If you are into running, you are likely to love it and have it as a hobby that you will never drop until you are old. There are just two camps of runners, those that hate it and those that love it. If you are reading this blog, you are the latter. Let's get to the point now.
When you heel hits the floor when you run it produces a force 3-4x of your body weight. No issue at all for the body since we are made to run. Regardless from many sports out there, running very often comes hand in hand with injuries, small niggles and pains. I've worked as a Sport Physiotherapist for 10years and I've seen runners, triathletes, sprinters and what not from beginner to international elite and none of them are spared unfortunantely.
So for you to keep running happily over the years, it helps a ton to get a better understanding of your body and early signs that your body is sending you and how to interprete them better. We want you running every week, or even every day whatever you desire and what keeps you happy.
If you had to be ruthless in summarizing the 2 most common running injuries I would definitely go for (not in that order necessarily):
Achilles region / calf pains
Knee pains
I don't want to go fancy on all the terms, muscle and tendon names - there is enough out there, I want to keep it simple for you.
The most common causes of knee pain and achilles pain
We cut straight to the point and I try to avoid all uneccesary "blabla" to keep you going with your day, but maybe a touch smarter than before when it comes to running.
Here are the most common reasons for trouble with either your ligaments, tendons or muscles that will get you injured eventually:
Zero to hero: You haven't been running much/ or at all or had a longer running break and your ego is controlling the ship by just getting straight into it: hard sessions, high volume vs. what your body is used to - you name it, Mr. / Mrs. Fullgas is steering the ship. "Quick results have to follow" says the ego, but endurance sports doesn't work that way. The most common and best way you will end up in the doctors waiting room wondering why you can't walk without pain.
The wrong tech for you: Since we decided it is too uncomfortable to run barefoot everywhere, we developed: Shoes - wow thanks for that tip, Matti. Hold on a sec there. Your shoes (daily life or running, both equally important actually when it comes to running injuries, more on why later) are the first contact with the ground when your foot hits the ground. So the shoes can either help stabilize and take load off the (3-4x bodyweight impact) or it can make your foot instable when landing (also walking) and therefore cause havoc of compenstation within a second up the so called "chain" i.e. knees, hips, pelvic/lowback and even up to neck. One thing you should know anatomically about the achilles tendon, it is an extremly strong structure BUT the direction of pulling it was made for is vertical / up and down of the foot, so if you got instable shoes your beautiful achilles tendon suddenly gets bounced around left and right /horizontal force applied. That the tendon does not like, like not at all. That's one the common reasons why runners get an unhappy achilles, their foot goes into weird angles due to a few reasons (not just shoes of course) and that causes pain eventually. Remember the brain has the goal of keeping your eyes & head horizontal at all times, so it will compensate the sh** out of your joints to make that happen. While marketing tells you which the best running shoes are, reality is each foot and body is unique and while the top 3-5 brands will very likely accomodate your stinky foot as well, some cheaper or less known brands might not do the trick for your foot to land in a stable way without causing havoc.
Okay so you got the message, running load and your shoes are (besides other stuff obviously) are key to keep you running healthy and consistent and therefore perform better over time, almost impossible not to to be honest.
What you should know about achilles pain as a runner
The main reason why so many runners get achilles issues, is because that structure is one big pain in the a** I promise you. It is insidious, sneaky and will stab you in the back once it's got the chance.
How achilles issue get started: The tricky part is, that tendon problems (could be a couple different ones causing the pain in the calf) don't necessarily start with pain right away! The first step of "overload" is stiffness, especially in the morning. Most will go and stretch it, which is the worst you can do, but you only find out afterwards since mostly likely in the next couple of days that stiffness will become a slight pain let's say 2-3/10 pain scala. Then suddenly it's during running, after running, you stretch more, more pain, you rest 3 days, no changes (tendons need load to heal, not just rest). Suddenly you can't walk anymore and we go the party started because now you are sitting in the doctors office looking for an answer. I am not into making people fearful at all, but trust me having seen so many achilles issues, you DO NOT want a long lasting achilles issue. That tendon from literally all tendons in the body, is I must say, the most annoying to get rid of by even ideal treatment. You must act really quickly once you got that stiffness coming, ask a specialists Physiotherapist what to do, now is the time to see him/her. That is what most people don't do, understandably since there isn't severe pain yet that drives them there. Once you got that pain/strong stiffness for 3 months straight while you kept running (almost everyone does this that's why I hope to "enlighten" you) you are in for the long hall and treatment to get rid of it will take a good ol' time. Bye bye running PB for the next couple of months, very likely.
