Recently, our physiotherapist Taha completed an extensive course run by Greg Lehman (MSc,DC, MScPT), a Canadian researcher with a special interest in reconciling pain science, biomechanics and running resilience.
Taha presented an in-service to our team last week on building up running resilience, and running injury management, that will no doubt help us all with our management of our patients with running injuries.
The 4 components that need to be addressed to improve running resilience are
- Specific load application – this refers to the traditional approach taken to treat injuries –exercises and stretches specific to the current injury (ie hamstring tear) and to improve and
underlying deficiencies in strength/power/endurance/flexibility that may have contributed to the injury
- Cognitive restructuring – this is particularly important to address any false beliefs that our patients might have about their injury or beliefs that may negatively impact their recovery.
False beliefs may be something like “I have been told I have arthritis, so I will never be able to run again” or “I have to completely rest, otherwise my injury will never heal”
- Micro-load management – this refers to things such as modifying running technique and use of different types of footwear/orthotic use
- Macro load management – this is essentially looking at your running program ie frequency, intensity, duration, running environment (ie hills, soft sand) and also includes looking at
whether there are enough rest days etc.
Another interesting part of the inservice, was to challenge preconceptions regarding the need for “Optimal” running technique ie foot strike technique, excessive pronation, lower limb
alignment. Whilst there is limited evidence that modifying movement patterns may help, there is little to no evidence that it is required to treat pain or injury.
Put simply, running resilience requires
- Good running training program
- Nutrition and energy availability
- Build tissue resilience – bones/tendons/muscles
- Good sleep
- Having healthy beliefs re pain and injuries and addressing any fears/worries and encouraging optimism
- Building general health
Treating running injuries
- Decrease all negative stressors (may be no running for a short period, or reduced speed/distance/flat terrain etc) but maintain positive stressors (cross training ie bike/pool exs)
- Slowly add stressors to strengthen ie weights/plyometrics/gradually return to, or increase running
- Optimise general health ie good sleep habits, nutrition, manage stress/anxiety
- Rehab exs for runners – generally, we want to develop attributes that their running has not already developed. These new attributes will carry over and help with running.
Exercises to prepare for running
- Build up specific strength so that they can achieve their running goal, then;
- Overprepare their system, so that their capacity can exceed their goal
- Train the entire lower body for strength and power. Compound movements are great, can train multiple areas at once. Need adequate load/frequency. Include jumping/plyometrics.