If there has been one positive outcome from the past year, it’s been seeing the amount of people out increasing the amount of time running and walking. This increase in activity means that more people are now reaching the recommended weekly guidelines of 150 - 300 minutes of moderate intensity exercise or 75 - 150 minutes of vigorous intensity activity, as set out by the WHO (https://bjsm.bmj.com/content/54/24/1451)
With meeting these targets, we know that the evidence overwhelmingly confers benefits for the following health outcomes: all-cause mortality, cardiovascular disease mortality, incident hypertension, incident type 2 diabetes, incident site-specific cancers, mental health (reduced symptoms of anxiety and depression), cognitive health and sleep; measures of adiposity may also improve.
However in this noble pursuit of increased activity and wellbeing, we can find ourselves sometimes unfortunately picking up different types of musculoskeletal injuries. Plantar foot pain, achilles tendonitis, calf strains, anterior knee or joint pain, and hip pain are some of the most common overuse running and walking injuries that we have seen in clinic over the past few months.
Most of the time this is simply because we go either too hard or too much too fast!
Simply put, the demand placed on the body is greater than our muscle, bone, tendon, ligament capacity to cope with it.
Capacity = Strength of tissue and how strong we are to meet the demand of an activity.
Here is the step by step process that we use in clinic to help overcome injuries and enable people to build that strength capacity to return, perform, and enjoy their activity of choice.
Assessment and Diagnosis
Provide as accurate differential diagnosis as possible through subjective and objective testing.
Imaging can also be a tool, but in overuse injuries initially does not need to be used.
Educate and Inform
Advice on the ‘why’ surrounding the injury.
The importance of Load management and strength.
Create a roadmap back to recovery with mutual set timelines, goals and targets.
How can we alleviate your pain;
Alter/reduce load, take away aggravating factors, introduce and increase easing factors.
Address Underlying Causes
Identify any strength and/or biomechanical deficits or asymmetries that may be contributing to the injury.
Progressive Strength and Conditioning
Research shows that strength training 2/3 times a week (also recommended by the WHO) can increase running economy performance. You use less energy during a run when you’re stronger. It also increases the elastic storage property of tendons reducing the chances of developing injuries to the tendons and associated muscles (Blagrove et al 2017).
Graded Return to Sport
Gradually re introduce walking and running. This is dictated by the length of time you have been off running. Progressive load, stress/adaptation - the right level of stress to drive adaptation.
Monitor, review, progress
Continue with weekly strength work following your return to your activity. Maintenance is key, as once you have had an injury once you’re at an increased chance of re injury to the same area.