START: Going the Distance


START is the Sports Medicine Clinic at the University Sports Centre. Bernie Li, lead physiotherapist and founder of the clinic, is
available for consultations and treatment of all musculoskeletal injuries during weekdays by appointment.

For more information, visit or call 01334 462 190.

It’s that time of year when people all over the country decide to ‘get fit’ or raise money for a charity by running the marathon. With
only three months before the Edinburgh marathon, this is about the time people start increasing their mileage and frequency of training. Unfortunately, it is also the time that avoidable injuries tend to appear.

Below is a list of common injuries and complaints (see illustration):

1. Plantar fasciitis

2. Achilles tendonitis

3. Calf strain

4. Shin splints

5. Hamstring strain

6. Patello-femoral joint pain (Runner’s knee)

7. Ilio-tibial band friction syndrome

8. Groin strain

9. Piriformis Syndrome

10. Lower back pain

Running is a skill most of us can do, but like most things running efficiently is very difficult. Everyone has a unique way of
running due to their body composition, posture, strength, age and sex. So to there is not a ‘right’ way to run.

How to minimise the risk of injury:

Dynamic Profiling: This is an assessment session carried out by the physiotherapist previously afforded to serious athletes where the major joints, muscles and tendons of the body are tested. Now it is available to everyone.

Video analysis of running, lunging and stepping can highlight small movements which are occurring at the lumbo-pelvic region as
well as pronation at the foot which are difficult to see with the naked eye.

A tailored exercise program to address stability issues and stretches is prescribed and recommendations for orthotics (insoles)
can be made.

Keep a training diary: Jot some notes down each day about the training session: what time, duration, intensity, how you felt during and after the session, any niggles. This gives you a record of progression or the onset of problems. Taking your heart rate in the morning as you wake up is also a good measure of improving fitness (as it gets lower with training). If your resting HR
increases, it may be a sign of overtraining. Only written records will help you with that.

Stretching: This should be a part of everyone’s day. Ideally for every four minutes of running, you should try to do one minute of stretching. Search YouTube for hundreds of stretches. Some commonly missed structures are Soleus and Tibialis Posterior (deep
calf muscles), Piriformis (deep gluteal) and Iliotibial-band.

Ice: Commonly used in injury management, ice is a cheap and effective way of minimising inflammation and aiding recovery for the next day’s training. Place real ice (not frozen peas) in a plastic bag and apply to different areas for up to 10 minutes. NB: Do not fall asleep with ice on your legs, otherwise an ice burn can result.

Footwear: The recent trend of “barefoot running” has both fans and critics in the healthcare world. Personally my opinion is that if you consider yourself to be anywhere near “overweight” or a novice runner, steer well clear of going commando. A good running shoe gives a mixture of cushioning and support. Any shoe that can twist easily in your hands will more or less
buckle with body weight and the stress is transferred directly to the foot/ankle/knee and hip.

Technique: If you run on a treadmill, unplug your iPod for 1 minute and listen to how loud or heavy your footsteps are. It is no coincidence that the louder foot is going to be the one getting the problems. Louder means more impact and eventually pain. Try to float along the surface and minimise how high your stride takes you.

Massage: A little pampering for some, aiding recovery for others. Apart from the obvious benefits of loosening tight muscles, it helps you become more aware of “hot-spots” which require more attention when stretching.



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