Achilles tendon pain? Which type do you have?

Massage on runners calf and Achilles tendonIf you have suffered from Achilles pain in the back of the heel or calf you know how long it can last and how bad it can be. Understanding why you’re getting Achilles pain plays a big role on the road to recovery and prevention.  The pain is often due to Achilles tendinopathy and used to be called Achilles tendinitis; “itis” means inflammation and we now no longer believe that it involves inflammation so we don’t use that term anymore.  Either way, Achilles tendinopathy is one of the most common runners’ injuries that I see at Sundial Clinics here in Brighton. In this series of articles you will learn some of the ways in which you can avoid, treat and manage this common and troubling tendon pain. 

Types of Achilles tendinopathy?

First off, it is important to establish exactly what is causing the problem and exactly what type of Achilles pain you have.  There can be several other reasons why you may be getting Achilles symptoms, but for the purpose of this article, we will concentrate on the most common.

Recent studies have shown that injury rates are as much as 29-58% in new runners. It’s also estimated that 60-70% of running injuries are due to overuse or training error.

In other words, don’t just concentrate on the painful point!  Rehabilitation from an injury can be complicated and unless you’re addressing the root cause of the problem, it’s likely to come back!  This is why seeing a physio can be useful: we can help you to understand the reasons for your symptoms and help you address the imbalance and weakness which may lead to injury.  

 

Diagram of Achilles tendinopathy, tendinitis

Mid Portion Achilles Tendinopathy

The most common cause of Achilles pain is mid-portion Achilles tendinopathy. This commonly affects the Achilles 2-7cm above the bony point at the back of the heel.  Typically, this is likely to appear swollen, be tender to touch and will often cause pain and stiffness first thing in the morning and when weight-bearing.

Insertional Achilles Tendinopathy

This condition is less common but still a prevalent problem that I see in the clinic.  The key difference between the two is that mid-portion tendinopathies are commonly caused by tensile loading and insertional tendinopathies are caused by compression.  

The main presentation for the insertional kind is a pain at the heel bone where the Achilles attaches and pain with the ankle flexed to stretch the tendon i.e. the position of the foot when walking up a steep hill.  This position of the foot is what causes the compression and aggravates the symptoms – and why exercises that exacerbate this should be avoided!

Below I will outline the best way to manage these conditions, along with links to some self-help videos for exercise and pain management.  However, it’s probably worth mentioning at this stage that these are only to be used as a rough guide and if you are unsure about your condition please book yourself in for a physio consultation.  The first appointment is free! And it may help you avoid getting it wrong and potentially delaying your healing time.

Tendinopathy Phases

Now that you have a rough idea of why you have tendinopathy, you now need to figure out what stage of tendinopathy you are dealing with.  To avoid going full physio geek on you, we’ll keep this simple and concentrate on two phases of tendinopathy, the first being the reactive type and the second being the degenerative tendinopathy. 

Phase One – Reactive Tendinopathy

Commonly caused by an increase in loading exercise, for example trying to run faster or further than you’ve ever done before…we’ve all done it!  This will typically cause pain during or after the activity and may be exacerbated first thing in the morning or during weight-bearing activity.  

The key to your management at this stage is to reduce the load that you’re putting through your Achilles and try and calm the symptoms down.  It’s pretty simple: if you carry on doing the same thing at the same pace and effort then you are likely to make it worse!

Phase Two – Degenerative Tendinopathy

At the tender age of 41 and having played sports for most of my life, sadly I would fit into this category.  In fact, I would say it is almost normal to have a degenerative tendon somewhere in your body if you’ve been active for most of your life, especially with high impact sports such as running, football, netball and basketball. So do not fear – this is common!  

Basically, if you’re older and have a previous history of Achilles pain and a grumbly tendon that is prone to flare-ups, it’s likely that you will also fit into this category.  The typical presentation is a thickened tendon, which is painful to touch and is often sore first thing in the morning and during weight-bearing activity. Again, load management is important. If you keep aggravating it, there is potential to make the situation chronic and potentially lead to a partial or full Achilles rupture.

