Injury prevention advice from the physio
Bupa asked Wild Running if we had any questions for their qualified physios, so I’ve passed on some of the questions you asked. Here are their answers:
-Have you noticed a difference in the injury rates among barefoot and non barefoot runners?
Barefoot runners are still in the minority and I am yet to notice a surge in barefoot runners presenting with injuries. I have seen some injuries from runners transitioning from shoes to barefoot and this is probably inevitable if you have spent your life running in shoes.
-Are there some people who are not cut out for these shoes?
Unfortunately there isn’t a solid amount of research into who does well and who doesn’t do so well running barefoot or in “minimal” running footwear. A changes in foot landing position is commonly but not always seen when people move from a traditional running shoe to a “minimal” shoe. Most commonly we see the runner change from a heel strike in a traditional shoe to a more mid-foot or front foot (fore-foot strike)when running barefoot or in a “minimal” shoe. This will tend to increase the pressure on the soft tissue at the back of the leg , especially the Achilles’ tendon. So If you have been struggling with an Achilles’ tendon problem I probably wouldn’t be going and changing to a “minimal“ shoe. But that said, later down the line once good tendon healing has been achieved – a small amount of controlled forefoot running may help to strengthen the Achilles tendon.
Everybody is a individual and running styles, biomechanics and foot positions vary between runners so much that each case needs to evaluated on an individual basis.
-When is it not sensible to train through a nagging injury?
Training through any injury should always be managed with caution and monitored closely – if it doesn’t feel right it probably isn’t. If a nagging injury is 2-3/10 that is present with running but not affecting performance and goes away shortly after the session then this may be acceptable, but if the pain starts to become more frequent, more intense and inhibit your running or training programme and remains sore after the session, then this is not acceptable. Quite often the symptoms may settle with rest but then returns as soon as the activity commences, this should be reviewed to identify the source of the problem as further rehabilitation or treatment is likely to be required by a physiotherapist.
-Can rock tape allow you to run on a niggle?
Rock tape or kinesiology tape, can help to reduce the strain on an overworked tissue or facilitate a weak muscle. This can be particularly useful for a big event such as a marathon, where you have had niggles in training before hand. However it is important that you have a proper diagnosis for your symptoms before applying tape. If in doubt seek advice from a Bupa physiotherapist, who will also be able to advise you on the most effective taping techniques for your symptoms.
-Where would you recommend buying foam rollers to help the IT band?
Most Sports and running shops now stock them, but they can also be found online. Do a basic search for foam roller and many different brands and shapes are available.
-What stretches would you recommend to relax the quads, apart from clutching the ankle behind the butt?
https://www.physiotec.org/images/exercises/lic_1000/images/FLE8413_A.jpgDynamic lunges and squats can help. But flexing knee to butt is the most specific, done in either standing, side lying or prone lying.
-What is the most common cause of tightness in the upper quads.
The quadriceps muscle is so named because it is made up of four component parts. The inside or medial muscle group, The outside or lateral muscle group. A deep muscle part and a superficial part. The superficial muscle is known as rectus femoris. This muscle can become tight due to overuse and over activity. It is important to ensure that muscles remain flexible and are in balance with their opposing muscle groups, i.e also maintaining flexibility in Hip flexors and Hamstrings.
-Apart from RICE treatment, what would you recommend for a slightly torn achilles, two months after the event, in terms of rehab?
Gentle stretching to maintain length in the tendon and calf muscle, but also gentle strengthening to maintain load through tendon., like calf raises, double and single leg. Low impact activity like cycling and swimming, then progressing to cross-trainer depending on pain. A physiotherapist can provide you with a more individualised rehab programme depending on your symptoms.
-Do you think we should build in strategic walking to a really long ultra run, in order to allow our bodies to recover/better endure the distance?
Cross-training has its benefits when training for long distance to help prevent injuries, recovery and use muscles in different way. Up to 8x body weight goes through the knee joint when running compared to only 1.2 x body weight with walking.
-Would you say you see more injuries from road runners or off road runners and what is the percentage?
More likely road runners due to the hard surface and repetitive nature. Differing terrain and undulation works the muscles constantly but in different ways.
-I know a wild runner who has been barefoot running (in minimalist shoes) for a while but who has a slight peroneal tendon problem (not too serious but niggling). Should she continue running in these shoes or at least what are the dangers associated with not wearing road shoes? DOK
Best to seek advice from a physiotherapist or podiatrist who can assess gait and running style and give advice on whether more support is required.
The physios who answered the questions were located at the West End Bupa Centre and Barbican Bupa centre. Links to the centres, if you would like to include them are:
http://www.bupa.co.uk/bupa-centres/regions/london/barbican
http://www.bupa.co.uk/westend