Since the ‘fitness inspired’ running craze of the 1970’s, Australians have embraced running and jogging as one of the purest forms of exercise. It’s a convenient and highly effective form of fitness, available both day and night (or even in your home with a treadmill), requires very little equipment, and is generally assumed to need very little preparation. But has this assumption of ‘minimal preparation’ set us on a path towards injury?
It has often been said that one of the most common causes of running injuries is over training. But what is over training, and should it be re-termed underprepared?
So let’s explore the most common causes of running injuries that I consider related to under preparation when engaging running for fitness:
Flexibility
There is a minimum amount of joint flexibility required to run efficiently. Restriction in joint flexibility often comes about from acquired muscle tightness, although there are other causes including genetics and prior injury. Running with an inefficient pattern can cause a compensatory strain and imbalance on muscles and joints and is a very common cause of injury. You can get lots of information on running specific stretches on the internet, or if in doubt get some professional advice from a Podiatrist, Physiotherapist or trainer.
Running Style or Technique
Are you a heel, mid-foot or forefoot striker? Do you drive with your hips of power yourself with your arm swing? And does it really matter? There is significant debate within the running public on the best way to run, but despite this confusion one this is for certain and that is that no one technique is right for everybody. Some simple advice for beginners is to ensure that when running do not overstride (take too large a step) and try to make contact with the ground with your foot moving backwards and roughly under your centre of mass/hip and not out in front of you. Again running technique relates directly back to efficiency, so if you running style does match your body you should seek advice from a fitness professional.
Footwear
There are at least a dozen categories of shoes, handfuls of brands and all with their own proprietary cushioning and support technology. Recently there’s even been some parties recommending running barefoot! It’s no wonder that very few of us will pick the right shoe straight of the shelf without some advice.
I think its common sense in our world of hard forgiving surfaces that most of us will benefits from shoes that allows us to supplely adapt to the ground and cushion or support according to our own individual needs.
A simplistic description of a shoe is simply an upper (the cloth covering the foot), midsoles (the middle bit) and outer soles (the hardwearing outer part) all stuck together. For running, an upper should be largely made from light weight and breathable mesh. The midsole construction in top brand athletic shoes is highly complex. On offer is a choice of added cushion, support and added durability, and the ability to match the shoe type the wearer’s foot type (see below). These days the materials are often a combination of cellular rubber (EVA’s) and non-cellular polymers (heavier but highly resilient elastomer) placed in areas requiring more localised shock absorption. The outer sole must have a tread pattern designed for forward motion, and with greater durability under the strike point of the heel.
Correct footwear selection is critical to running injury free, and getting advice before purchasing might just be the best preparation you can get. Very few footwear outlets have the ability to accurately advice on footwear choice, so before embarking on running check with your local podiatrist to see if they can provide a video gait analysis and advise you on footwear selection directly.
Foot Type
Your foot shape is as unique as your fingerprint, and can predispose you to a range of running injuries. Foot, heel, ankle, shin, knee, thigh, hip and even back pain have been linked to poor foot posture whether that be high, low arches or essentially normal looking feet. Only a complete running assessment including slow motion video gait analysis completed by a trained profession such as a podiatrist can detect and diagnose this. Don’t be confused by the retail theatre at some athletic stores, as foot pressure mats have no or limited correlation of foot posture or shape.
The ‘false flat foot’ is related to excessive pronation (roll of the ankle inwards) is a common cause of Achilles tendonopathy, heel pain, shin splints (now termed medial tibial stress syndrome), knee and lower back pain and more. High arches or supinated feet can be associated with stress fractures, ankle sprains, outer knee and leg pain plus many others.
A proportion of the population require foot orthotics (custom designed footbeds) to help them run efficiently and avoid injury. Like Optometry for glasses, Podiatry is the only profession trained to prescribe foot orthotics, and for runners these are generally made from a softer resilient rubber and specifically fitted to a correct running shoe. Orthotics can apply a force to the foot to realign the ankle, leg, knee of foot segments themselves. Although sports stores and chemist do sell readymade arch support, these are unlikely to provide the specific support most runners require.
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