For cardiovascular fitness, there’s nothing quite like running. Unfortunately, that comes at a price, and that price is the seriously high impact that your feet, knees and hips are all expected to cope with. Chiropractic can be instrumental in picking up the pieces when this all begins to take its toll, but it is just as important in trying to stop it getting to that stage as well.
I started running when I was 16 or 17. After years of being forced to take PE lessons, and hating every minute of them, I was suddenly released from that necessity as I started studying for my A-levels. It took me only a week or two to decide that, while being forced to play tennis or hockey was never going to be my thing, I did miss the rush of exhilaration that came with exercise and that release of endorphins all athletes are familiar with. So I began to get up early in the mornings, and head down to the athletics track to plod my way around the running track as many times as I could. I will never be the fastest or furthest distance runner in the world, but I still chug my way around various distances as often as I can. But this does also mean I have firsthand experience with many of the injuries that runners can suffer from.
The most important thing for any runner is footwear. Whether you are just starting and are aiming only to get to the end of the road, or whether you have been going for years and are in the middle of training for a marathon, your feet are what are going to get you there and so it only makes sense to take care of them first. It is a really good idea to go to a dedicated running equipment shop, such as UpandRunning in Shrewsbury to have a full gait analysis and professional shoe fitting performed, but if you can’t do this then the key factors to think about are impact absorption and support. Decide what type of running you are going to do – are you mostly going to be pounding the streets, or are you hoping to get off the roads and into the cross-country scene? On the roads, it is going to be really important to reduce the impact of each step you take by making sure the shoe is going to protect you as much as possible. You might think this means going for one of these air-soled trainers, or some other spongy-looking material, but don’t forget that support is also important so it can’t be too soft. If cross-country is more your thing, you generally won’t be on hard surfaces for as long, so it is going to be more important to have good grip and ankle support than impact relief.
Arch support is of major significance with running. While barefoot running looks like a great idea, and indeed it can be, you can’t just kick off your office shoes and go for a jog. Have a look at my page on foot pain for more information, but essentially supporting the arch is going to help reduce the chance of painful conditions such as plantar fasciitis developing, and will also stop you ending up with problems such as the joints in your foot becoming jammed into immobility. If you naturally have a good strong arch, then you will be able to use a shoe that has less support and more flexibility, but if the sole of your foot along the inside just sits flat on the floor, you’re going to need all the help you can get from your shoe.
I frequently also get asked about stretching, warming up and cooling down. Obviously, these are all widely known to be important, but they are less widely done and even less understood is the best time and way to do them. The answer is…there is no right answer. Seriously. I spent quite a lot of time at one point reading all the evidence I could find regarding how and when you should stretch, whether you should warm up by stretching or leave it until you are cooling down and what else you should do before or after you run, and pretty much every piece of research I came across had a different opinion! So what follows here is what I think seems most logical, based on how your body functions, the muscles you are going to be using and what seems to help in avoiding injury.
First, your warm up. In my experience, the best warm up for running is walking. Start off with a fairly slow pace, and gradually pick it up until you are briskly striding along. The length of time you take to get to this stage depends on various factors, including what you have been doing during the time leading up to your warm up, what the weather is doing and how often you go running. If you have been rushing madly around the shops, and it is a fairly warm day, you will already have fairly supple muscles with a good supply of blood flowing around them, so you can probably do a bit less than if you have just got out of bed in the middle of winter and are about to set off for your first run in six weeks.
Once your heart rate is raised slightly, and you muscles are nice and warm with a good supply, I tend to recommend a short period of stretching. This is more to check you haven’t missed any muscles in you warm-up, rather than specifically work on muscle length just yet. For running, you mostly want to address the quadriceps down the front of your thigh, the hamstrings down the back of your leg, and your calf muscles. Once you have made sure these are all nice and supple, you are all set to go for your run.