Why you are so smart and ahead of the curve. Since you are now offically enlightened and this knowledge cannot be undone from your coconut, the next time your feel some weird morning stiffness coming for 1-3 days after a hard run for example, act wisely. Meaning you need to first get rid of that tension in the muscle, by foam rolling, self-massage / massage appointment and especially "Dry needling" - which is from all treatment options one or the most successfull by a long, long, loooong mile. Not every country has it, I also hate needles (same as acupuncte needles btw) and don't want them poked into my muscles, but the effect is so good and clear that I've had people with legit phobia of needles that would almost pass out seeing them, allow me to do it since the effect was so good. Then go see a good Physiotherapist and/or good Chiropractor that will help you find the cause of the issue. It can be as simple as the wrong shoes for you (or the new model of the shoe that worked great for you got upgrades that are actually downgrades..). It can also be a hip or pelvis issue from either tightness or lack of muscle activation & strength in a needed muscle group that helps keep the leg nice and aligned when landing on the ground. It can also be as easy as that your calf muscles are the weakest link from your leg muscles and give in first.
For treatment you need someone that...
Helps you to get rid of the tension in the calf muscle and therefore reducing the "pull" on the achilles / therefor letting the achilles calm down
Helps you find the root / roots of the why the achilles gets more load to the point that it sends us signals that it's too much.
Lastly..."Heel drop"
Before we end your enlightenment session, I want to briefly mention "heel drop".
"Heeldrop refers to the difference in height between the heel and the forefoot of the shoe"
Some say a heeldrop over 7mm or even 12mm is considered optimal for runners struggeling with achilles issues. You kind of offload, the calves a bit that way, the same reason people with achilles issues squat with a small plate under to heel to offload the calves/achilles.
I have been running in Nike's for the last years and come along really well with some of them, namely for long & easy runs the "Nike invicible" and for speedy/tempo stuff in training either "Nike tempo" or "Nike Zoom fly (5)" - this doesn't mean it'll work for you so don't go shopping just yet, try them and go with your gut feeling if they feel good while running, that is for most a key metric how to choose your shoe.
I recently did a running race and ran it with a 5mm carbon shoe (not Nike) vs the 8-9mm training shoes my body is used to. The intensity of the session wasn't a lot more than what I did for weeks weekly in a key session before, but boy did that run mess up my calves and irritate tendons.. With one run! Sure load going into the run etc. all plays a role, but the major impact on the structures was eye opening to me. I knew about this before but feeling it first hand is again refreshing. Since carbon shoes are very expensive (250-350 dollars a pair) and realistically the bounce lasts up to 200km, which I hear a lot of pro's do not agree with. They say after 40km it starts to go, so they do one run of 20 Min. pre race, then race it and then it becomes a training shoe afterwards. So imagine us mortals who don't have a running sponsor (me as of now 2023 year 1 as a Pro triathlete) and we spend our hard earned cash on the carbon shoes. What naturally happens is that we use it rarely and want to "save" it for race day. Makes sense sure. Problem is that while running a hard session of 10-15 km in them gives you an indication of how the shoe feels, there is no gurantee at all that it will not load your muscles very differently after 25km let's say. Carbon shoes are bouncy and make you faster, that also must come at some price of a structure working differently.
Many times our run cadence also goes up, which is great, but again your hamstrings etc. might not be used to this. So maybe (maybe not) you get a cramp somewhere in the last 3rd of your stand-alone Marathon or IRONMAN Marathon simply because of the shoes. The fix for this is expensive, meaning you buy a pair and run it a lo in a key session in training until your body and brain knows the shoe inside out. Having not done that in training, which most will not anyways due to cash reasons, just be aware at your next post-race analysis that this could play a role as well why you cramped or struggled in the end.
That's it from my side peeps.
Chat soon,
Matti
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