The recreational runner….. with an injury…. why???
Runners are a funny lot, aren’t they? They freak out if they can’t run. They freak out even more when they have an injury! Yet 50% of runners will have an injury in any given year!
The story of “Kate”
This is the tale of a running patient we’ll call ‘Kate’ who had developed hip and groin pain with running. She was a relatively new runner who had been completely bitten by the running bug, and had progressed to doing way too much way too soon, and was wearing some of the consequences of that with a running injury.
Kate had already seen a chiro and another physio, an acupuncturist and a massage therapist, and was really sick of spending money and not getting better.
She had been told she had an adductor tendinitis, after an Xray and ultrasound.
Her hip pain had started a couple of weeks earlier when she was running at local running track.
This training run was an easy 7km one, but she had run 34km the day before, and 10km the day before that. She had been feeling sluggish, feeling burnt out for a few weeks.
Kate had started running regularly just 6 months previously, after needing to find something other than gym classes which were hurting her shoulders.
She started running 1-2 times each week, but within a month or so, she had been introduced to trail running as well.
Before the two month mark, she’d joined in with some new running buddies to do a 34km trail run adventure – her biggest run until then was 18km!
Kate loved running, loved discovering the trails, loved her new community of runners (because runners are awesome!). She was running 6 times per week and not doing any gym anymore (she didn’t have the time).
So what’s happening here?
A classic case to too much, too soon, without mixing up her training – such as doing a bit of bike riding, gym classes or swimming. This is called overload.
She then started training for the jewel in the Adelaide trail running calendar, the Yurrebilla Ultra Marathon, and was training 60-70km each week.
As the months strung together, with only “hard” weeks in the training schedule, there started to be some niggles. Funny hands after running wearing a hydration pack. Achilles soreness. Calf and knee soreness. Quads sore and tight after a run. These are all signs of overload. Your body’s way of saying ‘hey, will you change it up a bit please?!”
She was rotating her shoes well, but wasn’t sure if perhaps they were the best ones for her – trying to do the right things to look after herself and allow herself to still run with her friends on these trails. And then that big running weekend.
What happened when she came to Vital Core?
When Kate first came to Vital Core she was frustrated. She’d been looking for help for 4 weeks. She wanted it fixed “now”.
We started with education. Most running issues, especially tendon issues come from relative overload – doing more than your muscles or tendons are actually trained for.
Treatment is overwhelmingly geared to improving the load tolerance of the muscles/ tendons involved. Dry needling and muscle work (massage) can help reduce the short term pain and help you feel better, but we need to get the body stronger. Rest doesn’t cure it, but backing off the relative load and then getting to a point you can manage without overload is really important.
Kate’s groin injury meant that we needed to look at her total training and also at what was going on with her body around the area (back, glutes, groin, feet, abdominals).
We worked out that her hip was moving a bit oddly when she moved, indicating muscle tightness and weaknesses around the hip. She struggled to stand on one leg. The front of both hip joints felt swollen, indicating irritation. She stood with her tail tucked under, her knees locked back. The arches of her feet collapsed (worse on the dodgy right side), which affected her hip position. Her hip flexors were really overworked and tender, her glutes were not strong enough, her sacroiliac joint (back pelvic joint) was “cranky” with the funny forces around the joint from these muscles not coordinating well together and her left glutes were really tight and grabby, desperately trying to hold it all together. Whilst this may sound complicated it is a pretty typical pattern.
Treatment involved soft tissue work through her back and her hips.
Posture correction education was essential for Kate to be able to stand with her hips in the middle of their sockets instead of well forward in the socket, how to stand over her feet, and how to stand “on” her feet more squarely.
We explained how this overload has happened. Her muscles and tendons hadn’t had the time to strengthen up as she changed her exercise routine.
The warning signs had been there with her shifting aches and pains, and she had compensated everywhere she could, until she ran out of compensating options.
So what exercises was Kate given? Initially she was to work on exercises designed to improve her coordination and control around her hips and pelvis. There were stretches to help calm the grabbing muscles, and she needed to learn to stand more often in a square position.
Better shoes choices for non-running times were also important to reduce the load through the front of her hip.
Quickly her pain settled. A week later she wasn’t limping when she walked. She had no pain.
Kate did her exercises every day!!!!
Those that do their exercises exactly as prescribed and follow their treatment plan exactly as prescribed including all treatment sessions get better. They get better properly.
RunFit at Vital Core
RunFit is a term based course run over an eight week period. It is a progressive exercise and education course aimed to give you the tools to get your body strong for running. It doesn’t matter what distance you currently run. You may be just starting to get into it/ back into it/ recovering from injury or training for an event. RunFit is for all runners (that’s what we all call our selves).
What are your goals? What do you want to be able to do? What do you want out of this course? It is so much easier to remain focused when you have a working goal.
The one single most common issue we see in runners with injury is poor hip muscle strength and control. As a result a lot of what we will do in RunFit is get this area working properly. Weak glutes are responsible for a mired of injuries, from the obvious hip and back pain, to the less obvious Achllies (lower calf) and Plantar fasciopathy (arch pain) issues.
As well as the exercises in the class we also be send out weekly educational material via email and a scheduled home exercise program.
Please make an appointment for a RunFit Assessment and to secure your place.