Knee pain and running

Very recently, there was an interesting article in The Guardian on ‘runners knee’ and knee pain.  The link is here.  The article contains some great information.  But we feel where is does fall short is not mentioning how critical it is for the landing hip to work (not just your gluts) and how essential it is for the foot to be able to sustain the mass of your landing.   With knee pain, sometimes the last place you need to look at is the knee.  So many other factors can affect the knee.

Knee pain is certainly not just about ‘pronation’ or the ‘rolling in’ of your foot.  If you have a high arched foot your knee takes more hit as you are unable to react to the ground well.  Sometimes people need to pronate more!  Gary Gray from the Gray Institute coined the phrase ‘Everything changes when your foot hits the floor’ and he is so correct!  You also need to assess what happens to the ‘back leg or trailing hip.  If your left hip does not extend fully – the knee of your right leg will have to work harder.

I think it is critical to appreciate that everything is connected in our bodies.  How one area not working may or may not increase the load onto another and make the body compensate.    Then knee is stuck between your hip and your foot.  It is more likely that one of these is not working well and the knee pain is only the symptom.

Then the rehabilitation must then target the areas that are not working, rather than just the symptomatic areas.

If you are concerned about your running or indeed are suffering, make an appointment to come and see one of our great osteopaths.

Blog post by James Dodd

Biomechanics of running….

Good paper here on the Biomechanics of Running.

Running is VERY different to walking and injuries for both need to be addressed differently.  it is critical to be assessed correctly.

The practitioner needs to look at you thoroughly and understand chain reaction biomechanics.

It could be how your back leg or hip is not extending as to why you have opposite foot pain…..  As always… get it looked at …properly…

Nutrition tips for marathon runners

RUNNING THE MARATHON? 

Here are some vital nutrition tips:

1.   STAY HYDRATED

It’s really important to be hydrated for the marathon. The trick is in the preparation. You don’t want to be making lots of toilet trips during the race! Drink plenty the week before and in the morning 700ml will do, avoiding any for the hour before the race.

Make sure you have water throughout the run, but don’t feel the need to drink constantly. The most recent research suggests it’s best to drink when you are thirsty. This helps avoid over-hydrating and can also reduce gut discomfort and improve performance on the day. Coconut water is also a great natural alternative to the energy drinks in replacing lost hydration, sugars and electrolytes during the race.

2.    FAT THEN CARB LOADING GIVES MORE ENERGY

Research has shown that a diet (short term) high in fat before you embark on the more traditional pre-race carb loading offers great benefits for increased energy. 10 days of fat loading are enough to increase the muscles fat burning capacity, while the three day carbohydrate load ensures muscles have plenty of glycogen available for energy.

In the fat loading days, start 2 weeks before the race and aim for 65% of your total calorie intake from foods containing healthy fats. These could be avocados, cheese, eggs, salmon, whole milk, Greek yoghurt, nuts, olives and olive oil. In the carb loading days, start 3 days before your race and aim to get 70% of your total calories from carbohydrates.

3.    DRINK BEETROOT JUICE

Beetroot juice is packed with dietary nitrates, which dilate blood vessels, increasing blood flow to muscles during exercise. Studies have shown that drinking 500ml of beetroot juice 2-3 hours before running can enhance performance. Try it on a couple of training runs before your marathon day and see if the red juice helps.

REMEMBER YOUR NUTRITION IS FUEL
Getting it right can really make the difference not only in performance, but your enjoyment of the day. Good luck and fuel smart.

Written by Stephanie Gammell M.Ost FAFS
Functional Osteopath at Back to Back – The Earlsfield Osteopath

SHIN PAIN IN RUNNERS EXPLAINED

Lower limb injuries in runners are all too common and unfortunately hard to predict.  With the ‘Virgin Money London Marathon’ not too far off, we wanted to share some Back to Back thoughts on shin pain. 

Lower leg pain can come on for unseasoned runners or those that change their training routine too quickly without laying suitable foundations.  This could be switching to lots of hill running or adding in more speed work.

One or more of THREE pathological processes are often involved in shin pain.

Shin Splints or Medial Tibial Stress Syndrome/Inflammatory shin pain

This is normally pain on the front or inside of your tibia/shin bone.  It can wax and wane, but normally decreases as you warm up.  The runner can often complete their training but it can recur after exercise and be painful the following morning.  If left untreated, it can become worse.

It is generally agreed that if you have shin splints, you should stop running or alter your training depending on its severity. Reduction of the inflammatory response is key and it may be helped by rest, stretching, ice and soft tissue work.

Medical Acupuncture in the right places appears to be pretty effective. Off load your shins with alternative training methods or running in a pool.  When you return to running, do it gently and follow the 10% rule. Don’t increase your speed or distance by more than 10% per week.

Bone Stress Response
Pain in the shinbone may be due to a stress response/stress fracture of your tibia.  This without doubt is more serious than ’shin splints’ and needs to be ruled out if pain persists.  This sort of pain can be increasing or pretty constant.  It is often worse on impact or after use.  There may be some night pain.  Pain is normally more localised or acute than ‘shin splints’.

Compartment Syndrome
The muscles in your lower leg are separated into compartments.  Causes are not fully known, but as your muscles swell during activity, they create increased pressure in these ‘closed compartments’.  Signs and symptoms are directly related to use and intensity.  It increases with exercise and decreases with rest. Soreness can be minimal and diffuse. There may be muscle weakness and sensory symptoms into the foot and toes.

Seeking help is important if you have pain, especially if it does not go away.  Making sure you see an appropriate practitioner with suitable qualifications to enable a correct diagnosis or referral is important.