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Running and the Marathon
Unfortunately we are
not all built for running, but many
people still run despite their
physique.
Success in all exercise depends on
training and training correctly and
running is no exception. So even
those with the wrong sort of frame
for running can run, provided they
train well.
The Perfect Runners Warm up
Runners are often guilty of skimping
on their warm up and tend to dive
straight into a vigorous run, which
is like starting your car in 4th
gear—inefficient, difficult and
potentially damaging.
A warm up has a number of functions,
it raises body temperature,
increases heart rate and mobilises
the joints, making running an easier
and more comfortable task. While the
main beneficiary of a warm up is for
the body, the mind can also benefit.
You can use the time to think over
what you are going to do at each
part of your running session, to
ensure you run through your goals.
Even though running is predominantly
a lower body activity, you don’t
want to start running with stiffness
or tension in other areas. Begin by
gently mobilising the major joints
of the body—the neck, shoulders,
waist, hips, knees and ankle.
Movements should be gentle and
smooth, controlled circling, bending
and extending. Take a walk and
gradually increase your speed and
range until you break in to a light
jog. Warm up the hamstrings by
putting them through a full range of
movement swing with no impact. Stand
side on to a support and with your
knee bent, lift the leg to hip
height, and swing it up, down and
back in a circular motion, the leg
almost fully extended at the end of
the back swing. Do 10-20 on each
leg, increasing the range and speed
with each one but maintaining
control throughout. If you suffer
from knee problems, ‘prone kicks’
are a good warm up exercise as they
put your knee joints through the
full range of motion without the
impact of running. Lie face
down—head resting on your folded
arms and tummy gently pulled in.
Bring one foot up towards the bottom
and then back to the floor, then do
the same with the other leg. Start
slowly and gradually build up speed
kicking for 2 minutes or counting
120 kicks. It’s important to not let
the pelvis ‘rock’ during this
exercise. Finish off with some
‘short runs’ (about 25m) in which
you accelerate from a slow start to
a brisk pace.
After these exercises you should be
feeling warmer, have an increased
heart rate, be slightly out of
breath and Ready to Run.
Running Styles
Most runners simply ‘go out and
run’, without devoting any time to
developing or refining their
technique. The majority run with a
heel-toe running pattern – landing
on their heel and rolling forward to
push off from the ball of the foot.
This uses the normal heel and ankle
“rocker” to develop forward
propulsion, just as we do when we
walk. Recent running and triathlon
publications have highlighted the
development of the Pose method of
running.
In Pose running the runner maintains
a single pose or position, moving
continually forwards in this
position. It uses gravity as the
major propulsive force, letting
other forces assist it. The
objective is to redirect gravity’s
downward movement into forward
motion. As the body falls forward of
the stance foot, support is changed
from one leg to the other by pulling
the foot from the ground using the
hamstring muscles. This is in clear
contrast to the heel-toe running
style, which uses the quadriceps,
gluteal and calf muscles to push the
body forward.
The initial heel contact of a
regular running style is forward of
the body’s centre of mass, and
applies a ‘braking’ force to forward
momentum. This results in more
jarring through the joints of the
ankle, knee, hip and lower back, and
also requires the runner to use more
muscle energy to maintain forward
movement. The Pose runner lands on
the mid-foot rather than the heel,
with the supporting joints flexed at
impact and positioned underneath the
body’s centre of mass. This results
in less opposition to forward
momentum, as well as less jarring of
the joints, and less energy
expenditure.
Pose Runners supposedly experience
fewer injuries. However, learning to
run correctly in the Pose method
requires formal coaching, with a lot
of attention to developing and
maintaining correct technique.
Progression of the running style
also incorporates numerous strength
and conditioning drills, as well as
exercises for proprioception and
control of the pelvis and lower
limb. Heel-toe runners would
undoubtedly also see benefits in
performance and injury prevention if
they too paid similar attention to
running technique and
musculoskeletal conditioning.
Should I drink sports drinks
after exercise and if so how much?
Sweating is needed to maintain body
temperature but unless fluid intake
keeps pace with sweat loss
dehydration can occur. If dehydrated
by only 2% of your body weight,
exercise performance can be reduced
by 20-30%. Fluid loss over 3%
increases risk of heat cramps
exhaustion or heatstroke.
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Before Exercise: You
should drink 500ml 2-3 hours before
and another 200ml 15mins before
exercise. Sports drinks are useful
if carbohydrate intake has been low
or a long gap since the last meal.
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During Exercise:
200ml every 20mins.
Post exercise: Replace fluid and
sodium loss within next 2 hours.
Sports drinks should contain high
levels of carbohydrate to help
replace glycogen stores and sodium
to help conserve water (i.e. an
isotonic drink)
Specific Marathon
Instructions
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HYDRATION: is the
most important factor! If you’re new
at drinking on the move, then stop
to ensure you drink a whole cupful
at every drinking station. Even if
you’re not feeling thirsty drink at
every station. Your body controls
its temperature from the inside out.
Throwing a cup of water over your
head may feel fantastic but will
have little effect if you are
over-heating. You must put the
fluids inside. Try to drink both
water and sports drinks to replenish
your energy stores as you run.