It is also possible to have a reactive, degenerative tendon.  An example of this would be a 60-year-old man who has a history of Achilles pain with symptoms which have been under control for several years, but a recent increase in tennis has caused his degenerative tendon to become reactive.  If this is the case with you, then start your management at the reactive phase i.e. reduce the load, pain management, rehab exercises then graded return to activity.  Tendons are complicated and there is no one recipe for treatment. Finding the right treatment is an important part of your recovery.

Now that we have the geeky part out of the way, let’s look at treatment. Part Two to follow soon covers the treatment for both the mid-portion and insertional Achilles tendinopathy.

James Masterson
Physiotherapist

 

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Recent Posts on Sports Injuries …

  • Achilles tendon pain? Which type do you have? 4th December 2019 Achilles tendon pain? Which type do you have?
  • Brighton half marathon recovery tips: how to manage an acute injury 18th November 2019 Brighton half marathon recovery tips: how to manage an acute injury
  • Brighton Half Marathon runners’ offer 27th February 2019 After running the Brighton Half Marathon on Sunday you may still be getting muscle soreness or other aches and pains. Simple muscle soreness will get better over the next few days and massage can help speed this up. If you have a more persistent or painful niggle then you probably want to know whats wrong ...
  • How to manage an acute injury yourself 29th February 2016 “As a physiotherapist this is a question I get asked a lot and having just completed the Brighton Half Marathon you may be asking the yourself the same question.” says Sundial physio James Masterson.  He goes on to say “So in order to help you with your post run recovery here’s a few useful tips to ease you back ...
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  • Runners MOT – Brighton Half Marathon 30th November 2015 Running injuries often start with a niggle. Knee pain, muscle strain, tendon pulls, bursitis, ligament sprains and all sorts of other aches and pains are a constant reminder that marathon training and actually running it can be a hazardous business. Many people who enter for the Vitality Brighton Half Marathon will not complete it because ...
  • Do I need orthotics for running? 4th December 2014 Why would I need orthotics? Although running shoe design and technology has progressed leaps and bounds over recent years, there are certain foot types that will require more support, explains James Masterson, physio here at Sundial, Brighton.  However not everyone will benefit from orthotics and it’s important to gain professional advice before deciding on whether an orthotic is ...
  • Running shoes – top tips for the marathon season from Brighton physio 27th November 2014 If like me you’re considering starting your preparation for the up and coming marathon season then take a look at my top tips for staying injury free and completing the 26.2 miles with a smile on your face says James Masterson,  a physiotherapist here at Sundial, Brighton. Which running shoe shall I buy? Inappropriate footwear is the root ...
  • Is your spine slowing down your running? 26th February 2014 If back or hip pain is hindering your running performance and fitness goals then here are some facts to help put a spring back in your step writes Brighton chiropractor Amy Pease. Staying fit helps to prevent aches and pains, however various factors come in to play when pounding the pavements that could put you ...
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Brighton half marathon recovery tips: how to manage an acute injury

knee-examination-brighton-physioAs a physiotherapist, I get asked how to manage an acute running injury a lot and having just completed training session or race itself you may be asking yourself the same question.  So in order to help you with your post-run recovery here are a few useful tips to ease you back to fitness and training for your next race.

Physiotherapists love an acronym and what used to be known as RICE or PRICE is now often referred to in the industry as POLICE.  With each letter relating to a useful management strategy, this acronym can be a helpful tool in guiding anyone suffering from an acute injury.

Protection:  Depending on the severity of your injury you may want to use a brace, tapping or in more extreme circumstances casts and crutches, this will help to prevent excessive movement and protect the site of injury.

