient you are much more prone to injuries. Seeing a naturopath, nutritionist or dietician could help you tweak your diet to make sure you are replacing what you lose whilst exercising. The general rule for water intake is 1L of water per 25kg of body weight per day. Magnesium, potassium, sodium and calcium are important for bone and muscle recovery (particularly assisting in the prevention of delayed onset muscle soreness, muscle strains and stress fractures). A few important minerals for athletes include omega three and curcumin for anti-inflammatory support (as they assist recovery and prevent inflammation) and glucosamine and chondroitin for supporting joints and cartilage (especially speeding up recovery of knee and ankle issues).
As an ex-athlete, I have placed a lot of strain on my body in completing competitive running events. Having used these practices in my own training, I can safely say that my joints feel great, and are ready to go for a run at almost any time. With these tips, I hope that your joints will likewise stand the test of time and any running event that are you aiming towards, and that you have a long, healthy, and happy running career ahead of you!