A marathon … a race which London Marathon co-founder Chris Brasher called ‘The World’s Most Human Race’.

Thousands of people enter the London Marathon each year, and we can see why. There’s a buzzing atmosphere, and spectators showcase the best of the human spirit, as they tirelessly cheer people on urging them not to give up.

We have patients who enter each year, and we know many of you run regularly so we would like to give you some information about common injuries and hopefully how to avoid them.

Injuries can affect anyone, from experienced runners to beginners, and for everybody the same simple advice applies: don’t run if your body is telling you not to.

At Good Health Centre we see a variety of injuries; let’s have a look at some of the most common, how you can try to avoid them and how our osteopaths go about treating them …

‘Runners Knee’

• The most common causes are swelling under the kneecap as a result of repeat loading whilst the knee is flexed; loss of hyperextension of the knee joint; and poor ankle or hip mechanics.
• This causes significant pain to the runner who is forced to stop or to limit the distance, an obvious problem for a marathon runner.
• During a run, you may feel pain in front of the knee, around the knee and/or behind the knee cap.

Osteopathic treatment

When treating, careful examination of the lower extremity will take place. The osteopath may want to examine you while running, and/or a passive assessment on the treatment couch. We need to collate all the information and understand why this condition has occurred and what is preventing this patient from getting better. Once this is established a course of treatment is undergone, coupled with some strengthening and stretching exercises tailor-made to the individual. The osteopath will also be advising you as to your training regime and appropriate distances.

Achilles pain

• Regular running can cause wear and tear of the Achilles tendon (runs from the bones of your heel to the calf muscles), resulting in pain and/or swelling at the back of the ankle or heel.
• It can be a slight continuous pain, or a sudden, sharp pain. Patients generally find it is worse first thing in the morning.

Our advice would be to apply a cold pack if you can feel a lump in that area, and also massage the area with your fingers.

Some patients also find it beneficial to insert heel wedges in their shoes. 

Shin pain

• Commonly referred to as ‘shin splints’, you will feel a dull pain in the shin, which can lead to sudden, sharp pain.
• It is an overuse problem.

Osteopathic treatment

It is useful to firstly find out if unusual ankle biomechanics is the underlying cause of the problem.

Patients find it useful to use a foam roller up and down the calves, and it may be worth seeing a podiatrist to see if orthotics may help you.

Our osteopaths would start by careful assessment of all your surrounding joints. We will also look at your training programme, perhaps you’re loading too much too fast.

Heel pain

• Runners sometimes experience pain or swelling in the heel or bottom of the foot.
• It usually occurs when a patient progresses with their running and is doing so more regularly; runs on an incline; or if their shoes are not supportive enough.
• The pain is often sharp and occurs when weight is put on the heel; it can also feel as if you are walking on sharp stones.

You will probably have heard of plantar fasciitis, which results in pain in the areas discussed. You’ll find it is at its worst at the start of the day, can be brought on by bending the toes up towards the shin, and is exacerbated by a tight Achilles tendon.

We would also look at the possibility of a calcaneal spur, which is an extra growth on the bone of the heel. They can be difficult to treat as you are constantly putting weight on it making it impossible to rest it.

We have found some patients respond quickly to manipulation of the foot (there are 26 bones in each foot!). If we can get all the joints moving well, it means the loading of the plantar fascia is reduced.

Muscle strains

The most common muscles we treat in relation to running are the hamstrings (three posterior thigh muscles) and the calf muscles.

Muscle strains are common in new runners, as they are exercising muscles that are not used to being pushed.

If you experience muscle strain, we advise that you stop running, and apply a cold pack for around 20 minutes a few times a day. You can also try elevating your leg, and use a pillow for support to reduce any swelling. 

A few tips from our osteopaths …

• If you are training for a marathon, don’t forget to build up your muscle groups alongside getting the distance in. Try skipping, strenuous walks up hills, and HIIT workouts.
• Make sure you are wearing the correct footwear. Buy your trainers from a running shop where you can get shoes tailored to your feet.
• Warm up properly. Try a 5-10 minute brisk walk or a gentle jog to warm your muscles up; it may help prevent injuries.
• Cool down properly. Finish your run at an easier pace, or walk for 5-10 minutes; it can help your body recover.
• If you are a new runner, build up your speed and distance slowly; allow your body to adapt.

It is also important to be honest with yourself; running a marathon may be on your bucket list but some people are just not suited to running.

If you would like to be seen by one of our osteopaths or if you have any further questions, then please get in touch with us. You can call us on 0113 237 1173 or email info@goodhealthcentre.co.uk, and we will get back to you promptly.