MARATHON RUNNING: INJURY PREVENTION AND CONDITIONING

“No Pain, No Gain.” How many times have we heard that being said over and over again like a broken record; so often in fact that we have begun to believe in it. Well, the truth of the matter is, pain is a term that is too widely bandied about and it is about time to understand that not all form of pain, leads to gain.

Runners are one of the most susceptible sportsmen on the planet to encounter some form of pain in the course of their running exploits. Training for a marathon distance increases that likelihood. One though must learn to identify the different physical sensations associated with pain and know whether to carry on, or rest and recover. A runner experiencing and sharp or stabbing pain should seek professional medical opinion, whilst pain that is constant and associated with movements, and that do not subside after a couple of days should also be investigated. Workout soreness, and dull muscle aches are common and are easily overcome with active recovery exercises.

Pain and injury goes hand in hand. Injury is one of runners’ greatest fears, as it forces the runner to be out of action for a set period of time, and that in itself feels like the worst punishment as all runners want to do is to go out and feel the exhiliration a run outdoors brings. What are the running injuries that literally bring a runner to his knees, you ask? There are so many that it would fill a book to list them all, but here we will discuss a few common ones and how to stay away from them.

One of the most common plagues is shin splints. Shin splints, which is more of a cumulative stress disorder rather than an injury, is an inflammation of the front part of the tibia and in more serious cases, minute fractures to the bone structure. Shin splints typically occur in one or more of the following situations; consistent heel-striking while running, running on hard unforgiving surfaces for long periods, or wearing running in shoes that are worn out or not providing adequate support. The pain is often described as dull and aching and can occur during exercise or after running sessions. Back in 2013, Team 2ndskin athlete Annie Yee was struggling with shin splints for almost 6 months. Frequent icing on the affected area, rest and cross-training via swimming and cycling (to reduce impact on her shins whilst keeping her fitness levels up) allowed her to ease back into running gradually. She now trains with more cushioned shoes and saves her lightweight race shoes for races.

Team 2ndskin resident ultramarathoner Azrulhisyam shares with us his experience in overcoming a common injury which many runners would undoubtedly come across in the course of running mile after mile year in and out. Plantar Fasciitis, also known as plantar fasciopathy or jogger's heel is a common painful disorder affecting the heel and underside of the foot. The causes are very much alike to shin splints but affecting a different area. Azrulhisyam theorizes that the cause of his plantar fasciitis injury was due to excessive workout and running over a long duration or distance. Another probability that was identified was probably the use of racer shoes with zero drop when his foot muscles have not been conditioned well enough to absorb such impact. Upon rest and recovery, the pain gradually went away and it helped when he wore more structured shoes and after better conditioning and leg strengthening, he started to transition from cushioned shoes to less minimal drop shoes again, like the Skechers GOrun 4. Plantar Fasciitis remedies include icing, ultrasound therapy, rolling the underside of foot with foam roller or even golf balls, but most importantly, is to rest and recover. For injuries like shin splints and plantar fasciitis, pushing through the pain does more harm than good.

Running is an extremely enjoyable sport. The time spent outdoors, the fresh air, the adrenaline rush, the camarederie, all contribute to running being one of the fastest growing sports in Malaysia. Don’t allow injuries to be a spanner in the works. Keep in mind that moderation and maintenance is key.

Many runners, especially beginners tend to do too much too soon. They start running, and they see fitness gains and the feel-good factor shrouds them in an envelope of invicibility. They think that the more they run, the faster they go, the more benefits they reap. In a nutshell, overzealousness gets the better of them. Going over your limits consistently when your body is not yet conditioned for it, is a precursor to injury. Mileage and speed should be increased in a gradual progressive manner, by following a structured program. Rest is also an integral part of a proper running program, and rest does not mean cross-training or hitting the gym for strength training. Rest is pure and simple, rest. The body needs to recover from physical exertions, so although it may seem counter-intuitive, rest and recovery is just as important as that next training run.

Just like any sports car, your body requires physical maintenance to keep the muscles limber and flexible and ready for your next running session or race. We have all read about hydration and fueling in the previous article, but maintenance is not just about nutrition. Maintenance is also about body conditioning.

During and after workouts and exercise, the muscle fascia (tissue that binds and interconnects the muscles in the body) gradually become tight and develops knots that need to be stretched out or “released”. It is a condition that gradually builds up and because the tightness and pain is below the runner’s sensory threshold, they are not aware of it until its too late. When the tight muscle fascia starts affecting mobility, cause pain and soreness in the surrounding muscles, injuries happen and recovery takes longer. How is this situation to be addressed? By incorporating a regular conditioning program into marathon-training that involves foam rolling, trigger-point therapy and stretching.

Dynamic stretching before a run and static stretching after helps keep the muscles limber. Running contracts the major muscle groups and over a long run the muscles tighten up. Light stretching after a run helps to elongate the tight muscles and increases blood flow back into the working muscle groups. Some runners believe that a foam roller is a runner’s best friend. We at Team 2ndskin concur with that notion. Foam rolling all the major muscle groups involved in running like glutes, hamstrings, calves and quadriceps; and the “hotspots” like the Iliotial Band and Tensor Fascia Latae frequently and consistently (before and after runs) will help to release knotted and tight fascia tissue build up. For each muscle group, foam roll for about 15-20 repetitions and go on to the next muscle. If there is any soreness or tightness, use trigger point balls to concentrate on the nagging spot. Total time taken for foam rolling and trigger point should not take more than ten minutes a day, so there is actually no excuse not to incorporate it into your routine.

It is advisable to perform stretching and foam rolling everyday in the week leading up to marathon race day. Target the shoulders and upper back as well; due to stress and pre-race jitters in the build up to race day can create tension and tightness. As what we at Team 2ndskin say, “ten mins of rolling a day, keeps the doctor at bay.”