Optimal Loading:  The key part to remember here is OPTIMAL, the right amount of loading will help stimulate the healing process of a muscle, tendon, ligament and bone. This could be any type of activity such as standing, walking or swimming, however in more serious injuries such as fractures or full tendon ruptures the OPTIMAL load might be no loading and may require casting, crutches or surgical intervention.runners-start-vitality-brighton-half-marathon-sm

Ice:  Applying ice during the initial stages of an acute injury can be beneficial for reducing both pain and swelling.  Although medical professionals have been recommending ice for several years the evidence is far from conclusive.  I usually advise my patients to wrap an ice pack in a flannel or thin towel and apply directly on the site of pain for 15 minutes 3 to 4 times daily within the first 72 hours of injury.

Compression:  Similar to ice compression can be used for managing swelling, applying a simple tubigrip or neoprene strap can help to compress the injury site.  The applied compression should be tight but comfortable with good circulation above and below the strapping, I often ask patients to remove the compression for short periods throughout the day and take the strapping of at night to allow the skin time to breath.

Elevation:  Can also be very useful in reducing swelling.  For example, if you’ve acutely sprained your ankle lying on your back with your leg raised and supported can reduce the amount of blood rushing to the affected area.  With this specific injury you may wish to do a few ankle pumps to improve the blood flow and help with the healing process.

At this point, it is probably worth mentioning that I recommend anyone to seek medical advice if you are unsure about an injury.  Although the POLICE protocol is a useful tool for managing an acute injury it is not a one size fits all strategy!!  If you are having difficulty weight-bearing or have symptoms such as bony tenderness, considerable swelling, loss of range of movement or the feeling of instability in a joint then I recommend seeing a medical professional ASAP.

James
Sundial’s Physiotherapist

Sundial is a partner for the Brighton Half Marathon on 23rd February 2020 providing clinical care and advice for sports injuries for the runners. If you have any niggles then give us a call and our physio’s, chiropractors and massage therapists can see you quickly. Sundial Clinics offers a free 20 minute physiotherapy assessment to anyone who would like advice about an injury, this session is a great way to get some useful tips on how best to manage your injury and to see if physiotherapy is right for you. Call for a free Runners MOT

Recent Posts on Sports Injuries …

  • Achilles tendon pain? Which type do you have? 4th December 2019 Achilles tendon pain? Which type do you have?
  • Brighton half marathon recovery tips: how to manage an acute injury 18th November 2019 Brighton half marathon recovery tips: how to manage an acute injury
  • Brighton Half Marathon runners’ offer 27th February 2019 After running the Brighton Half Marathon on Sunday you may still be getting muscle soreness or other aches and pains. Simple muscle soreness will get better over the next few days and massage can help speed this up. If you have a more persistent or painful niggle then you probably want to know whats wrong ...
  • How to manage an acute injury yourself 29th February 2016 “As a physiotherapist this is a question I get asked a lot and having just completed the Brighton Half Marathon you may be asking the yourself the same question.” says Sundial physio James Masterson.  He goes on to say “So in order to help you with your post run recovery here’s a few useful tips to ease you back ...
  • Great stretches for running 10th February 2016 Stretching may help reduce injury and improve flexibility in runners. Most runners include stretches in their routine. It is important to prepare your muscles for a run by gently warming up and keep flexible by doing these stretches. These exercises put together by our physio can help stretch the main running muscles. These stretches should be ...
  • Runners MOT – Brighton Half Marathon 30th November 2015 Running injuries often start with a niggle. Knee pain, muscle strain, tendon pulls, bursitis, ligament sprains and all sorts of other aches and pains are a constant reminder that marathon training and actually running it can be a hazardous business. Many people who enter for the Vitality Brighton Half Marathon will not complete it because ...
  • Do I need orthotics for running? 4th December 2014 Why would I need orthotics? Although running shoe design and technology has progressed leaps and bounds over recent years, there are certain foot types that will require more support, explains James Masterson, physio here at Sundial, Brighton.  However not everyone will benefit from orthotics and it’s important to gain professional advice before deciding on whether an orthotic is ...
  • Running shoes – top tips for the marathon season from Brighton physio 27th November 2014 If like me you’re considering starting your preparation for the up and coming marathon season then take a look at my top tips for staying injury free and completing the 26.2 miles with a smile on your face says James Masterson,  a physiotherapist here at Sundial, Brighton. Which running shoe shall I buy? Inappropriate footwear is the root ...
  • Is your spine slowing down your running? 26th February 2014 If back or hip pain is hindering your running performance and fitness goals then here are some facts to help put a spring back in your step writes Brighton chiropractor Amy Pease. Staying fit helps to prevent aches and pains, however various factors come in to play when pounding the pavements that could put you ...
  • The 7 R’s – Brighton Marathon Training Tips 5th February 2014 The Brighton Marathon is the highlight of our sporting calendar. We have supported Brighton runners and their charities for many years but we have noticed that many people are not getting the support and advice they need to complete the marathon injury free. One in five people who enter the marathon will not complete it ...