After running, always walk for a short while to gradually reduce the blood supply to your legs. If you just stop, you risk decreasing the circulation too quickly, which may allow lactic acid to build up in the muscles, causing cramps and that horrible day-after muscle soreness. Having walked around for this time, it’s time to get in to some serious stretching. By stretching after you work out, you are aiming to prevent injury happening the next time you run by keeping the muscles as long and flexible as possible; after exercise they have a tendency to shorten and become tight, and stretching helps to combat this. So work with the same three muscle groups you addressed in your warm up, but this time spend a bit longer on each area, and challenge them a little more with each stretch. Generally holding each stretch for three to five sets of 30 seconds is sufficient for most people. On top of your quads, hamstrings and calf muscles you should also stretch out your inner thigh muscles, iliotibial band and gluteal muscles during your cool down.
By adopting these practices of good supportive footwear and an adequate warm up, stretching and cooling down period you will be doing a reasonable amount to protect yourself from injury. But however hard you try, running is still a high impact, high intensity form of exercise which can cause problems with your joints.
Simple muscle strains are fairly common, as are repetitive strain injuries such as stress fractures in the feet and hips. As mentioned previously, plantar fasciitis can also occur in people who haven’t done a lot of running previously, especially if their footwear is providing insufficient support for their arch.
Another repetitive strain injury seen in runners is commonly called shin splints. More correctly, this is a condition called anterior compartment syndrome in which you experience varying levels of pain down the front of your shin when you start running. It happens because the muscles down the front of the shin are encased in a strong connective sheath. When you use these muscles more than they are used to, they can end up with swelling around them. This swelling has nowhere to go, because the connective tissue sheath is unable to stretch, so it becomes extremely pressured in the area and this causes pain. In its mildest form, there is no real problem from this besides the discomfort. However, if it becomes severe then the blood vessels can become compressed and a vicious cycle of increasing swelling can be seen and then urgent surgery is required to relieve the pressure before long-term damage is done. So while shin splints are a very painful but not particularly severe condition in most cases, it is very important you don’t simply ignore it. Initial treatment is rest from the activity that caused it in the first place, and then a gradual and careful reintroduction back to that activity with plenty of stretching to make sure the muscles have time to naturally become used to the new movement without becoming swollen. Chiropractors will often use soft tissue work to help with this recovery process.
There is in fact also a whole condition which is known as “runner’s knee”, because it is so strongly associated with the sport. It is also called jogger’s knee, patella-femoral pain syndrome, chondromalcia patellae and about a dozen other things, but what is important is it can be extremely painful and it can also be helped by Chiropractic care. Essentially it is pain located somewhere around the knee joint which is felt usually while running, or while going up and down stairs. Although the pain is most frequently felt at the front or middle side of the knee, it can be felt elsewhere – or everywhere – in the joint. Usually it is associated with a tight quadriceps muscle, and pain at the point just below the knee cap to the inner side, where there are a lot of muscles all coming in to attach at one particular point. Working with these muscles to release tension is usually sufficient to relieve the pain associated with this condition, but sometimes the mechanics of your gait need to be addressed.
One of the reasons this condition can develop is due to a weakness in the gluteus medius muscle, which is responsible for holding the thigh out in a straight line, rather than letting the knees collapse in towards each other in a knock-kneed stance. If this muscle is unable to perform its function adequately, and the knees are allowed to collapse, then it puts a much greater stress on the knee joints and consequently causes pain and stiffness in the area. A few simple exercises to strengthen then gluteus medius muscle, and then a bit of training so that the brain learns a new way of moving the joints to use the newly strengthened muscle will soon see a much more healthy movement pattern through the knee.
Finally, I would just like to comment quickly on something that I find rather interesting. There is, functionally, such a thing as running like a girl – and consequently, running like a boy. Research has discovered that women generally have comparatively more strength in their hamstrings than in their quadriceps, while men tend to have the reverse. This produces an observable difference in running style – generally, women will run by pushing off behind them, using their hamstrings most to produce quite a flat, smooth running gait while men will generally run by bringing their leg further in front of them and pulling their body along to catch up, requiring a greater use of the quadriceps muscle and giving a much higher step to their running stride. Of course, there are women who have stronger quadriceps and men who are better at using their hamstrings, but in general it is the other way around. So there you are – next time someone says you run like a girl, you can just thank them for complimenting the strength of your hamstrings!