Safe running: technique, progression, avoiding injuries

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  • #6060
    Mariner_9
    Participant

    Some brief background:
    – from 2009-2012, I was running ~2-3 times per week, around 3-5 km each run, probably Z2 or Z3. Exercise rather than training and ‘intensity trap’!
    – from 2013-mid 2014, I was running ~2-3 times per week, with 1-2 short runs of around 5 km and 1 longer run which went from 7 km to 9 km to 16 km and as high as 25 km. This was all Z2/ Z3. Again, exercise rather than training and still in the intensity trap. I developed ITBS, probably from running “too hard” (I suspect longer stride length => higher impact => higher chance of injury) and perhaps from increasing the mileage too quickly
    – from mid 2014 to end 2016, I switched to road cycling as it’s lower impact. I quit because of the objective danger (where I lived was not bike friendly) and the lack of sports specificity (I read TFNA in late 2014 and slowly absorbed the messages!)
    – from January to May 2017, I did stair climbs (no weights) for my aerobic exercise (and stair climbs with weights for ME). In June, I resumed running. Started 2 times per week doing around 9 km each time, all road running in Z1/Z2, which meant a very slow pace (I was doing walk/run, slowing to a walk when HR went into Z2 and allowing it to come back down before resuming a running pace). No problems. Increased to 1x 9km run and 1x 15-18km run each week. Still no problems. Since July, I have been doing a mix of trail running and road running (same frequency, distances and intensity). In the last two weeks, I noticed pain in the Posterior Tibial Tendon of my right foot.

    Is this just overuse? i.e. too much, too soon in terms of mileage? Or are the other explanations? I had running shoes properly fitted with video analysis of my gait so I doubt the issue is the shoes. And having switched from all road to trail/road, I would have thought I would be less likely to develop problems.

    I’m keen to continue running because the transfer to ‘uphill athletics’ is better but I obviously have to put it on hold for now until I get a diagnosis and treatment (which will take several months due to the vagaries of the medical system here and my insurance).

    Thanks for reading what’s a relatively long post, and for any advice/help you can provide.

  • Spectator
    Scott Johnston on #6069

    Mariner;
    Sorry to hear of your injury. I’m not a medical expert and I assume you have had this diagnosed professionally and are sure of the problem. It really doesn’t matter at this point what caused this injury but the most likely cause is “too much, too soon” as that is the cause of 90% of running injuries. Now you need to focus on getting well. STOP running immediately! If you have a tendon injury you must stop doing what likely caused it and allow ample time to heal. An running focused Physical Therapist or Podiatrist should be consulted for the potential fitment of orthotics. This is because the Posterior Tibial tendon/muscle supports the arch and each time your arch flattens, even a tiny amount, such as in running it stress that tendon.

    Therapy for this injury is best done with seated light resistance, high rep exercises of ankle inversion/eversion using rubber bands for resistance. You can find good suggestions here:https://runnersconnect.net/posterior-tibial-tendonitis/

    Until your symptoms subside you should not do anything that irritates this condition. If you can hike/walk, get on a treadmill and set the angle up. But don’t run. Be prepared as tendon issues can take months to clear up due to tendons poor blood supply.

    Good luck,
    Scott

    Participant
    Mariner_9 on #6071

    Scott, as ever thank you for taking the time to read and respond – much appreciated.

    I’ve stopped running. For now, aerobic exercise will have to be via road cycling. I know it’s sub-optimal, but it’s better than nothing and it doesn’t seem to bother my ankle.

    Due to moving house, I haven’t done any ME for several weeks. I’m going to try that (with reduced duration and weight) and see how I get on with my ankle – obviously I will err on the side of caution. Thanks to the move, I’m now able to do proper water carries rather than lugging the weights up and down stairs in a high-rise.

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