Core stability & avoiding injury
Overuse running injuries are not caused by bad luck; and runners should not be fatalistic about them. Most are caused by an identifiable and avoidable biomechanical problem, often excessive ankle pronation. You cannot completely eliminate the risk of injury – but there are some key steps you can take to reduce the risks.
Five steps for avoiding injury
First, start running slowly. People who are new to running and try to do too much too soon will usually become injured, often in their third month of running (see Chapter 2 for more information about starting out).
Second, get the right running shoes. By far the biggest cause of overuse injuries is overpronation, which can usually be corrected by choosing appropriate running shoes. Unfortunately, many sports shops don’t know how to sell you the right shoes. (See Chapter 3 for more information about buying shoes.)
Third, get a check-up by a sports physiotherapist and podiatrist. This may sound excessive for a hobby runner; but it could well save you from considerable pain, frustration and expensive treatments later. A good sports clinic will make a video tape of you running on a treadmill, and use this to assess your running pattern (sometimes called gait analysis). They can then give you exercises and stretches which will partially correct your biomechanical imperfections, and so greatly reduce the risk of injury.
Fourth, stretch. Maintaining flexibility will reduce your risk of injury. Stretch your muscles when they are warm. It is not necessary to stretch before running, but it is necessary to stretch.
Fifth, never just “run through” pain. As you become more a experienced runner, you will learn to distinguish the normal aches and pains that are associated with hard training and effort, and pain which is your body’s way of telling you that there is something wrong. When you experience discomfort, don’t just keep running and hope that it will go away – the chances are that it will become worse. Nor should you simply stop running – whatever caused the problem will do so again when you return to running. See a specialist who can help to identify the cause, so that you can tackle it (often a straightforward matter of different shoes, simple exercise and stretches, or orthotics in your shoes) before it creates a serious problem.
Soon after I started running, just as I was really starting to enjoy it, I had to stop for six months because of injury. First I got tendonitis in my groin because I pushed myself too hard every time I went running, instead of interspersing easy runs between hard sessions. Then I got an inflamed Achilles tendon because I increased my mileage too rapidly. Looking back, I wish I had been more patient and built up a firm base of fitness, and invested more in what may seem like side issues, such as flexibility and core stability before trying to build up my mileage. And because I’m relatively new to running, I’ve realised I should concentrate on shorter distances at first. The main lesson for me is that you have to listen to your body – if it hurts all the time you are doing something wrong. One week’s missed training is better than 6 months moping about not being able to run at all.
Matt Siddle, 24
The biomechanical weaknesses that cause overuse injuries occur primarily because our lifestyles are not consistent with the range of activities for which the human body evolved. For example, because the average city dweller spends large parts of every day sitting down, our thigh muscles become elongated and our hamstrings (on the back of the upper leg) are become too short. Because of our lack of physical activity, muscles are underused and become too weak, or are sometimes not fired (recruited) at all.
You may be thinking to yourself that none of this applies to you, because you are fit, you run and you go regularly to the gym. You are very likely in a better position than the average sedentary person. But we are increasingly coming to understand that the dynamic exercises we do while running or working out only address part of the problem.
Some physiotherapists suggest that we need to pay more attention to our core stability – that is, the ability of key muscles around the abdomen, pelvis and back to hold the torso steady. The muscles that do this are not the large surface muscles that are used in dynamic exercises such as sit-ups or leg curls. They are deeper muscles, designed to work statically (that is, they prevent rather than generate movement). In people who get injured, it appears that these muscles fire late, or not at all, and are too weak to perform their stabilising function. Annoyingly, the exercises most of us do in the gym to strengthen our trunk (e.g. sit‑ups or trunk curls) target the wrong muscles because they are dynamic exercise. Indeed, they may even do the opposite, because the dynamic muscles dominate, allowing the static muscles to become lazy and atrophy.
It is clear that having good biomechanics depends on the proper functioning of these key muscles around our lower trunk, and on all our muscles being properly recruited, the right length and sufficiently strong and flexible.
Specialists often ascribe running injuries to over-pronation. The implication is sometimes that, with the right pair of shoes or inserts, the problem will go away; or that the injured runner should simply give up because they are not cut out for running. But over-pronation is itself a symptom of some other problem, which could be anywhere from your abdomen down to your big toe. Once diagnosed, it is often easy to fix (and better shoes or inserts may well be part of the solution). But if you have an injury and your therapist seems to be tackling only the symptoms, try to find one who looks for the underlying cause and helps you to fix that, or you will find yourself going back time and time again.
Core stability is a deceptively simple but important idea. It tells us that we should look for the causes of injuries, not in our running, which is consistent with the evolution of the human body over millions of years, but in the weaknesses and imbalances in our bodies caused by the lifestyles we live today for which our bodies are not well adapted.