Time to talk about your running injuries

Time to talk about your running injuries

We collected a number of injuries from our followers on Facebook and through our customers against the promise that we would write about how their particular injury could be fixed permanently by using Tony Riddle’s principles. Going to one of our workshops are clearly an investment. Why do so many of us go onto the Apple store and purchase the new IPod for €399? (I’m not one of them unfortunately). Well, the answer is simply that we value what we can do with the IPod enough to pay it. Natural movement is not well known today and seems controversial, and very different, so it can be hard to know what to make of it, take this example of an approach to healing injury:

How running out of bed cured ankle pain!

Jason, now well on his way to full recovery, has been back running for the last few weeks but felt he woke up with a stiff ankle every morning. “Can it really be right,” he said, “that I should have to wake up with that.” “No,” I replied, “you should ask Tony about it.”Jason did. Tony replied: “It’s in your mind, mate,” and ordered Jason, much to the chagrin of his wife, to jump straight of bed every morning and run from the first step. It is working. Is all our advice so controversial and counter-intuitive? No, not really, but there’s good science behind it all.

And they told me: “perhaps you should give up running”

Ready to give up running because of injury?
Ready to give up running because of injury?

One of the runners I coach through ChampionsEverywhere admitted to me that while he had taken great enjoyment from his schedule and felt much fitter than before he struggled with recurring knee pains and at times it was so frustrating that he felt he might have to give up running. Giving up running is a piece of advice always best ignored. How would you react if someone told you “you need to give up walking”? Both movements are equally natural and equally essential to basic human function and health but they need to be done properly.

My mother, a laconic character at the best of times, who would say to my dad and I if we showed any signs of limping: “If you were a horse, you’d have been shot.” And for good reason, a hunter-gatherer who can’t hunt is a dead hunter-gatherer.

Always start with the classics – knee injury and knee pain

So why do we suffer knee pains? Tony Riddle explained this to me by taking me back to how the body’s shock absorption functions: “Essentially, you have three shock absorbers – your plantar arch takes 17% of the shock, your Achilles tendon takes 33% and your knee 50%.” If your movement pattern is incorrect, then one or more of these shock absorbers will handle more force than they are designed too or none at all. Tony calls this a “victim-culprit model of injury” – so in the example of the knee, if the plantar arch and the Achilles are not doing their job, then the forces they should be absorbing go up into the knee. This way, the knee becomes “the victim” of “the culprits” (the plantar arch and the Achilles tendon). Keep this principle in mind as we move on to other injuries.

Knee injury
Knee injury - the knee joint has a function, don't tell it to do a job its not equipped to do! Would you?

Another outcome of poor movement is that joints which are meant to provide mobility (e.g. “move”) are being used instead for stability (e.g. “locking”). The knee is a classic example of this. When you run in heavily cushioned shoes, you can land in many odd ways on the side and heel of your foot and ankle. When this happens your entire body is extremely unbalanced when your centre of mass (e.g. “most of your weight”) moves over that point. Imagine balancing all your weight on the outside of your heel. This would be very painful and very difficult to do without shaking. But yet, some people do this thousands of time when they “jog” (running with a heel strike).

In those cases, not only does the knee get jarred as it helps flick your foot back to the ground properly, it also tends to become stiff or sore as the body tries to enforce some kind of stability. If you have ever seen calcification of a joint, you know what we are talking about. Joints should be moving (that’s why they are joints) and when they calcify it is the body’s attempt to lock them in place so they do not get damaged. Fixing a sore knee is simply a case of filming a runner, identifying “the culprit” and fixing the situation so that the knee stops being a victim.

Plantar fasciitis and heel spurs

Aoife suffered for a long while with heel spurs but is now thankfully back running regularly, easing herself back in running 5km to 8km in minimalist VivoBarefoot shoes and doing her drills multiple times daily. A heel spur is a “hard spot” somewhere around where the plantar fascia connects to the heel bone. Inflammation and irritation in this area, with or without a heel spur, is called “plantar fasciitis” and remains one of the most mysterious injuries to most runners as it was for me when I suffered from it in 2008-2009.

Thankfully, it actually does not matter what plantar fasciitis and heel spurs are (but if you want to know, they are overreactions of your body’s defensive mechanisms) if you want to heal them. You simply need to find out why your body is building a bone spur on your foot or why it is inflaming the area. This goes back to the theory presented above: if you move in a way that forces the plantar arch to deal with more forces than it was designed to handle, then the body will have to do something to stop you doing permanent damage. Building a protective layer of calcium or inflaming the area, is a natural response.

The pain makes it more difficult to return as you will tend to tense up your feet and run and walk awkwardly, starting a vicious cycle. Plantar fasciitis and heel spurs defy practically all traditional treatments and feel career ending while they last. Yet again, however, we simply need to identify the source of the excessive loading or incorrect use of the plantar fascia arch and the problem dissipates relatively quickly.

Foot pains, arch pains and flat feet

Foot injuries
A mobile natural foot is less likely to suffer injuries. And yes, it will be flat some of the time, its meant to be!

Another key source of “foot pain” and “arch pain”, as similar symptoms in other spots under and on the sides of the foot are often simply referred to, is the softness of modern running footwear (Tony Riddle calls this “compliance”). The human body is engineered to work as a soft spring against any hard object it encounters in nature. When your foot strikes a hard object a chain reaction of movements take place to allow you to spring back off the ground unharmed and be on your way. One of these little details is that when the arch of your foot strikes the hard surface, it will collapse downwards until your foot is flat on the ground. This has to happen and is one reason all the talk about runners having problems because they are “flat footed” is nonsense.