Brighton Half Marathon runners’ offer

After running the Brighton Half Marathon on Sunday you may still be getting muscle soreness or other aches and pains. Simple muscle soreness will get better over the next few days and massage can help speed this up. If you have a more persistent or painful niggle then you probably want to know whats wrong and what to do about it.

We understand how annoying aches and pains can affect your running and can even stop you doing what you love. You don’t have to put up with it.

We’ll give you 50% off your next physio or massage session here at Sundial for all Brighton Half Marathon runners.

  1. Book an appointment for a massage or physio session
  2. Get a customised treatment plan based on our review
  3. Take the first step towards pain free running

50% off your next physio or massage session – Book now

Download Top Tips to Beat Running injuries pdf

We have treated thousands of runners over many years and have been the clinic partner for the Brighton Half Marathon for the last four years.
Achilles tendon massageOur patients say:
A sequence of physiotherapy and home exercises continued over the next few weeks and gradually the condition improved until it completely cleared.
Lee Ashton

He tried various techniques with me to find exactly what worked for me. We tried different physio exercises to build up the strength in my knees and the pain has reduced massively. I am really grateful for his help, and the lovely team at Sundial who are always welcoming and kind.
Charlotte S

50% off your next physio or massage session – Book now

How to manage an acute injury yourself

Runners knee pain“As a physiotherapist this is a question I get asked a lot and having just completed the Brighton Half Marathon you may be asking the yourself the same question.” says Sundial physio James Masterson.  He goes on to say “So in order to help you with your post run recovery here’s a few useful tips to ease you back to fitness and potentially your next race.”

Physiotherapists love an acronym and what used to be known as RICE or PRICE is now often  referred to in the industry as POLICE.  With each letter relating to a useful management strategy this acronym can be a helpful tool in guiding anyone suffering from an acute injury.

 Protection

Depending on the severity of your injury you may want to use a brace, tapping or in more extreme circumstances casts and crutches, this will help to prevent excessive movement and protect the site of injury.

 Optimal Loading

The key part to remember here is OPTIMAL, the right amount of loading will help stimulate the healing process of a muscle, tendon, ligament and bone. This could be any type of activity such as standing, walking or swimming, however in more serious injuries such as fractures or full tendon ruptures the OPTIMAL load might be no loading and may require casting, crutches or surgical intervention

 Ice

Applying ice during the initial stages of an acute injury can be beneficial for reducing both pain and swelling.  Although medical professionals have been recommending ice for several years the evidence is far from conclusive.  I usually advise my patients to wrap an ice pack in a flannel or thin towel and apply directly on the site of pain for 15 minutes 3 to 4 times daily within the first 72 hours of injury.

 Compression

Similar to ice compression can be used for managing swelling, applying a simple tubigrip or neoprene strap can help to compress the injury site.  The applied compression should be tight but comfortable with good circulation above and below the strapping, I often ask patients to remove the compression for short periods throughout the day and take the strapping of at night to allow the skin time to breath.

