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Running injuries – lessons learned by our Physios


Running is becoming increasingly popular.

As many new runners strap on the shoes, to join in the Park Runs (5 km runs – held on Saturdays in suburbs everywhere, including Aldinga and McLaren vale).

Running Injuries are also becoming more prevalent.

And it can strike experienced runners too.
Principal Physio, Tom Anthoney learned this lesson recently as he rapidly increased his mileage in training for the Barossa Marathon in May.

Lesson 1 : the 10% rule

The ‘rule of thumb ‘ when increasing ones Volume of running is to increase by 10% per year.
Especially in runners who are 40 years+ , Tom A is 52.  He knew the rule (he’s writing this blog). But he increased his volume by 50% (from 2022 to 2023).
So, where he used to run 25-30kms a week he was now running 50kms a week.
He may have been heard saying “I’ve never felt fitter” a week before tearing his calf muscle.
But on reflection, (while sitting around nursing the calf injury) realised his calf muscles had been progressively getting sorer.
Running when your legs are already tired, e.g. going for a slow run the day after a long run can build “fatigue resistance”.
And this had worked very well leading up to the race.
Tom ran 28, 30 and 33 km in training and had never “felt fitter” cardio-vascularly.
But ignoring the leg soreness ultimately didn’t work.
Ten days before the Barossa marathon event, Tom’s calf muscle “pulled” when running up a hill with a younger, fitter mate.

Lesson No 2: should have stopped

He did not stop, instead, he pushed through it for another 5 kms resulting in a Grade 1 Soleus Strain.

As Physios we are expert in differentiating a Grade 1 Strain from a Grade 2, 3 etc. And we know a Grade 1 will take 10-14 days to heal.
Toms’ injury occurred 9 days before the race.
Uh oh!
He rested it and got as much good Physio and massage treatment as he could, (Thanks Tom Daw, Thanks Fern) but knew he probably was in trouble.

Come race day, walking was pain free. “I might be ok” was not a convincing mindset for an Endurance, 42 km test.
The pain kicked back in hard at the 2 km mark. Harder than before if truth be told.
Pain / cramp – “stop”… he didn’t.
Stubbornly (some would say stupidly) he limped on to the half way point (21 km) , using every other muscle and every trick in the book.
Discomfort is something one must endure in endurance events.
But by 24 Kms he knew he “was cooked”  He apologised to his running partner Luke and stopped to a walk.
No one likes a DNF (Did not finish) but walking another 17 km would have been pointless.

The limp back to the start/finish line was the longest 3 km he had ever known.
Emotions of disappointment, frustration and failure were hitting hard.

Lesson No 3: Stride length

For runners, still reading, he realised that he had let his stride length get too long in training as he was getting tired (long lunging strides put extra load on the calf muscles).
So improved cadence (160-170 steps a minute) would be the third lesson learnt.

Rehabilitation has included:
Rest, ice, compression- no stretching or exercising for the first week.
Then, massage, ultrasound and gentle stretching week 2.
Then more massage, dry needling, and strength work week 3.

In rehabilitating soft tissue injuries, as physios we generally use the rule, when you feel good “give it another week” before you really test out the injury…especially for our more mature athletes.

This was lesson 4:

Tom has been listening to his Physios and ticking every box and just returned today (with a very short run – 3 weeks from the injury)
He felt he could have run last week (14 days after injury) but ” gave it the extra week” and …. Success!!

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