-
SAFETY: running a
marathon can be dangerous. The most
common serious illness is heat
exhaustion. Know the signs. If you
experience any of the following,
stop running and immediately seek
help: light-headedness, unexpected
shortness of breath, confusion,
nausea and vomiting. Muscle cramps
and exhaustion are lesser signs that
more fluid is vitally necessary.
Remember a dehydrated muscle is more
likely to strain.
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PACE: start the race
slowly or the last few miles will
kill! An early fast burst will
significantly deplete your muscle
energy stores. One suggestion is to
run the first 3 miles at a slower
than race pace and build up over the
next couple of miles.
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CLOTHING/FOOTWEAR:
Do not go to the shops and buy a
spanking new outfit to run for the
big day! New clothes may rub or
labels can irritate. Shorts may
chafe the skin. Shoes should be worn
in, so as to avoid blisters. They
should have at least 50 miles of
use, but not so much that they lose
their shock absorption. For the same
reason do not apply Vaseline or any
other creams to the feet which may
increase their movement within the
shoes thereby increasing friction
and the likelihood of blistering.
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WARM DOWN: Take
advantage of the army of volunteer
physiotherapists and masseurs for a
warm-down massage. This will help
with your circulation and prevent
some of the post-exercise toxin
build up that occurs. Alternatively
find somewhere to rest with your
knees and feet up, so that they are
higher than your hips. Again this
helps with the leg discomfort by
aiding the venous drainage from your
legs to your heart.
Shin Splints
Runners who develop shin pain which
is brought on by exercise often
complain of ‘shin splints’. This is
not a specific term as there are
several conditions which can cause
shin pain and a physiotherapist my
differentiate between these
conditions to give the right
treatment. Here are a couple of
examples:
Medial Tibial Stress Syndrome (MTSS)
Common in runners who describe pain
in the shin brought on by running
which takes hours or even days to
settle. If feels tender over the
inner border of the lower 2/3 of the
tibia. It’s usually associated with
abnormal biomechanics, especially
over pronation, but can be from
running on hard surfaces or having
worn out trainers. Treatment for
this injury consists of a rest from
running, some physiotherapy in the
form of ultrasound and possibly a
visit to a podiatrist to get some
orthotics to assist biomechanical
problems.
Tibial Stress
Fracture
Stress fractures are ‘overuse’
injuries of bone to the point of
mechanical failure. A repetitive
strain which occurs during running
cause bone trauma on a microscopic
scale, there is some localised
tenderness over the area and if not
treated early can progress into a
stress fracture. Stress fractures
tend to be more common in women. A
rest period of 6-8 weeks is usually
required and sometimes a plaster
cast in necessary.
The overlap between stress fractures
and MTSS is great and for this
reason if you are experiencing any
of the symptoms mentioned, a visit
to a physiotherapist is advised,
sooner rather than later.
Get a massage
Probably one of the most underrated
tools available to runners is
utilising the services of a good
sports masseur. Running causes micro
damage to the muscles which if left
untreated, can eventually result in
a build-up of scar tissue and
injury. It’s no coincidence that
Paula Radcliffe spends many hours on
the massage couch as part of her
programme to keep her body in peak
condition. After a race or every
couple of months, treat yourself to
a full leg massage, which will flush
away toxins, realign muscle fibres
and help ensure that you can
continue running week-in, week-out.
The Josephine Lawson Physiotherapy
Clinic has a great massage therapist
available at Fenchurch Street and
Gresham Street.
Running Shoes
Marathon season is fast approaching
and it is about now a lot of casual
runners are digging out their old
used running shoes with concern. For
the die-hard runners who have been
plugging away during winter then it
is also about time for a possible
new pair of wheels.
Lately in the media there has been a
lot of debate surrounding the very
existence of running shoes. It may
surprise you to know that indeed
they do cause the body a lot of
harm, primarily due to the soft and
often excessive heel height and
width causing a profound change in
biomechanics and therefore muscle
and joint function.
However, the
benefits of the shoe in the context
of training for a marathon and
indeed running one on public roads
most often outweigh the negatives.
That is, the original purpose of the
shoe is for protection, something we
can all agree is likely to be
required in the streets and parks of
London.
With this in mind,
the vast majority of us will need to
be shod. For this reason we have
concocted a list of shoe buying
tips. Seek the help of your local
running shoe specialist store –
these individuals are trained to
look for foot irregularities and can
easily ascertain size, shape/brand
and whether you need a supportive or
neutral shoe – trust me, the amount
of individuals we see in our clinic
who develop injuries due to
inappropriate footwear is
staggering! Buy your shoes at the
end of the day when the feet are at
their widest, this is especially
important to avoid those nasty
blisters on the toes.
Don’t be stubborn
when it comes to shoe brands, each
differ slightly in shape and you may
have a lot less problems with a
different brand! Get in the habit of
changing your shoes every 300-400
miles, as the materials have limited
bounce/memory and lose their
integrity and support. Make sure you
ease into your new pair of shoes,
the body needs to get used to the
minor joint changes the support and
cushioning will initially give.
Conan Dickie – Sports Medicine
Podiatrist.
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