Elevation

Can also be very useful in reducing swelling.  For example, if you’ve acutely sprained your ankle lying on your back with your leg raised and supported can reduce the amount of blood rushing to the effected area.  With this specific injury you may wish to do a few ankle pumps to improve the blood flow and help with the healing process.

 At this point it is probably worth mentioning that I recommend anyone to seek medical advice if you are unsure about an injury.  Although the POLICE protocol is a useful tool for managing an acute injury it is not a one size fits all strategy!!  If you are having difficulty weight bearing or have symptoms such as bony tenderness, considerable swelling, loss of range of movement or the feeling of instability in a joint then I recommend seeing a medical professional ASAP.

Sundial Clinics offers a free 20 minute physiotherapy assessment to anyone who would like advice about an injury, this session is a great way to get some useful tips on how best to manage your injury and to see if physiotherapy is right for you.  Why not call the clinic today to arrange a free informal consultation and stop that niggle turning into a pain!

Great stretches for running

Stretching may help reduce injury and improve flexibility in runners. Most runners include stretches in their routine. It is important to prepare your muscles for a run by gently warming up and keep flexible by doing these stretches. These exercises put together by our physio can help stretch the main running muscles.

These stretches should be held for over 30 seconds – don’t rush. Aim to do these exercises once a day although doing them twice a day is three times as beneficial. Stay relaxed and breathe out as you develop the stretch. Develop the stretches gently to avoid overstretching and injuring yourself.

The 3 stretches we recommend for running are: hamstring, hip flexor and calf and here is how to do these.

You can download the stretches for running for free here VBHM stretches

Hamstring stretch

Dynamic hamstring stretch

Sets three each side

Hold 30 to 60 seconds

  • straighten one leg, grabbed the back of your thigh and target your leg towards your chest until you feel a gentle stretch.
  • Bend your leg at the knee slightly coming off the stretch
  • repeat by pushing your heel towards the ceiling
  • alternate your legs

Note: avoid kicking violently or arching your lower back

If it’s shaking your doing it well!

Hip flexor stretch

Hip flexor stretch

Sets three each side

Hold 30 to 60 seconds

  • hands on hips, tuck your tailbone under to flat on your back
  • lean forwards while maintaining a straight posture and keeping your head up
  • avoid arching your low back or letting your hips roll forwards

Note: do it next to a wall if you feel out of balance

Calf stretch

Sets three each sideCalf stretch

Hold 30 to 60 seconds

  • have front toes and knee touching the wall
  • move your foot back a little until you can just about keep your knee against the wall and heel on the floor
  • hold
  • Move the back foot away from the wall to feel a stretch
  • keep back heel on the ground and knee straight as possible
  • hold
  • swap legs

In partnership with the Vitality Brighton Half Marathon

VBHM logo

Runners MOT – Brighton Half Marathon

physio or chiropractic for PFS in BrightonRunning injuries often start with a niggle. Knee pain, muscle strain, tendon pulls, bursitis, ligament sprains and all sorts of other aches and pains are a constant reminder that marathon training and actually running it can be a hazardous business. Many people who enter for the Vitality Brighton Half Marathon will not complete it because of injury. We aim make sure you are not one of them.

For the next few weeks we are offering a free Runners MOT especially aimed at runners in the Vitality Brighton Marathon. We want you to be fit, strong and ready to run in support of the Sussex Beacon.

Our physios will check you out top to bottom concentrating on your footwear and leg and foot movements. We will check all the usual things like over-pronation but also things that often over-looked like jamming of the hinge joint of the ankle which changes stride length. We will look at knees, hips and backs too. At the end of our Runners MOT you will have an in depth risk profile of the likelihood of future running injuries and a plan for prevention. If you are having problems currently then we will give you a plan for the best recovery.

So don’t let a niggle turn into a pain, call to make an appointment.

