Running & Sports Injury

Our Approach

Over the years we have successfully treated runners ranging from International athletes to those just starting out and enjoying their “couch to 5k” programme. People who love running will identify with the fact that it can become somewhat addictive and, as such, runners can become a challenging group to treat. Whereas athletes are often perceived by many as somehow different to the rest of us, the truth is that they are, first and foremost, just people with the same physical and mental frailties as everyone else. Better athletes are in better physical shape for sure, but then they push themselves harder - it is all relative. To deliver really good care to this group of patients, we consider movement efficiency, biomechanics and strength & conditioning but we must not forget the emotional and mental well-being issues that often contribute significantly to the problems that runners have.

Please scroll down to read more. It is very likely that you have not fully addressed all the issues that we can cover for you. Call for an appointment or simply get in touch to ask questions; we are more than happy to call you back and are likely to have the answers that can get you back on track. One of the most important parts of running injury rehabilitation, one that is usually missing from traditional treatment programmes, is the ‘skill-based rehabilitation’ described blow. At The Good Physio this is one of the main areas of focus and something that we excel in.

Clinical Examination

We use expert physiotherapy and podiatry assessment to accurately assess your foot structure, movement and function so that any underlying movement problems associated with lots of walking and running pain or injury is identified and treated effectively.

By really listening to what our patients tell us and accurately marrying this to a range of clinical tests, it is usually pretty clear as to what is going on with around 90% of the runners that come to see us. Where it is not totally clear, we will arrange for orthopaedic consultation where x-rays and other imaging such as MRI can be utilised to confirm the clinical picture. However, scans rarely provide the whole story and can often be misleading as runners without pain can often have the same features on their MRI scans as runners who do have symptoms. Looking at scans is part of the information gathering process but we will always treat the patient in front of us, not just their ‘pictures’.

Biomechanics

Whilst it is often easy to observe running styles in other people, it is hard to appreciate how we are moving ourselves. We use high speed video analysis to look, frame by frame, at your walking and running action and are often able to see very clear mechanical reasons that may be contributing to increased tissue stress in these weight bearing activities. Pain is far more complicated that simply looking at tissues under stress, but by moving more efficiently we can help to reduce the volume of sensory input that the brain has to interpret. Sub-optimal movement patterns are less efficient leading to reduced performance as well as an increased stress in key load bearing structures. This can lead to sensitivity in those structures and eventually to more obvious physical injury if tissues quality continues to suffer unchecked.

If you can learn to run more optimally, not only do you significantly reduce your risk of getting recurring overuse injuries but you also stand to improve your performance at the same time. Our patients often report big improvements in their PB’s when they return to running after treatment.

Mental Well-Being

Lots of people may have heard the term “runner’s high”. This relates to the effect that ‘endorphins’ have on our brain’s ability to desensitise our central nervous system during moderate to high intensity exercise such as running, cycling or swimming. Many people are starting to realise how running can be a really effective way, along side other lifestyle variables, to control a whole variety of mental health issues from anxiety and depression to bipolar disorder. We also need to be aware of the tendency, in some individuals, to become obsessive about running to help them deal with issues such as body dismorphia and eating disorders.

As with all types of pain and injury, looking at the issues through a biopsychosocial lens will provide our clinical team with a much more accurate understanding of what drives people’s behaviour and subsequently how they feel.

Strength & Conditioning

We are always amazed at just how weak many very ‘fit’ runners coming to see us are given what they are asking their bodies to be able to cope with. It might be that they are weak at the point of coming to us because they are injured, but it would be easy to argue that it is often because runners are relatively weak that they become injured. Looking at it in round numbers, we know that peak ground reaction forces easily reach 3-4 times our body weight depending on how efficiently we are running. So for an average runner weighing 75 kg, this equates to more than 225 kg peak ‘load’. This is only for a brief instant each time you contact the ground and push off again but then you are doing this thousands of times on each leg during an average run. We will guide you through strength and conditioning programmes, if required, that will help to enable you to run more economically and efficiently and reduce the risk of injury by having tissues that are more able to tolerate larger forces without losing quality.

Skill-Based Rehabilitation

Over the years we have had numerous runners coming to see us who appear unable to rid themselves of their niggles despite investing a great deal of time and effort trying to rehabilitate themselves.

They often describe what sound like quite plausible diagnoses given their presenting conditions. However, the majority of the time, they go on to describe how ‘weaknesses’ have been identified and ‘strengthening’ exercises have been prescribed. They can see how much stronger they have become but, despite this, still do not seem to run in a more efficient manner and are still in pain. So, how is this possible?

Of course, running needs a prerequisite amount of strength, conditioning and flexibility; we understand this. However, first and foremost, running is a movement skill. The key word here is “skill”. If you ‘strengthen’ something, you repeat movement and add resistance. The problem is, if you are moving inefficiently in the first place, this strategy will just end up making you better at moving inefficiently. In our experience, this is possibly one of the most important flaws in most approaches to running injury rehabilitation. The analogy we often give our patients is this; if I have a hopeless tennis serve or golf swing, there is no point in me just going to the gym to get stronger. Inevitably, I will end up hitting the ball harder but quite possibly in the wrong direction still!. Becoming more skilled involves breaking down a movement pattern, practising each part in a better way and then reprogramming it again into a functional whole body movement pattern again.