Niggles – Who do I turn to?

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It’s that time of the year again. Comrades athletes are out and about piling on the mileage to their weekend long runs. To avoid common injuries that can leave you sidelined on 9 June, it is necessary to listen to your body and the necessary precautions. While there are certain tried and tested methods of ramping up mileage to avoid getting hurt, there is no guarantee that it will not happen to you. For this reason, when niggles and injury do occur, it is helpful to know who to see immediately, so that you can get back on the road as soon as possible.

One of the most common causes of injury amongst runners is as a result of doing too much too soon in terms of mileage or high-intensity sessions. As a newbie runner, the lure of a new-found adrenalin inducing activity leads to poor decisions, such as entering every race in the calendar; a marathon this weekend, and an ultra the next. This problem is particularly acute amongst us ultra-loving South Africans. For more experienced runners, too much could be as a result of wanting to improve – in a quest for more speed, we just push our body too hard, too often. The key-word here is BALANCE.  Be sensible. Increase your long run mileage gradually (roughly 10% per week) and your quality sessions too (an extra session every two weeks). There is no quick-fix for building your aerobic endurance capacity.

Right, so who do you need to see if you are experiencing some discomfort while running or are worried that a niggle may be the start of something more serious? Here are a few options to consider as a starting point.

At the first sign of knee or hip niggles, the first thing to consider is whether your shoes are at the end of their lifespan. Look at your mileage; depending on your weight, size and running style, you may need to replace your shoes every 600-700km.  When your shoes have done too much mileage, the midsole becomes compressed and the support that the shoe was designed to provide is no longer able there. Remember to change your shoes regularly.

It’s also important to bear in mind that if you have never had an assessment of your running form done, you may be running in the incorrect shoes (i.e. ones ill-suited for your particular biomechanics). As you progress through long runs, your running form will be affected and as you tire, all the underlying imbalances and weaknesses will be exposed, usually resulting in injury. Some injuries may be easily fixed by ensuring that you have the correct shoes. I have found that my local shoe shop, The Sweat Shop in Dunkeld, Johannesburg, has a wealth of knowledge and experience to assist runners with choosing the correct shoes, whether it is a stability and support issue which may require anti-pronation shoes or just that you need a wider toe box to avoid blisters and toenail damage. The choice of running shoes is endless and it is worthwhile chatting to experienced running shoe stockists for advice.

For more serious niggles and pain, medical experts are the first port of call. Podiatrists treat the foot, ankle and related structures of the leg. Our feet are responsible for stability, and take on a tremendous amount of shock from pounding on the road. A podiatrist can also assist in treating minor issues, such as ingrown toenails or more major issues which require the formulation of orthotics for your shoes.

Sometimes a good sports massage can loosen the tight, overused muscles, bringing relief to your whole body so that you can get on with your training. Other times seeking assistance from a Physiotherapists is necessary, particularly to diagnose a muscle strain or tear. Their knowledge of medical science enables them to offer a rehabilitation plan and exercises for such situations. Physiotherapists make use of physical manipulation to mobalise joints, stretch and release tight muscles. These days, most physiotherapists have access to ultrasound equipment to promote muscular healing, as well as shockwave therapy machines which stimulate collagen, treats chronic inflammation, mobility, pain relief and so much more. Another technique that physiotherapists employ is dry needling. This differs from acupuncture and is supported by research. Needles are used to release trigger points thereby relieving pain and improve range of motion. This technique is used in conjunction with other treatment methods.

More serious back and hip problems need the expertise of a chiropractor – preferably one who specializes in neuromuscular disorders. These medical experts have a different approach to that of physiotherapists, although they also use methods of physical manipulation. Chiropractors use spinal alignment techniques such as joint clicking to correct body movement. Chiropractors can also perform dry needling on patients to provide muscular relief to tight spasming muscles which affect alignment.

Biokineticists specialize in human movement and can thus address the underlying cause of pain, injuries and running form. Typically this is done by taking a video recording of you running on a treadmill, after which the biokineticist will analyse your movements, and identify the exact muscles that are weak or movements that need correcting. A rehabilitation exercise programme may then formulated to address the underlying problem to minimize the likelihood of injury re-occurring.

There are many ways to keep your body in tip-top shape in the comfort of your own home. Prevention is better than cure. Consider purchasing a foam roller. It is an essential part of your training regime. Rolling your ITB, glutes, hammies, calves, and back will get rid of tight knotty feeling from the high mileage. A tennis ball works well for glute muscles too. Stand against a wall and place the tennis ball between the wall and the affected area. Now, do a semi-squat so that the tennis ball moves over the affected area. By doing this, you can apply varying amounts of pressure. Light stretching is a good, but under-utilised activity. Runners (myself included) typically do not like stretching. It feels like a waste of time, right? Maybe, but after just a few very gentle stretches you immediately feel like you are a little looser after your run. Give it a try – just 3 variations (calf, hamstring, quad).

https://www.apma.org/Patients/content.cfm?ItemNumber=992

https://www.shockwavetherapy.eu/subpage

https://www.moveforwardpt.com/resources/detail/dry-needling-by-physical-therapist-what-you-should

https://www.thejoint.com/texas/mansfield/mansfield-28040/186802-what-does-chiropractor-do-anyway

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