VBHM logo

 

 

 

 

Do I need orthotics for running?

Orthtoics for Runners KneeWhy would I need orthotics?

Although running shoe design and technology has progressed leaps and bounds over recent years, there are certain foot types that will require more support, explains James Masterson, physio here at Sundial, Brighton.  However not everyone will benefit from orthotics and it’s important to gain professional advice before deciding on whether an orthotic is right for you.  A full biomechanical assessment from a physiotherapist or chiropractor can help determine whether the underlying root of the problem stems from your feet and whether or not an orthotic is appropriate for your foot type.

Orthotics can help running and are designed to optimize the alignment of the lower limb, which can improve shock absorption in the lower extremity and realign joints from the foot all the way through the kinetic chain to the spine, preventing problems foot, knee or hip.  The main role of an orthotic is to restore a neutral alignment which will in turn reduce the stress carried throughout the body during weight bearing activities.  This is particularly important during running as (hopefully!) the feet are the only part of your body in constant contact with the ground.

An orthotic can either be an off the peg prefabricated orthotic, with a selection made to fit most general foot types, or a custom made orthotic, normally constructed by a podiatrist which is made specifically for the individual. The off the peg orthotics work well for most people and are considerably cheaper. We sell Superfeet orthotics at Sundial.

Another important factor worth considering with orthotics is that most people change their shoes several times throughout the day.  Although your running shoe will provide you with support whilst you’re wearing them, it’s likely that you will spend more time out of these shoes than in them.  This can potentially lead to overuse injuries during regular every day activities, especially if your profession requires you to spend large amounts of time on your feet.  This is another way in which an orthotic can be useful as it can often be taken from one shoe and placed in another.  However orthotics aren’t your only option and if possible should only be used as a short term solution, please see my future posts on physiotherapy exercises to improve overpronation.

The three basic foot types:

Firstly, it should be noted that pronation is a natural movement of the foot’s mechanics.  It occurs at the joint below the ankle called the subtalar joint and this movement allows the foot to roll in slightly during the stance phase of gait and helps the lower limb deal with shock.  Although this process is not necessarily detrimental to your body it can affect your running style and possibly lead to injury.

 Neutral foot:Over pronation, Brighton physio

This means that you’re a neutral pronator, meaning your foot rolls in slightly and you push off evenly through the front of the foot.  Sometimes you can tell if someone is a neutral runner by looking at the sole of their shoe, running from the heel to the big toe along the outer surface there will often be signs of S-shaped wear and tear.

Underpronator:

Underpronation, or supination as it is often referred to, is when the outer surface of your foot hits the ground at an increased angle causing minimal or no natural pronation.  Again this leads to access shock throughout the lower limb and can be potentially damaging to your body when running.

Overpronator:

There is significantly more inward rolling of the foot meaning more weight is transferred to the inner surface of the foot late in the stance phase.  This causes instability and leads to compensatory movement patterns throughout the kinetic chain, potentially leading to injury throughout the lower limb and within the spine.

If you have any queries or want more help then book in for a free Runner’s MOT

 

Happy running.

Running shoes – top tips for the marathon season from Brighton physio

Choosing running shoe, Brighton physioIf like me you’re considering starting your preparation for the up and coming marathon season then take a look at my top tips for staying injury free and completing the 26.2 miles with a smile on your face says James Masterson,  a physiotherapist here at Sundial, Brighton.

Which running shoe shall I buy?

Inappropriate footwear is the root of all evil when it comes to running.  Before embarking on the long and tedious road to the finish line every runner should start with their feet.  Visiting your local running shop for a gait analysis is a good place to begin. As well as being advised on the most appropriate running shoe for your foot type it’s also an opportunity to view yourself in action.  Video analysis taken during these consultations will allow you to look at your lower limb alignment whilst you’re walking and running, giving you a good idea of movement patterns which could potentially lead to overuse injury.

