By Cathal O’Kane, Specialist Musculoskeletal & Sports Physiotherapist at Kingsbridge Physiotherapy Clinic
MARATHON training is an amazing journey! Whether you are new to running or have been running for most of your life, the satisfying feeling after you’ve completed a run for the first time or you’ve reached a new distance is like no other. However there are always things to consider no matter what stage of running you are at. Cathal O’Kane, Musculoskeletal & Sports Physiotherapist offers his advice.
With the Belfast City Marathon just around the corner, many will be training away to make sure they are ready to take on the challenge. Cathal O’Kane, Musculoskeletal & Sports Physiotherapist offers his advice on reaching the finish line.
How important is warming up and cooling down after a run for injury prevention and performance?
For most runners a warm up is a very important way to both mentally and physically prepare for running. For a warm up to be successful runners should perform it consistently, keep it short and simple, make it specific to their needs and add some progressive plyometric exercises.
A study by Fradkin et al (2004) defined warm up as “a period of preparatory exercise in order to enhance subsequent competition or training performance.” Performance appears to be where runners may get most benefit from a warm up. A plyometric warm up involving squat jumps, scissor jumps, and double leg bounds has been shown to improve running economy by 4-9% (Wei et al, 2020).
Top tips or advice for training to avoid injury?
It is believed that 60-70% of running injuries, if not even higher, can be attributed to training error (The Running Physio, 2020). The balance between external load (distance, speed, frequency etc) and tissue capacity plays a significant role in injury prevention. Sensible training structure with a planned, gradual progression and individualised strength and conditioning can be a powerful combination in preventing injury.
With this in mind planning and preparation for all levels of runner is key. Three essential areas for a runner to be aware of in term of preventing injury are:
1. Prehabilitation Exercise / Strength & Conditioning
Ensuring you are robust enough to cope with demands of a running programme is essential. When runners visit our clinic, we have certain strength targets we would expect them to meet, and if is not the case we would prescribe an individual programme to address their deficits. In a highly effective and successful training programme for runner’s time should be set aside for prehabilitation/strength and conditioning. Ideally this should be specific to the athlete, facilitated within the training week and completed on a long-term basis.
2. A Training Plan
No matter what level of runner you are there should be some thought surrounding an appropriate training programme for your goals. Often the biggest injury risk factor for runners is ‘too much too soon.’ A lot of runners start out with the belief that ‘more is better’ and that they must be pushing hard at all times. Seiler (2010) suggests approximately 80% of training volume should be low intensity and only 20% high intensity (e.g. Tempo runs and interval sessions). Doing more high-intensity exercise may not actually improve performance and may elevate injury risk. Having a structured training plan which is adaptable and allows time for the athlete to gradually build is more likely to be successful long term.
3. Planning Your Recovery
Although this is essential for effective injury prevention and performance this area is often overlooked by athletes with a busy life outside of their training schedule.
For any athlete that has suffered an injury or is unsure how to programme their training or progress it in terms of strength and conditioning I would suggest having a look at our new Apex Athlete Programme.
What should runners do when they first feel a niggle or an injury?
Unfortunately, injuries and niggles are a common risk factor of running. Thankfully the benefits far outweigh the risks and fear of injury should not hold a runner back.
Seasoned runners may be very comfortable with managing niggles and happy to adjust their training accordingly. Others may be unsure how to proceed and need further assistance.
In this scenario I would suggest speaking to a professional as quickly as possible to avoid large gaps in the training programme. Sometimes the reassurance that it is ok to continue or a very a simple adaption to the training plan can be enough to keep a runner on track.
Suggested recovery tips after running a marathon?
Athletes, even at the highest level spend more time recovering than they do training. However, particularly at amateur level, a huge emphasis is not placed on the role of recovery in performance and injury prevention.
My advice would be to keep it simple and get the basics right, ideally getting these good habits in place long before the marathon arrives:
Nutrition and hydration: ideally protein and carbohydrate rich foods within 30 minutes of the event and a balanced meal with 2 hours.
Good quality sleep, aiming for 8 hours: Limiting blue light and electronics at least one hour before bed.
Active recovery strategies/mobility exercise: This can be specific to the individual and their preferences e.g. yoga, pool recovery.
When these foundations are in place other strategies such as ice baths, contrast baths, compression skins, massage etc. can be explored depending on availability and personal preference.
What treatments are available at Kingsbridge Physiotherapy Clinic if you have suffered a running injury?
At the clinic we manage a large number of running related injuries on a regular basis. Our work with Queen’s University Elite Athlete Programme exposes us to some of the top young athletes in the country and constantly challenges our thinking in terms of the best way to keep athletes performing at the highest level. Some of our most enjoyable work is often with clients who have just started running and are maybe trying to work their way through a couch to 5k.
Regardless of the goal when someone attends the clinic we will spend time getting to understand their injury, their training history and what they want to achieve moving forward. We will then create a plan together to decide what is the best way forward for the client.
At the clinic we have the added benefit of our testing equipment which gives us a more accurate measure of the client’s abilities:
- Forcedecks – to analyse balance, strength and movement strategies in a range of exercises and jumps.
- NordBord – to accurately monitor an athlete’s hamstring strength and imbalance.
- Dartfish – a running analysis software.
In terms of other treatment options, we have Shockwave Therapy which is a modern treatment tool often used in the management of tendon pain.
Our new partnership with the Health & Recovery Hub provides patients with a way to get back to activity sooner than expected post injury or to enhance those active recovery strategies we discussed earlier.
Get in touch!
Whether you are new to the sport or a keen runner, if you would like to get the most out of your recovery or would like to improve upon your skills and performance, please do not hesitate to contact Kingsbridge Physiotherapy Clinic.
Email physio@kingsbridgehealthcaregroup.com or visit kingsbridgephysiotherapyclinic.com for further information.
Queen’s University Sports Centre
