Watch your body language: Early signs of 7 common injuries
Tuning into the whispers of your body’s early warning signs means you can head off injuries at the earliest stage. Sidestep soreness, training disruption and crippling physio bills with our expert pre-pain prevention plan.
Foot
The whisper “An important early warning sign to tune in to comes when you step out of bed,” says physiotherapist Paul Hobrough, owner of Physio & Therapy UK. “It’ll feel like you’ve just trodden on a frozen pea, and will hurt for about three steps. That will increase to four or five steps a few days later – always immediately after rest. Most people will ignore this, but it’s the right time to act.”
What it’s telling you...
“This is a really horrible injury, very common among runners,” says Hobrough. “Essentially, it’s damage to the thick tissue on the bottom of your foot – the plantar fascia – which connects your heel to your toes. After time, left unchecked, your body starts laying down calcium deposits to mend it, which can then create a heel spur.” And that’s when it’s time for the knife...
Stop it becoming a scream The solution can come in the same place as the warning: your bedroom. “Lying in bed, raise your foot and write the alphabet in mid air,” says Hobrough. “It sounds simple, but alongside toe-grabbing on a towel, it can reduce the symptoms dramatically: you’re pumping blood into exactly the right part of your sole, making it pliable again.” Not writing your alphabet spells trouble.
Shin
The whisper When you step out of your post-run shower, watch for a “niggly, puffy pain inside the front of your shin,” says Hobrough. “Your body will have had enough time to cool down and stop producing endorphins, so that’s when it will realise there’s something wrong – particularly with the action of stepping out of a shower or bath.”
What it’s telling you…
More commonly known as shin splints, this is a painful condition that can result in stress fractures if it’s not properly treated.
Stop it becoming a scream The worst thing you can do is rest this one. “Shin splints occur when the muscle is weak, so you need to focus on strengthening it,” says Hobrough. “Toe raises are perfect. Standing with your back flat against a wall, step roughly 30cm away from it, keeping both of your legs straight and together. Now, with your heels on the floor, raise both sets of toes up and down simultaneously.” Start with three sets of 20 reps, always last thing at night to give your muscles maximum recovery time afterwards (and to mischievously disrupt your other half’s bedtime reading).
Heel
The whisper “You find it painful to put your heel down, and it’ll feel like you want to walk on tiptoes,” says Hobrough. “You might also hear a slight creaking sound.”
What it’s telling you...
ACHILLES TENDINOPATHY
A swelling, stiffness and weakness in your all-important achilles tendon. This injury deteriorates very quickly and can result in a tear.
Stop it becoming a scream Sadly, neither high heels nor WD40 are the answer here. Instead, Hobrough recommends the preventative power of baked beans: “Slow, heavy, eccentric calf raises are the answer – but the key is applying more than your bodyweight while you do them,” he says. “Put three or four cans of baked beans in a rucksack, put it on your back, then stand on your toes on the edge of a step. With your good foot off the ground, take six to 10 seconds to lower the heel of your bad foot down as far as you can.” After three sets of 15 reps, wash the baked beans down with an energy drink. Legendary GB running coach Bud Baldaro believes achilles injuries are often the result of long-term muscle dehydration – in particular, a deficiency in magnesium and potassium. Head to the Science in Sport website for how to restore your balance.
Front of hip
The whisper Pain above the groin. “Your main hip flexor travels up alongside your groin, which is where you’re going to feel tightness first,” Hobrough says. “In particular, you’ll start noticing pain in the groin area while lying on your front in bed.”
What it’s telling you...
FACET JOINT OVERLOAD
Chronic lower back pain, usually caused by tight hip flexors pulling on your facet joints (located either side of your spinal column) while running.
Stop it becoming a scream “You need to optimise flexibility through the front of your hip to solve this one,” says Lack, who prescribes rotating squats. “Go into a squat position, with your lower back neutral and your arms across your chest. Rotate left to right with your lower back stationary but your upper back moving. Do this for four sets of 30 seconds, twice a day. Your hip flexors will become supple and flexible, propelling you forwards, fast.” As opposed to yanking your spine out of place slowly.
Ankle
The whisper This one’s not necessarily about pain, which makes it harder to ‘hear’. “You’re looking for a marked feeling of instability or loss of balance when you try to stand on one leg,” says Hobrough.
What it’s telling you...
Back pain from running? This could be why
It might start with a harmless sprain, but if it’s not dealt with properly it can lead to lateral ankle instability and, from there, chronic pain and loss of function, eventually needing surgical correction.
Stop it becoming a scream “Get yourself on to a wobble board, which is ideal for strengthening the ankles,” says Baldaro. Nike master trainer Sonja Moses suggests doing a combination of narrow and wide squats on your new toy: “Place both feet on the wobble board and find your balance point,” says Moses. “Drive your hips forward as you lower, keeping your arms out to balance yourself. Go from narrow to wide in this squat position: you want balance challenges that maintain symmetry to avoid overloading one ankle.” Aim for three sets of five minutes, four times a day.
Hobrough’s approach is simpler: “Brush your teeth standing on one leg at a time, building proprioception [your body’s sense of movement and orientation],” he says. Better balance, stronger, more responsive ankles and shiny teeth. Now that’s multitasking.
Inner ankle
The whisper “A tenderness around the medial arch of your foot, or on the inside of your ankle, particularly during a run,” says senior physiotherapist Chris Whittle. “It’ll feel like a nagging ache – not dissimilar to a toothache at the wrong end of your body. You might also find it painful to stand in the same place for a long time.”
What it’s telling you…
POSTERIOR TIBIAL TENDON DYSFUNCTION
One of the most common problems in runners, it occurs when your crucial posterior tibial tendon – which travels along the back and inside of your foot and ankle – becomes inflamed or torn. Whittle warns that this can lead to your foot’s arch collapsing, which could result in adult-acquired flatfoot syndrome. Not something that’ll help add to your medal collection.
Stop it becoming a scream “Go back to basics,” says Whittle: “Whatever you do, don’t try to run through this. To prevent it becoming serious, give it plenty of rest and ice.” When your misplaced toothache has eased sufficiently, head straight to your nearest running shop. “Orthotics prescribed by a physiotherapist or podiatrist can help by supporting your arch and stopping this condition from worsening,” explains Whittle. Flossing less so.
Knee
The whisper “A bruise-like pain underneath your kneecap, particularly when you’re going downstairs or crouching to pick something up,” says Hobrough.
What it’s telling you...
PATELLOFEMORAL PAIN SYNDROME (PFPS)
‘Runners’ knee’ in the less medical parlance: irritation on the undersurface of your kneecap. Ignored, it can lead to tendinopathy and, eventually, the operating theatre. Long term, warns Simon Lack, senior physio at Advertisement - Continue Reading Below, it’s a recipe for arthritis. Not a tasty treat in anyone’s book.
Stop it becoming a scream Moses says the very first thing you should do here is start taking daily glucosamine supplements – ideally 2,000mg – which will repair and strengthen the knee cartilage. For a more immediate effect, once you’ve had your gait re-analysed and the support in your running shoes checked (which is a classic cause of knee problems), Lack recommends doing single leg bridges: these will strengthen the iliotibial band (ITB), which holds your knee in place. “From the bridge position, raise your bad leg up as far as you can, while keeping it straight,” he says. “Now, still as straight as possible, lower to the ground and repeat for 20 reps.”
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