 Top 5 running injuries caused by over use and inappropriate footwear:

1. Plantar fasciitis

2. Achilles tendinitis

3. Medial tibial stress syndrome (aka shin splints)

4. Patellofemoral pain syndrome (aka Runners knee)

5. Iliotibial band syndrome

When it comes to purchasing your shoe it’s likely that you will come across the below terms. Remember it’s not all about what foot type you are!  Take the time to get a feel for the shoe, being able to stand, jump, walk and run before handing over your cash is a great way to find out if the shoe works for you and reduce the risk of injury later in your training.

Useful tips for purchasing your running shoe:

  • Try having a foot analysis in the late afternoon/evening as your feet swell as the day goes on and may give you a false feel when purchasing your running shoes in the morning.
  • Pick a shoe that matches the contour of your arch, you won’t be able to feel this by just standing in them so always make sure you take them for a spin before handing over your cash.
  • Try and have your feet measured before trying on your shoe, this will give the running shoe assistant an idea of the size and width of your foot.  Different brands suit different foot types and not all shoes will equal in size, for example, Nike shoes tend to be good for wider feet and Adidas tend to be better for a narrow foot type.
  • Don’t buy your shoes too small, the fabric will loosen as time goes on but generally if a shoe has hot spots that aggravate your feet whilst trying them out in the shop then it’s likely this will occur during your training.  Remember! Tight shoes equal blisters and potential toenail damage, this will limit the amount you’ll be able to train and will also look horrendous in a pair of flip flops.
  • Lace your shoe up from the bottom up, not just at the top two eyelets!  This allows you to support the shoe around your foot equally and avoids excess movement.  Your heel should fit snug within the shoe and your toes need to have some wriggle room at the front.  A good test for this is to see if you can still scrunch up your toes whilst the shoe is fully laced up.
  • Change your shoes according to your individual usage, most manufactures will recommend that you change your shoe roughly every 300 – 500 miles but this is dependent on so many factors, for example a person’s weight, gait mechanics and running terrain will all play a massive factor in your choice to change your shoes.  Let’s be honest running shoes are expensive, so my advice is look for signs of wear and tear and as soon as the natural cushioning of the shoe starts to depreciate this is probably a good time to start looking for your new runners.

If you have any queries or want more help then book in for a free Runner’s MOT.

Happy running.

Next: Do I need orthotics?

 

 

Is your spine slowing down your running?

photoIf back or hip pain is hindering your running performance and fitness goals then here are some facts to help put a spring back in your step writes Brighton chiropractor Amy Pease. Staying fit helps to prevent aches and pains, however various factors come in to play when pounding the pavements that could put you more at risk of injury. Pain in the low back or hips can arise from inflamed muscles, ligaments, nerves, discs or spinal joints. Injuries can range from mild muscle strains to more serious conditions such as a disc herniation; a chiropractor will be able to tell you the cause of any discomfort with an examination.

Injuries occur because of underlying dysfunction

When you run, 2-3 times your own body weight is transferred from your feet into your ankles, knees, hips, pelvis and spine every time your feet strike the ground. This process should not be painful when repeated regularly providing you have a good running posture and healthy function in your joints and muscles. However underlying muscle imbalances and stiff or unstable joints could eventually cause problems; this may not be noticeable until you increase your mileage or training frequency. For more information on two common muscle imbalances below.

3 Top Running Tips…

  1. Build up your mileage slowly – this gives your muscles, ligaments and joints time to adapt and build endurance to the increased workload, reducing your chances of injury.
  2. Strengthen your hips and core – weakness in these areas are often associated with a poor running posture and back pain. Strengthening these areas will help to stabilise your back and pelvis protecting your spine. The chiropractors and physiotherapists at our clinic can give personal advice on what exercises you should be doing. Alternatively Pilates or yoga may be useful.
  3. Get your shoes fitted by a professional – unstable arches or over-pronation when running often need rebalancing with a suitable trainer and/or a foot orthotic (a specialised insole). Trained staff at a running store should be able to advise you on choosing the right shoe. Additionally at Sundial we fit Superfeet orthotics.

