I thought for this blog update, I would take the opportunity to look into the mind of one of my most admired and experienced colleagues. An old friend of mine and an exceptional Physio, Jon Castle now resides in London. He holds the position of Department Head of Staff Occupational Health at King’s College Hospital, as well as being partner in Bespoke Physiotherapy, a highly regarded Physiotherapy Practice group, soon to be opening it’s doors in Covent Garden.
Recently when I was in London, Jon and I spoke about running injuries and the similarities and differences for our population and climate in each of our home towns. Here are Jon’s responses to the London side of the discussion.
What are the 2 most common running injuries you see in London and what is the main cause of each?
The most common running related injuries I see here in London would definitely be patello-femoral pain syndrome (runner’s knee) and Achilles tendinopathy.
Runner’s knee generally presents as pain at the front of the knee around or behind the kneecap. The most common cause of runner’s knee is poor biomechanics, which is to say poor alignment of the hip, knee and ankle/foot during running. Onset is generally associated with a sharp increase in the amount of running someone is doing.
Achilles Tendinopathy presents as pain around the Achilles tendon and or the back of the heel and once aggravated is often worse first thing in the morning and can be quite debilitating if not addressed properly. The main causes of Achilles tendinopathy in runners are poor running technique, a lack of support for the foot and ankle while running (i.e. the wrong running shoes), and once again, poor biomechanics. Functionally speaking, poor mechanics stems from a lack of adequate muscle control at the pelvis hip and knee. This is where Physiotherapy and specific rehabilitation is most useful.
What are the 2 biggest mistakes novice runners make that lead to injury?
The first is that most people go too hard too soon. New runners tend to get the running bug and they increase the distance and volume of running too quickly. The other big mistake is not factoring in sufficient recovery time. In real terms this means a lot of new runners do not have enough rest days, do little or no warm up, cool down or stretching exercises, and focus too much on running and not enough on cross training.
What is your advice for new runners, who have never run before?
I would say start slow and low. Start off running at a comfortable pace for relatively short distances. Avoid running on consecutive days initially and factor in enough time for warm up, cool down and stretching. When you do start to build things up, only change one factor at a time. Start by building up your distance and then work on your pace. Many running overuse injuries stem from people trying to increase speed and distance simultaneously.
What are your 3 favorite stretches for runners?
Obviously everyone is different and there is no set of exercises that will suit every runner. However, these are 3 of the exercises that I find are most useful to many runners. The most useful stretch that is under-used I think is the kneeling hip flexor stretch, which helps with pelvic and spinal posture during running, decreasing the risk of associated low back pain and facilitating greater activation of the gluteal muscles. My favourite strength/control exercise would be step ups/step downs. Doing these slowly in front of a mirror with correct technique and alignment really helps build single leg control, essential for all runners. Finally, an old favourite is rolling out the Ilio-tibial band with a foam roller. It’s not a very comfortable exercise but it’s much more effective than an ITB stretch and it helps prevent patello-femoral pain and ITB friction syndrome.
for more info, take a look at Jon’s website www.bespokephysiotherapy.co.uk
and find me at www.inclinicphysiotherapy.com.au
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