It is a great deal of running involved in daily life of every serious runner, and with constant improvements in performance and growing sporting ambitions running takes over pretty much every aspect of training. We all tend to narrow our focus into improving physiology and reduce the amount of time spent for the maintenance of our musculoskeletal (running) bodies. Training them to move forward efficiently in the multi-dimensional plane is as important as improving maximal oxygen consumption or lactate thresholds. Lets forget the myth, that higher mileage will solve all muscle strength, mobility issues and that we can run through injuries, pain and discomfort, assuming that these will disappear naturally. Even complete rest from running doesn’t solve them. I am confident to say that every single runner that spends long hours running, at some point will experience(d) knee, ankle or lower back issues, and it is not ok. Therefore, it is best to understand the nature of certain injuries that accompany running and change the way we run.
Lower back pain. Ignoring lower back pain could become a long-term issue. It is important to understand that lower back discomfort for runners is usually a result of incorrect pelvic position due to insufficient stabilisation by core musculature, not weak core muscles. Runners with incorrect (not neutral) pelvic position cannot optimally engage posterior chain muscles (glutes, hamstrings) and tend to overstride rathen than putting the leg behind the body for a good push-off. This affects running economy and, in general, is not efficient use of energy.
What to do? Try to feel your pelvic position when you work, sit in front of the desk and especially – when you run. Sometimes it is worth dedicating all training session thinking about your pelvic area, and observing yourself if you have a tendency to arch your back, and knowing when this usually happens – at the beginning of your training session, or when you are tired, or running uphill or downhill. Having a good awareness of separate body parts is a skill that could be practised and learned (we can call it – somatosensory awareness). After you will master this skill, try to use it everywhere – during strength and conditioning sessions and when you run. Keeping you lumbar/pelvic area in the neutral position will reduce the strain to lower back muscles, and is very likely that Lower back discomfort will gradually disappear.
Calf and Achilles tendon injuries. Generalising, all calf and Achilles tendon problems are caused either by chronic overload or inadequate use of those structures. Achilles – is the biggest tendon in the human body and is perfectly developed to absorb free energy with each step and release it during the push-off phase. We see runners that instead of letting tendons to do their job, over-activate muscles (for the same task), and eventually overstrain all calf muscles, including Achilles tendon.
In many cases, problems in the Achilles area indicate that runner is overstriding and push off phase is poor. There could be an easy fix just by learning to increase the stride frequency. However, this habit to overstride could also indicate insufficient ankle mobility or restricted hip extension (due to tight hip flexors). Invest your time to achieve good ankle mobility and release hip flexors, using standard stretching exercises or lacrosse ball, or foam roller.
Anterior knee pain. Very similar biomechanical reasons and running technique aspects, described along the calf problems, are causing anterior knee symptoms and pain. There is no way to run faster other than having a good push-off! If you are not capable to get your leg behind your body fully and without restrictions, anterior thigh muscles (quadriceps muscle, aka. quads) will try to compensate for this by working harder, which in a long-term will lead to the development of anterior knee pain due to patellar maltracking. Next time you will go for a run, try to feel which muscle groups are fatigued first: if you’ll feel waisted quads after your training session, it is likely that you fit the above-mentioned description. Heel-lift exercises, short (50-100 metre) sprints will help to develop a good sense of push-off. Try to incorporate this into your training program, whether you are a road or trail runner.
Hips – another area that needs some attention. Running could be compared to a many small single-leg squats. Try to do a few single leg squads at home and you will realise how tightly hip position is related to a knee position. As an example, excessive hip internal rotation during each step drives your knee in the same direction – to rotate inward, and usually it is only a matter of time before anterior knee pain or ITB (aka. iliotibial band) syndrome develops. Improving lateral hip stability and strength of hip extensors (glutes) is a solution to prevent this type of injury, and to improve overall running economy.
Various joint and muscles pains. Beginner runners (and a few experienced ones) sometimes reach the point when their training is heavily affected by never-ending cycle of injuries, occurring at different muscle and joint locations. In that case, reducing the overall impact of running to all musculoskeletal system could be a good approach. Practically that means – how to improve running technique. There are so many elements of efficient running, however I would pick a few very important ones: optimising stride frequency (think about approx. 180 steps per minute), achieving good push-off, balancing your body position to a point that foot contact occurs in the midfoot area. The former could be achieved by trying to run more softly and concentrating your attention to a foot position, and practising this until it becomes a skill. Neutral pelvis and spine position is essential for distributing running load between muscles and joints. Exercises that engage core muscles in the variety of scenarios not only strengthen them, but also improve somatosensory feedback, making it easier for you to sense and control pelvis/spine position when running.
That's all, a few ideas for you to digest and incorporate into your training. More to come!