Running injuries that crop up during marathon training are a real bummer! Here’s part two of our Q and A with physical therapy doctor Ben Shatto. In this episode you will hear about injury recurrence, plantar fasciitis, knee pain, ITBS and more. My favorite quote from this episode is, “Injury is never normal”.
[Part 2] Running Injuries Q and A
Disclaimer: This blog post and podcast are not meant to replace the advice of your doctor/health care provider, or speak to the condition of one particular person but rather give general advice.
Questions Featured in this Episode:
1. Is there any risk of damaging yourself if you continue to train hard while having PF (other than the pain progressing)? -Lee The short answer is YES. There is a significant risk. You don’t want to tear the plantar fascia. The surgery is a very long recovery. As the pain worsens, you are likely experiencing more and more micro tearing (which can eventually tear the plantar fascia completely and sideline you for a very long time). Recovery includes possibly a cast and/or a rigid walking boot. Based on the severity, weight bearing can also be completely limited. The longer you take to address this, the longer it will take to treat and heal. For more information, please refer to this page
. 2. I’ve recently changed my form from predominantly heel striking to a forefoot strike. Any input on whether changing form is ever a good idea, and if so, how to make that type of transition during training might be helpful. -Jon In general, there is no real reason to change running form unless there is a repeated injury or a significant issue with the technique that is likely to cause an injury. There isn’t any conclusive proof that a heel strike is better or worse than a mid foot strike or that a certain running method is better than another. Transition is always longer than expected. The older you are, then the harder on the body the transition can be. A fast transition would be 3 months, but it’s common to take a full year to fully adapt. The body needs time to adjust to the new stresses placed on it with the new technique so you have to rebuild a base. Be sure to work very hard on recovery during the transition to limit the risk of further aches, pains, and injury. 3. Feet! The ball of my left foot, but more medial and even to the top has bothered me for a couple years! If I back WAY off running, it’ll subside, but one run does me in! I don’t know if what I have is metatarsalgia or not, but it has given me the blues. Second, deep muscle tightness. I carry weight in my “backside” and thighs, and I have a hard time really working on knots with a stick or foam roller. I feel like I need a left leg transplant, from waist down!!!! It’s tight, knotted, twisted and pained…all the way to my toes! -Julie Fascia does not remodel easily. It takes 6-12 months of diligent work to remodel fascia. Don’t expect a quick fix, and don’t give up! Use your body weight and a harder ball, such as a softball, to self-mobilize areas with dense tissue.
May need assistance from a masseuse or body worker. For some, fatty tissue can have many knots and nodules. Don’t worry about them. They can be painful, but are not serious.
Look into a run/walk protocol to help increase running distance. Please refer to MTA’s fantastic interview with Jeff Galloway
. Work through the plantar fasciitis protocol (see links below). If you’re still aren’t experiencing any relief, ask for help. 4. I would love to hear what to do about metatarsalgia. I understand it is a normal injury for runners. -Judith Injury is never normal. This term is used for many different kinds of pain that is located in the ball of the foot. It could be a neuroma, a stress fracture, pain at the metatarsophalangeal joints, arthritis, and gout. Typically associated with overtraining and/or poor foot mechanics. Risk factors include: poor fitting shoes; high heel shoes; being female; being overweight; hard running surfaces; and tight Achilles tendon. Treatment is similar to plantar fasciitis in many case: (1) Begin foot intrinsic muscle strengthening (see linked article below). (2) Address footwear and/or possibly add an orthotic. (3) Shorten stride length and quicken cadence. (4) Look up the kinetic chain for possible imbalances. For more information, please refer to this article
. 8. What are some keys to injury prevention for masters’ runners? -Steve Be consistent with a recovery protocol. Warm up longer, and take more time for a cool down. Focus on body work by utilizing a foam roller or lacrosse ball or by working with a masseuse. Focus on strength training. Muscle mass slowly diminishes with age (particularly, Type II muscle fibers). Regular strength training is important. Focus on a clean lifestyle of proper eating and hydration. Supplement as needed (particularly with a quality glucosamine supplement like Mt. Capra CapraFlex). Work toward limiting inflammation with your food and supplement choices.
Also Mentioned in This Episode
The Runner’s Toolbox – free resource
to help combat injuries. Jabra’s February give-away. Be sure to sign up for their newsletter
in order to be entered in the drawing. Exercises for IT band, knees and feet
- One leg squat AKA pistol squat
- Reverse lunge with knee lift
- One leg balance with knee raise- 60 seconds/side
- Negative calf raise- heels hang down off step
Read and listen to Part 1 here
which focusses on glutes, hamstrings, muscle imbalances and more The post [Part 2] Running Injuries Q and A
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