We are all born with slightly different arches but having a less pronounced or barely noticeable arch (as in a “flat looking foot”) simply means that you have a less aggressive spring in the foot itself and you are possibly less likely to become a top class sprinter. For an endurance runner this is of no real importance. How you use your foot is important, not how it looks (unless it is malformed).

When running in very soft shoes, I noticed this problem myself, with every foot strike my arch wants to collapse into the ground until it hits a hard surface. Think of it as running on sand – your foot sinks in until it hits a harder surface that it can “bounce back off”. The longer this takes, the longer you stay on the ground and the more pressure on your arch. I began noticing irritation in my arch when running more than 10 miles fast in my Nike LunarRacer shoes. The sole is so spongy that it “acts like soft sand” and every time I hit the ground, my arch tries to “dig through the sole”. Foot and arch pain are very often related to poor footwear but when not their root cause comes back to the “victim and culprit model” – that your feet are asked to absorb more force than they were designed to do.

Ankle pain
This type of excessive taping and strapping up is completely unnecessary for a natural mover

Hip pain, adductor pain and groin pains

A few posters mentioned the very uncomfortable pains and strains that are becoming more common in runners around the groin, hip and adductor/abductor area. These are very immobilising pains and make a runner feel terribly stiff and look even worse when they run. The “old man’s gait” is often invoked in a runner with these symptoms.

Once again, however, while these injuries get mysterious names (such as “osteitis pubis”, another injury I suffered from), they are just another symptom of incorrect use. In the victim/culprit model, forces tend to transfer from the “root of the tree” (the foot) up towards the branches (the hip, abs and back muscles). So if any part of “your chain” below the waist is not doing their proper job, then suddenly you are asking hips, adductors, abductors and core muscles to do jobs they were not meant to be doing or transferring excessive forces. Imagine that your knee, achilles and foot only absorb 50% of the energy they were meant to absorb. Then obviously these forces move onwards and upwards (they need a place to go) which leads them straight into your hip. As this causes pain and irritation, these areas begin to stiffen up in order to protect them from damage (another defensive response from your body, it will not be abused!).

A bad habit starts forming now where your running gait becomes increasingly stiff and unpleasant from the inflammation and soreness in your core area and hip flexors. Because you are not aware what part of your movement is causing the overload, you cannot alleviate it and break this cycle. Anti-inflammatories and rest may soothe some of your immediate discomfort but cannot provide a lasting solution. Attempts to strengthen the core also only addresses the symptom (you could put extra suspenders in your car as well, but perhaps you should learn to drive properly instead?) and generally has the effect of further tightening up the core area as certain muscles become overly tense from exercise. Excessive sitting contributes to this as your frontal muscles tend to become very tense and strong (because they are always “on” when you sit, try it) while the posterior muscles become inert and “weak” (such as your glutes – try squatting straight after sitting for 5 hours, they’ll be asleep!).

Achilles tendinitis/tendinosis and posterior tibialis

If I continue much longer, I fear repeating myself because the clever reader has figured out by now that there is a theme to healing all types of injury through natural movement: find “the culprit”, ensure that area in pain is used correctly and the symptoms will lift. It really is that simple.

Posterior tibialis and Achilles tendinitis exemplify this – these are very common areas for runners to overload when running incorrectly. Bad running technique has numerous effects which contribute to overloading of posterior tendons such as the Achilles tendon or my own favourite “tib posterior”. Often a bad gait means that you get “sticky” (spend more time on the ground) which increases the loading time on your posterior tendons. Runners who “push” themselves off the ground with every step are also over-utilising the calf muscles, making them tense and over-active. This can pull on the adjacent tendons such as the Achilles tendon.

Correcting muscle imbalances

Natural movement in action
Natural moves such as vaulting a fence require perfect muscle coordination and leaves on room for imbalances

I have had great issues with posterior tibialis irritation myself, a little “bite at the foot of the Achilles”. This made it difficult to run relaxed when working with Tony. He would help me with two quick interventions: 1) some hands-on trigger point massage to create some quick relief for the symptoms and help me relax and 2) help me “wake up” the anterior tibialis muscle (the muscle next to your shin). When one muscle is tense, the muscle opposite to it tends to be inert or “weak” and getting that muscle reactivated can provide quick relief in most cases and long term healing when combined with an overall correction of running technique.

As I mentioned in my article yesterday, doing natural movements as your cross-training is one of the best ways to help you avoid the muscle imbalances which can be part of the cause for injuries such as posterior tibialis or adductor/abductor and hamstring strains because all your muscles have to work together in harmony during such movements whereas isolation exercises allows you to do movements that would never occur naturally.

Treat the root cause not the symptom!

Tony looks at “what are you doing wrong” and may frustrate you because he’ll be much less interested in hearing what diagnosis you have (“what is wrong with me”). The symptom gives an early indication of what your issues are very likely to be, but until you have been filmed in slow-motion and assessed, you cannot see the root cause. Once the root cause is identified, the symptom – be it groin pain, knee pain, plantar fasciitis, Achilles tendinitis or some other injury will heal. Removing fear and tension from your pain also plays an important part in healing you permanently but that is another topic worthy of it’s own article, but you can read more about that topic on my blog.

Does this make sense to you? If it does, get in touch and let’s discuss how we could help get you back running injury free once and for all. For information about natural movement for injury prevention and our next workshop go here.

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René

Director and coach at Borg Coaching Services
Rene Borg is the head coach of Glendalough AC and a passionate runner competing over all distances and terrains.

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