Simon Redstone is the Director and clinical lead at Physio and Pilates Central. A keen sportsman throughout his life, his focus is now is on cycling and snowboarding with the odd triathlon thrown in for good measure. When he has experienced injuries himself, one common frustration was the fact that problems were frequently ‘managed’ and not actually fully resolved. Therefore, when setting up the company in 2013, the aim was to ensure injuries were 100% fixed, with a particular focus on strength and conditioning to not just resolve the injuries, but improve performance as well. This focus continues following the opening of their second clinic in Wimbledon in 2016.
Off-season is the perfect time to get some well deserved R&R but it’s also time to get those injury niggles looked at. The earlier you start, the more time you’ll have to come back raring to go for a (hopefully) injury-free 2018.
So what’s the best plan to get these injuries addresses? Here we take a look at a problem that I’m sure will be familiar to many runners and triathletes…
This is essentially an overworked achilles, where overuse has resulted in a structural change to the tendon and pain for the person on the receiving end! The main factors we often see for this include excessive training, a rapid increase in training volume or issues related to biomechanics.
Training volumes can be addressed with a more structured and graded increase, along with strength work to deal with training loads. We’ll take a look at some useful exercises later on, but first the other cause.
The biomechanical aspect
Contrary to what some running shops would have you believe, you are meant to pronate the foot (i.e. roll in towards the big toe). This is because most of the propulsion for your next step comes from the big toe so the important thing is not whether we pronate, but how we control it.
When running, as your foot lands the gluteus medius/minimus tense up to provide control and ensure that you don’t collapse.
As your weight starts to move forward, they gradually let go so the knee starts to move inwards and the muscles behind the shin and the fibula take over.
These muscles run from behind the tibia and fibula and down to the arch of the foot. They ensure the foot continues to pronate in a controlled way and doesn’t just collapse into pronation. You are then in the right position to push off the big toe, using these same muscles, particularly on called flexor hallucis longus which runs to the big toe, as well as your calf muscles.
Why does this matter?
If there’s a weakness or timing issue at any point in this process then the foot can roll in with a lack of control leading to overloaded muscles or tendons further down the leg – which could be the calf or Achilles tendon. The result can be anything from hip pain, IT band issues, shin splints, runner’s knee, Morton’s neuroma, bunions or, finally, Achilles tendinopathy.
So what’s the solution?
First up you should strengthen the achilles using this exercise – really focus on pushing up through the big toe as there can be a tendency to roll to the outside of the foot.
These exercises should be done alongside more functional ones, such as this single leg squat. For this one, focus on keeping a straight line from the outside of the hip across the outside of the knee and down to the outside of the ankle, ensuring the knee doesn’t fall inwards and the hip doesn’t fall outwards.
Together these will directly address any pain in the achilles, as well as the movement pattern issues that need addressing to avoid the problem happening in the future.
Pain in the achilles is just one example of potential injuries that can arise from biomechanical issues that you tend to notice only during endurance sports due to the highly repetitive nature of the movements. By improving strength and movement patterns you may find an improvement in performance as well as the improved comfort.
[At Physio & Pilates Central we’re used to treating sports men and women of all levels and abilities, from those starting out on their first 5K runs to European-standard triathletes. If you’re worried about a niggle or anything else just give us a call or drop into one of our clinics and we’d be happy to help out.]