Recovering from injuries and prevention

Summary:

• Regarding asthma, please read this excellent article (from roadrunnersports.com).
• For knee issues, and approach, see here. But be aware that footstrike technique choices have implications - generally, the more you heel-strike, the more you will be likely to increase impact and stress on the knee. Also, a faster turnover (aiming for around 180 steps per minute) will reduce "peak joint force" by a massive 14%*.
• For ankle issues, especially if you are like me and have ALREADY suffered from ankle sprains, see here. Also, please see my blog post for a summary of the physio exercises I have been taught from various physios, along with their risks and necessary equipment. But be aware that footstrike technique choices have implications - generally, the more you forefoot-strike, the more you will be likely to increase strain and pressure on the ankle.[update Dec '13: 8 months of ankle difficulties following some repeat sprains on left ankle have lead to an injection]

It will happen sooner or later

I don't know if it's because I'm getting a bit older and crankier, but there seems always to be physical issues that have had serious impacts on training. In February 2012, a serious chest infection leading to prolonged periods of coughing and asthma meant I had to withdraw from my spring marathon - a big disappointment. In April 2013, a sharp twist of my left ankle took me out of at least 8 months of competition, and possibly London 2014 too.

Approach and treament

Marathon Talk (episode ?) have some excellent advice, and the following I have actually applied:

• get the problem diagnosed.
• you are better when you can do a session you couldn't do without discomfort - TWICE.
• a week off won't make any difference
• for respiratory issues: if below your throat, eg chest infection, don't run. If a cold, then you can consider still going out there.

One of the great things about variety in training and about trail running especially is that repetitive strain is reduced.

For treatment I know virtually nothing, so better off referring to a reliable basic approach to treatment which I find very clear and simple from the NHS: here.

Prevention

I love running grass when I can, which where I live is hardly ever! The reason is that I can feel how this significantly reduces impact. For me, the key thing is my knees, but presumably we, as runners, need to be looking to reduce impact for the entire body. It's about "Running Correctly", as Julian Goater puts it.

In Kindle location 1234 from his book "The Art of Running Faster", he says "if you run correctly, you'll be less likely to get injured". Yep. In October 2011, I had to see a podiatrist and have insoles fitted = expensive, adds extra (and assymetrical) weight to each shoe. Also when I changed shoe, the new shoe wasn't compatible and caused bruising to my upper foot.

When a coach told me that I would never run faster than 16 kph if I ran with heel strike, I took up the challenge to teach myself to land mid-to-front foot. That is still work in progress, but the insoles have been out of action ever since this change.

However, as noted above, I have now come to realise that actually there is a trade-off in footstrike technique. Yes, on many levels changing my footstrike toward the middle and front of my foot brought many benefits in terms of injury prevention and knee protection (insoles discarded), however, it has been shown that this can also actually increase pressure and strain on the ankle. I need to find the reference for this but my own testing has shown that with my 2013 ankle injury that forefoot striking did seem to cause more discomfort.


* Runner's World p21, Jan 2014.