First they will ask you why you do it, then they will as you how you do it.

Wednesday, 19 March 2014

Reducing injuries in runners.

The biggest frustration for any runner is the injuries which prevent us from running.

They tend to occur at the worst possible times, as you are reaching new levels of fitness or increasing your distance in preparation for that big race.

Lot's of work has been done into the amount of runners who get injured every year and the statistics in these medical studies vary wildly.  But for an average long distance runner who trains regularly and takes part in the occasional long race, the overall yearly incidence rate for running injuries varies between 37 and 56%. 50-75% are overuse injuries and recurring episodes of these injuries sits at 20-70% - 1992 Nov;14(5):320-35.

Different people approach running in different ways, with varying degrees of success. I know people on runstreaks into the hundreds or even thousands of days without injury  and others who crosstrain like crazy and then deliver on race day.

But as shown above, for the majority of people running regularly, increasing distance and effort will lead to an injury and there is a strong likelihood that it will recur.

Where most novice and amateur runners let themselves down is in core strength and proprioception. A lack of either of these will lead to imbalances which will cause wear and tear on unintended areas leading to lower back pain or patellofemoral pain (runners knee) among other common runners injuries

In this post I am going to look at core strength and explain why it's so important. Let me start by saying that I am not recommending hundreds of ab crunches. Your six pack (rectus abdominis) is largely unused in running. The reason it becomes so apparent in distance runners is the lack of body fat, not the required strength in that area. 

When you run the body makes thousands of minute corrections to your balance through the central and peripheral nervous systems. These minute corrections allow you to remain upright, allowing for the angle of your foot, the floor, your pace, shoes, incline. posture, load, terrain and so on and so on. In my opinion, best thing runners can do to reduce the risk of overuse injuries is improve core control.

There are two muscles in particular which give core stability and with training will improve control. Transversus Abdominis (TVA) and Multifidus (Mf).

Details on the structure and innervation of the TVA can be found here. The TVA works in tandem with the Mf to stabilise the lower spine. And while we are hard wired to have this control from an early age, start running longer distances, or at a more intense level and any weaknesses become more apparent.

But as runners the main thing we want to do is run. The issue is that it is the increase in distance without developing the supporting muscles that cause injuries.

Imagine having a small car. Cheap and usually reliable. One day you decide you want to tour the world. You would need to adapt the car in a number of ways. You may want to put better tyres on it, make it faster or more economical. Get a trailer to carry more stuff maybe?

If that car is fundamentally weak in it's structure, you can have all the performance in the world and a great looking car but it won't make it to the end of your journey. A corny analogy but I hope you see my point.

By training the TVA and Mf, you increase your core control, spinal stability and the ability to transfer power from your body to the extremities. In other words, for your body to have good control and placement of the legs when running, you need to have a stable spine and an engaged core.

How to train the TVA.

The most common and very effective exercise for training the TVA is abdominal hollowing.
  1. Lie on the floor, legs out straight and with a comfortable curve in the spine. Never try to straighten your spine out to match the shape of the floor. Your spine should look like a gentle S from the side not a I.
  2. Take a deep breath in and as you exhale, pull your belly button in towards the floor, this hollows the abdominal cavity (hence the name).
  3. Hold the contraction for a count of ten, breathing normally.
  4. Relax and then repeat the exercise for 5-8 repetitions.
A toned TVA will increase core stability and flatten the stomach. Think of it as a corset which wraps around your core and holds your insides in. As it tones and tightens, so does the corset.

But you shouldn't develop one muscle group without training the opposing muscles or you're likely to introduce an imbalance which may not have been there before.

The antagonist to the TVA is the Mf. It is a series of smaller muscles which run the length of the spine and stabilise the joints/segments.

Think of a house cards. Wrap a corset around the bottom half of the house and it becomes more stable. Add a series of bands that connect each floor to the one above and below it and suddenly the structure gets strong.

To strengthen the Mf, try the following exercise.
  1. Adopt a box stance, on all fours. Check your knees are directly under your hips and your hands directly under your shoulders.
  2. Lift your right arm out in front of you and your left leg behind you so that they are parallel to the floor. Your arm should be by your ear, hand pointing forward.
  3. Hold this position for a count of five, return to the start position and repeat on the opposite side. Left arm and right leg.
  4. Repeat for 5-8 repetitions.

Regularly adding these exercises to your workouts will increase core strength and control. This will allow your body to better adapt to load, fatigue, terrain or distance and reduce your chances of injury.

As you can imagine the topic is a lot more detailed than I have covered here. What I want to do is get you thinking about alternative training and strengthening your body to help your running, not replace it as an exercise. I maintain there is nothing better than running.

My aim is to get people stronger and fitter so they can run further and faster.

If you have any questions get in contact with me via

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