#Londonmarathon – #marathonprep

epa03192532 Runners advance to the finish of the 32nd London Marathon on the Mall in London, Britain, 22 April 2012. Seen in background is Admirality Arch. Organisers said that just over 37,500 entrants have registered for the race. EPA/FACUNDO ARRIZABALAGA +++(c) dpa - Bildfunk+++The London marathon is a few weeks away, and recent visits from runners preparing for the event have reminded me of the many questions asked, and the tactics we have recommended to keep them on form; or to prevent injury and in many cases, to enable them to recover quickly from strains or  “niggles” as they like to say.  Training for a marathon is quite a particular process, and the psychological battle of a marathon runner is quite different from that faced by, say, a half marathon runner, or any other endurance athlete.  Therefore, the treatment and advice given need to join in with the particular conversation the marathon runner is having in their head – which is not always a rational one. An endurance athlete will be accustomed to pain, or at least, discomfort.  It is to be expected for the demands they are placing on their bodies. Understanding pain and when it is safe to “run through it” is very important.  So when a marathon runner presents with pain, it is usually because something is different.  A different pattern of recovery; different area; different quality; different behaviour; different distance.

For those who listen to their bodies and take heed; they tend to consult with us before this “difference” becomes an issue and starts to curtail their training. We will normally see these people at week 6 or 5 before the actual event.  For those who are not listening; or ignoring, or just not sure – we will see these people at our clinic 2 to 3 weeks before the event. We know this because they will say something like “It started off as a niggle about a month ago…..”

The charm of the London Marathon is that it attracts both seasoned and new runners.  However, the people we see at week 6 or week 2 does not tend to correlate with the amount of running experience.  What brings people in at 6 weeks or 2 weeks may be due to their inherent ability to listen to their bodies clearly among the other, not always so helpful, voices in their head.  The key to helping a runner at the various intervals leading up to a race is therefore to diagnose their state of mind as well as the physical complaint.  The reason I say this is because of the huge psychological mountain that carries a runner through a race like this.  And the treatment and advice we deliver are with this very important consideration in mind.

Here are some of the questions we get from marathon runners in the last weeks before a race:

Top questions

Do you see a lot of marathon runners at your clinic?

Before and after a high profile race is when we are introduced to new patients who are runners – and there is a broad mix of running experience within this group.  Existing patients who are runners are usually seeing us throughout the year and are “strategically”  programming us into their training and event schedules.

If I get a “niggle” should I run through it or will I do myself permanent damage?

In the absence of meeting the person asking this question and diagnosing the cause of their symptoms, the best answer we can give is as follows.  Keep an open mind.  If it continues; or changes in behaviour; and/or it is undermining your confidence / mental resilience, then get it checked out by us or a similar professional.  Chances are you developing a repetitive strain as your training intensifies and your body needs some adjustment to cope with the increased mileage and frequency of training.  These symptoms are much more straightforward to deal with if we have at least 6 weeks before the event.

I have injured my hip/calf/back / etc!  I really want to do the race. Will I be able to run?

We will only be able to advise on this if we have examined and diagnosed your injury at the clinic.  The most frequent injury I see in the 2 to 3 weeks before a race is either calf injury or hip injury.  So far all runners I have seen, bar one, have not been able to overcome injury to enter the race.  The one who did not follow my advice and treatment recommendation.  I cannot categorically say that is why she did not make the necessary recovery but what I have come to realise it is not just the intervention that makes the difference, but also the confidence that the runner has that the injury can get better and that they will not be permanently injuring themselves as a result.

Will I have to stop running to recover from my injury?

That depends on the injury but it is our intention to keep you active during your recovery  We can do this by making any of the following recommendations which are applicable to your case.

  • Regress your training plan / reduce mileage to recommended level for a recommended period
  • Rest but continue with non-weight bearing CVS exercise for a recommended period

How will I know I am safe to push my injured body after recovery?

We will teach you how to stress test the area after we have stress tested the vulnerable areas and confirmed you are ready to get back on track with training.

What exercises can I do to help recovery or prevent injury?

Again, this is very individualised advice, because it is based on a full evaluation of your case.  The exercises will include stress testing, once we judge you are recovered enough to do them yourself.  Do not be surprised if we give you exercises that do not seem related to the symptomatic area.  We are giving you these because we have judged other areas to be linked to your current complaint.  This is all explained in your consultation.

How much treatment will I need?

Again, this varies according to each individual.

When would it be considered too late to get help?

Although early assessment and intervention are recommended, it is never too late to seek osteopathic advice and treatment.

Should I get an X-Ray or MRI?

This depends on whether your practitioner feels it is necessary to do so.

Is it beneficial to see you after the race and maybe for proactive treatment to assist my running throughout the year?

Absolutely, post-event osteopathy can help in many ways. Restoring the muscles to a relaxed state as part of the recovery process will reduce the risk of next day muscle soreness. This will also help to reduce any swelling and thus promote faster healing time.

Osteopathy is hugely beneficial for prevention of any further potential injuries. For example, if you have suffered a knee injury after your event, we will be able to work to relax and strengthen the structures supporting your knee and hence retain mobility of the joint. This will then prevent any further injuries throughout the year and allow you to continue running!