If you think the topics raised in this article may apply to you, give us a call to make an appointment.

Weak hip abductors, unstable pelvis
Weak hip abductors, unstable pelvis

 

When you think about it, running is simply an uninterrupted series of jumps from one leg to the other. The hip abductors are an important group of muscles that stabilise the pelvis when standing on one leg.  So when one or more of the hip abductors are weak (usually the Gluteus Medius) the pelvis will drop on one side. This drop places increased forces through your low back and pelvis often causing stiffness or discomfort.  A recent study on 300 people found that people with low back pain had significantly weaker hip abductor muscles than those without. It is also common for the hip abductors to weaken after an ankle sprain on that side.

 

 

Weak abdominals, tight hip flexors
Weak abdominals, tight hip flexors

 

Weak abdominal muscles allow the pelvis to tilt forward; this overloads the joints in your low back often causing stiffness or discomfort. To compensate for this weakness your hip flexors will work harder. Interestingly the main hip flexor (Iliopsoas) connects to your spine and pelvis, and can be the root cause of low back pain when aggravated. Your deep abdominals (obliques and transverse abdominus) along with your back muscles work together like a brace to protect your spine when performing bending or twisting movements, learning how to control these muscles is essential to a healthy back.

Amy Pease
Chiropractor

The 7 R’s – Brighton Marathon Training Tips

Jewel runs Brighton Marathon
Jewel runs Brighton Marathon

The Brighton Marathon is the highlight of our sporting calendar. We have supported Brighton runners and their charities for many years but we have noticed that many people are not getting the support and advice they need to complete the marathon injury free. One in five people who enter the marathon will not complete it because of injury. We aim to make sure you are not one of them!

Pre-Training/Training Tips

Before you begin marathon training, you should be able to run for at least 30 minutes without stopping. Distance is not important right now. You just need to get your body used to running.
Combinations of runs/walks are great to use during pre-training because they ease your body into the exercise and minimize the chance of experiencing a running injury. Follow a set schedule or rota of training leading up to the event, so that you can set yourself small goals to work towards on a weekly basis.

Recovery Tips

Take recovery days equally as serious as your running days.
You should not run every day as your body needs to rest between runs, so it can recover from one run to the next, getting stronger between each run.
Use your non-running days to rehabilitate and to refuel with the right foods.  Ice any soreness, particularly in your knees or shins, four times per day for 15-20 minutes.  Stretch all the muscle groups in your legs, spine and upper body as you use them all!

Injury prevention

Never run through an injury, get it checked out by a professional!  Most of us are aware to use the RICE (rest, ice, compression and elevation) principle if we sustain an acute injury such as an ankle sprain or shin splints but there are other, less acute pains to be aware of, that may turn from a niggle into a strain.
Wear the correct footwear.  Your trainers should be no more than 6 months old or have been subjected to 500 miles of running.  Older shoes lose shock absorbing ability and increase the risk of injury. Check the soles of your trainers for abnormal wear as this could indicate a biomechanical problem elsewhere.  When choosing new running shoes go to a running shop staffed by experienced runners who can advise you on the correct shoes for your foot and running style.

The 7 R’s for marathon training

Run for 30 minutes before starting specific training
Rota – set up a schedule of training with goals
Rest is important because your body builds muscle, strength and stamina in this recovery phase
Refuel – improve your diet with our video program to get the right building blocks for recovery
Rehabilitate – stretch all over and ice any injury
Replace worn out running shoes
Runners MOT – this free check up is available to all Brighton Marathon runners – don’t let a niggle turn into a pain
Our physios and chiropractors support Brighton marathon runners with the offer of our Runners MOT at either of our Brighton clinics.  So if you have an injury or just a niggle, call and get it checked out!