As runners, at one stage or another we have all been at this point. You are either increasing your running load after that lazier than normal Christmas break, or you have reached your highest ever weekly mileage in your marathon training program when that niggle starts to creep into your runs. Whether it is that old achilles injury, an ache through the front of the knees or sore hips, the last thing you want messing with your training mojo is pain.
This idea of managing risk is especially poignant with the current COVID-19 crisis affecting everyone’s routine. We are in uncharted territory where people are spending more time indoors working from home. The gyms are closed and running is one of the best exercise options left in these unprecedented times. With these changing loading patterns brings a certain amount of risk for injury.
Running-related injuries have been reported as affecting 92% of runners at some stage in their running lifetime. These injuries occur due to a range of physical and non-physical factors, so to effectively manage these risk factors, a multi-modal approach is needed.
A simple categorisation approach (RISK framework) can be adopted to help injured runners manage their pain and return to running pain-free (Barton, 2018). It is helpful for both clinicians and runners alike and if put into practice should allow runners to prevent similar injuries in the future.
The overarching principles of the RISK system include:
- Reduce overall loads
- Improve capacity to attenuate loads
- Shift loads
- Keep adapting to the goals and capacity of the runner
Reduce overall loads
Load management has been an important factor in not just the running world but many professional sports around the world. Total load as well as the type of load has been shown to be an important factor in running-related injuries. Reducing the overall load is the easiest and often first parameter that injured runners can change safely. Examples of reduced load in injured runners may include restricting mileage or speed for a short-term period, or even increasing your step rate/cadence to help reduce overstride.
Improve capacity to attenuate loads
Targeting muscle strength in key areas of the injured runner has ever increasing evidence of building both resilience and reducing pain in the affected area. An example may include building strength around key areas like the gluteals and quadriceps in runners with patellofemoral pain. The research does show however that increasing strength does not seem to change the runner’s kinematics or gait pattern. In other words, all the resistance training in the world will not change your running technique if that technique has helped cause the injury. That is where we need to treat running as the skill that it is, as discussed below.
Gradually increasing running load is also a key factor in improving your running capacity. The body is an amazing machine and will build resilience as long as the ramp up of activity is a gradual one. The good news every runner wants to hear is that in order to build this resilience, the body needs regular stimulus. This means regular runs at the right level. The biggest challenge in the injured runner is finding that right level.
Article by Kieran Watson