Runners Problems

The London Marathon always increases the patient numbers at Physioworks

Injuries are usually lower limb and are related to overuse. Common problems include arch of the foot pain (plantar fasciitis), achilles tendonitis, runners knee (patello femoral tracking problems), and iliotibial band tightness to name a few.

Overuse can be described as a particular tissue of the body failing due to increased load, usually a relatively low load over time, such as a minor pull on a tendon repeated many times. This is actually how most runners start to train. One key component of running is the appropriate slow build up of strength by slowly increasing training. Slow build up actually allows the tissues to change in response to the stimulus they have: tendons become stronger, muscle bulk increases to help with power but also endurance improves as different muscle fibre types react to the stress of increased work. Overuse then usually occurs when the body is not allowed to adapt fast enough or is not held in the correct alignment while repeating movements over and over. It is often the body part that ‘gives’ that becomes the injured part, though sometimes the tight bit that forces another area to ‘give’ may be affected. For example achilles tendonitis can often be related to a sudden increase in running with poor footwear. This can allow the foot to excessively ‘roll in’ (over-pronate) which means that the calf muscle can become excessively tight which overloads the achilles tendon this then becomes inflamed.

What physiotherapy does best is to identify for the client any areas of ‘give’ that are likely to cause injury before that injury happens - it can then work to give appropriate exercises to reduce the give and suggest training strategies. All too often however, people wait for the early warning signs – minor pains or ‘niggles’ to become significant, which means the physiotherapist has to deal with symptom alleviation as well as the rehabilitation – not efficient or cost effective!

Physio also corrects knee alignment and strengthens the muscles of the trunk to help reduce the risk of low back pain. Physioworks can make orthotic devices to help correct foot positioning. Early advice is preferable but patching up problems prior to the marathon or other event has been done before and can be done again!