Getting fit for the Sydney running festival

With the upcoming Sydney Morning Herald half marathon fast approaching many of you would have started to develop little aches and pains as a result of your training schedules. Recently, we have seen a lot of people complaining of sore shins and knees, and these are two of the most common areas to be injured while running. Both areas can cause severe pain and interfere with training schedules but the good news is they are both very treatable and with proper management you shouldn’t be sidelined for too long. First of all, what causes shin pain? The most common area to develop shin pain is on the inside of the shin roughly 5-10cm above the inside ankle bone. This type of pain is classically termed ‘shin splints’. The muscles on the inside of the shin are not very strong and if they are overloaded through a sudden increase in training, running too frequently on harder surfaces or through poor foot biomechanics then the muscles can become very tight and begin to pull on the bone at the front of your leg called your tibia. If we continue to run through this tightness the lining of the bone called the periosteum begins to become inflamed and tenderness and pain develops. The best approach for treating this condition involves an initial rest period including regular icing and anti-inflammatory medication. Soft tissue work to the muscles on the inside of your shin should also be commenced to reduce any tightness that exists to reduce the chances of the muscles continuing to pull on the bone. To prevent the pain returning a thorough biomechanics assessment should be completed to ensure any factors contributing to the cause of your pain can be addressed and corrected by your physiotherapist. Effective long-term correction is really important because chronic over-stress of the tibia in this way may lead to stress fractures and much more extended periods off running. Similar to shin pain, knee pain is often caused by a sudden increase in training, running too frequently on harder surfaces, or because of faulty leg biomechanics. The muscle of the inside of our knee is called our vastus medialis oblique, or VMO. This muscle acts to keep our knee-cap in the correct position. If this muscle has become weakened or is not strong enough to withstand regular running then the kneecap can be pulled out of position, causing rubbing on the back of the kneecap and producing pain. The good news is that rapid short-term relief can often be achieved by taping your kneecap to hold it in the right position. This minimises training disruption and time out of running, but remember it is only really a temporary fix and must be combined with a proper assessment to find and correct the real cause of the problem. An effective long-term fix usually includes core stability to improve hip biomechanics, VMO strengthening, biomechanics correction, and focussed stretching. Basically, once you have sorted out all of these factors then they will hold your kneecap in the right place and you will no longer need the tape. However, if you just tape and don’t fix these other things then once you stop taping then your kneecap will start to shift out of position again and your problems are likely to recur. Like most things that go wrong with our bodies both of these conditions are so much easier to treat when they are at their initial “niggle” stage, rather than at their full-blown painful stage. So a big key for anyone in a training program for an event is that if you have a “niggle” get it checked early – your relief will be faster, your training will be less disrupted (if at all!), and it will often be good for your wallet because early intervention usually means less visits to the physio. So good luck to all of the people getting out there this Sunday in the Sydney ½ marathon, and also those in training for the Gold Coast marathon in July!