As many of you begin preparations for this year’s London Marathon, I’m sure you’ll be thinking about how to prevent running injuries.

marathon runners

In this article I’ll give you the tools to screen yourself for potential problems and show you what to do when you discover an injury may be on it’s way.

Despite the fact that injuries are seen by many to be down to bad luck, most follow a fairly predictable pattern, especially in endurance event competitors such as yourself.

The first indicator that trouble is brewing is restrictions in range of motion or muscle tightness. These restrictions indicate that some muscles have been overloaded and your nervous system has responded by increasing tension in others to keep your joints stable.

In most runners these breakdowns will occur in muscles that are responsible for pronation. Whilst pronation has a bad reputation (particularly in shops that are trying to sell you shoes that aim to prevent it), it’s actually a critical motion to preventing injury because it’s how your body absorbs force as you run. Think of it as your suspension system.

runner pronating

Far from being something that only occurs at your feet, it’s actually a series of motions involving your foot, ankle, lower leg, hip and trunk, as can clearly be seen on the image of Rita Jeptoo. Assessing yourself for restrictions in 3 key areas will give you an indication where you may be vulnerable to injury.

How to assess pronation.

Use these 3 range of motion assessments to check your current ability to pronate.

Tibial internal rotation.
Sit in a chair with your feet and knees hip width apart and your shins perpendicular to the floor.
Place both your fists between your knees (to prevent your hips from moving).
Keep your foot flat on the floor (bare foot is better) and begin to twist one foot towards the other. If the sole of your foot comes off the floor then you’ve gone too far.
Note how far you are able to go and then repeat on the other side.

Hip internal rotation.
Stand with feet hip width apart.
Twist one hip in making sure the motion comes from the hip.
Let the foot slide in on the floor with the movement and note how far you are able to go. Return that hip to neutral and repeat on the other side.

Trunk rotation.
Sit tall in a chair making sure your thighs are parallel to the floor.
Loosely fold your arms across your chest.
Slowly rotate your trunk in one direction as far as it will go. Note how much range you have before repeating on the other side.

What did you find?

It is common to find restrictions through one side of your body in particular. This will usually be the side of your body where you experience the most aches and pains for the reasons I have already discussed.

So now you have a snapshot of how well you’re able to absorb force and therefore which side of your body is more prone to injury. What I’m sure you want to know now is how you can improve this situation.

Whilst the standard approach is to stretch these tight areas to remove the restrictions, I want you to think about this problem differently. If the tightness is a solution to overloaded muscles being unable to contract, then stretching the muscles that are keeping your joints safe is a bad idea. A better approach is to get those muscles that are presently unable to contract working again.

An effective way of doing this is with low intensity isometrics. These subtle exercises encourage overloaded muscles to begin contracting again and in this instance will improve your ability to absorb force as you run and reduce your risk of injury.

Tibial internal rotation isometric.
Start in the same position you were in for the assessment.
Rotate the limited foot in as far as it will go.
This time bring the other foot across to block the motion at the end of your range.
Think about twisting in further and very gently push the limited side into the other foot.
Use no more than a 5% effort and hold the push for 6 seconds before coming back to the starting position.
Perform 6 sets of 6 second holds with a 5 second rest in between.

Internal hip rotation isometrics
Because of the large amount of motion available at the hip there are 3 different isometrics.
1) Start by laying down on the floor. Rotate the limited hip inwards and very gently (5% effort) push straight down into the floor (extension). Hold the contraction 6 seconds and repeat 6 times with a 5 second rest in between.
2) Now twist the same hip in again but this time bring your opposite foot across to block the motion on the inside of the working leg.
Holding the rotation push directly across into the opposite foot (adduction). Hold 6 seconds and repeat 6 times with a 5 second rest in between.
3) Lastly twist the hip in again and holding the rotation take the target leg away from the other leg as far as it will go (abduction). Have an immovable object block you on the outside of the working leg and gently push out as if trying to take the leg further away. Hold 6 seconds and repeat 6 times with a 5 second rest in between.

Trunk rotation isometric
Lie on your back with feet hip width apart.
If you had a right trunk rotation limit take your right leg over your left and place your right foot on the outside of your left knee. Reverse the procedure for a left trunk rotation limit.
Rotate your pelvis as far as you can to the left keeping your shoulders on the floor.
Place your left hand on the inside of your right knee to provide a block.
Using a 5% effort attempt to rotate your pelvis further to the left into the blocking hand.
Hold for 6 seconds before coming back to the floor.
Perform 6 sets of 6 second holds with a 5 second rest in between.

For each limited position you should see an increase in range of motion following the isometrics. This means you have improved the ability of the target muscles to contract and therefore your ability to absorb the forces that enter your body as you run.

Use the 3 range of motion assessments on a regular basis to check for any changes that may be occurring as you increase your training volume. Perform the isometrics on the limited ranges you find to address the restrictions and reduce your risk of injury.

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