How a physio will improve your running ability

If you’re injury-prone, or just want to get more out of your runs, here’s how a physio will improve your running ability.

As more and more people take up recreational running and take part in charity fun runs we see a great deal more running-related injuries at our sports injury clinic. Many of these injuries can be avoided with planning and regularly seeing a specialist sports physiotherapist or massage therapist.

A gravity pattern

The most common injuries we see are over pronation-related injuries (i.e. overly flat feet) and these can manifest in several different ways. Often called a ‘gravity pattern’, over pronation is when the arch of your foot collapses, so you lose the shock absorbing capacity that is naturally built into the foot. The stress forces are then transferred up through the leg, causing knee and calf issues, such patellarfemoral syndrome (often called runner’s knee), iliotibial band friction syndrome (ITBFS) and medial tibial stress syndrome (often called shin splints). A physiotherapist or podiatrist can help correct this with shoe inserts that you put in your running shoes. These orthoses help support the arch of the foot. You may also need to stretch your calf muscles and strengthen the muscles in your calf, shin and thigh to balance out the muscles in your lower leg.

This over pronation pattern can also lead to other types of foot pain and knee pain and a tightening of the illiotibial band down the side of your leg, which can cause ITBFS. Self myofascial release exercises on a foam roller are a sensible way to get rid of adhesions or tight spots in your IT band. This can be quite uncomfortable and it’s important to get this exercise right. Our team of therapists can show you the correct way to foam roll for the most effective treatment.

Quad dominance

Another issue runners suffer from, particularly female runners, is quad dominance and /or tightening of the hip flexors. The thighs and hip flexors are predominantly used when running and over periods of time, over-use of these muscles can lead to adaptive shortening of them. This causes the pelvis to be pulled forward, which can lead to lower back pain and sacroiliac joint pain. It can also exacerbate some of the knee and ankle issues we’ve already looked at. A good way to treat this is to thoroughly stretch the thigh muscles and hip flexors regularly and especially prior to running, and strengthen their opposite muscles, which are the gluteals and the lower abdominals. You can also use the foam roller to massage the quads after you have stretched them.

Lunges and step ups are a great way to strengthen the gluteus maximus, gluteus medius and quads, and Pilates-style exercises tend to focus on core conditioning, particularly the correct engagement of the lower abdominals, which is why it’s so good at alleviating low back pain.

It’s a style thing

Finally, your running style could be to blame for any niggles you are suffering from. If you are a heel strike runner then you’re at risk of tibial stress fractures. Every time the heel strikes the floor there is a deceleration force transmitted through the tibia and over time (especially if you have poor foot biomechanics) it can overload the shin bone and cause stress fractures. If you are predominantly a forefoot runner, but you haven’t got your technique right and are running too high on the toes, you could be overloading your Achilles tendon and calf muscle. Over time this can lead to degeneration in the tendon micro structure leading to a condition called Achilles tendinopathy, or to a very tight and painful calf muscle or even recurrent calf strains.

Steve Hines is a top physiotherapist based at Wandsworth Physiotherapy.