Common Running Injuries and How to Avoid Them During the NYC Marathon

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Common Running Injuries and How to Avoid Them During the NYC Marathon

Why Inuries occur at events like the NYC Marathon

NYC Marathon at Marcus Garvey Park
New York Marathon, Marcus Garvey Park

In the coming weeks the Marathon will be upon us and many hundreds of thousands of people are training for it as I type. This is always an exciting time, but today even more so since the NY Marathon was sadly cancelled in 2020 due to the pandemic. If there is a bright side to that, it’s that many of the participants had an entire year to train for this year’s event. Hopefully that will mean we see less injuries, more record times, more participants and more new runners.

There is no way through this beast of an event other than training hard, consistently and, most importantly, training smart. I hate to say it but there is always the possibility of a runner getting injured due to overtraining, under training, inadequate nutrition, lack of information or being new to running. With these things in mind, we can make informed decisions in our workouts to minimize our chances of getting injured while accomplishing our ultimate goals. Whether that goal is finishing number one or finishing at all, we can get there without hurting ourselves. Below I will list 3 possible injuries that a runner might experience during training or the marathon. These injuries are usually caused by repetitive use.

Common running injuries

  1. Runner’s Knee (patellofemoral syndrome) – This injury is self explanatory. This is an injury to the knee mainly caused by over-usage. A runner may experience pain on the kneecap or around the knee.
  1. IT Band Syndrome (iliotibial band syndrome) – The IT band is a fascial sheath that runs down the lateral aspect of your thigh that tends to pull in different directions by hypertonic or tight muscles that are connected to it, such as your lateral hamstring and/ or your lateral quadriceps and/ or your TFL (tensor fascia latae). A runner may experience hip or knee pain due to a repeated rubbing or friction to the IT band to the bone, especially around the later aspect of your knee. The pain becomes more pronounced when you bend the knee.
  1. Achilles Tendinitis – Your Achilles tendon is what connects your calf muscle to your heel. We wouldn’t be able to walk without it, let alone run. There are many reasons why a runner may develop Achilles tendinitis but a common one is super tight calves and/ or weak calves that puts stress on the Achilles leading to inflammation of the tendon – hence the name! This can make it very painful to walk, especially if the tendon isn’t warmed up. Athletes who suffer from this injury will notice, upon taking the first few steps after being stationary for a period of time, that it will be extremely painful at first then the pain subsides.

Now I’m going to list prevention strategies a runner should consider before training and before the marathon.

Preventing injury while running

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  1. A proper warm up – There is nothing more valuable than a proper warm up. It’s one of the tenets of injury prevention across the board. Making sure that you get a proper full body warm up will get your body and mind ready for the activity.
  1. Increasing your running volume slowly – This is very important if you want to increase your fitness level properly and safely without hitting a wall. Many inexperienced athletes will try to bite more than they can chew and end up either getting injured or becoming discouraged because they couldn’t handle the load. So, make sure you increase your volume slowly and methodically in order for you to develop your strength and endurance the right way.
  2. Cross training – Many athletes are so dedicated to their craft that they won’t deviate from their primary sport. However, cross training can be very beneficial for improving your overall athleticism for your primary sport. For instance, consider weight lifting for running. Light weight training can strengthen the core, hips, balance and coordination: all things that a runner needs. An amazing tool for injury prevention.

The NYC Marathon is a big deal and historical event, but participating doesn’t mean you need to completely sacrifice your body. Take the precautions I’ve laid out here and find a healing sports massage to minimize your chances of a major injury. Good luck!

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Strength & Conditioning for the Cyclist

 

By Ivan Garay LMT/CPT

Strength training can improve a cyclist’s performance and protect against injuries. Research on endurance athletes shows that strength training improves the three most important predictors of endurance sports performance[1]: economy (the ability to do a certain amount of work using as small amount of energy as possible), velocity/power at maximal oxygen uptake (How fast you can pedal on your endurance races), and velocity at maximal anaerobic running threshold (How fast you can sprint before burning out at top speed).

When designing a strength training program, you must first focus on correcting any imbalances in posture and movement patterns. The prolonged bent over position on the bicycle and miles of pedaling create common muscle imbalances in cyclist. They include tight/shortened muscles, the calves, psoas, quadriceps, hamstrings, lumbar spine, pectorals, upper trapezius, and neck flexor muscles. Along with these shortened muscles,there are weak/lengthened muscles, the tibialis anterior, gluteus maximus, abdominals, rhomboids, middle and lower trapezius, and neck extensor muscles.

Below is a sample routine that will balance muscles and improve cyclers posture:

First release tight muscles with foam rolling or active stretching:
Calves, psoas, quadriceps, hamstrings, lumbar spine, pectorals, upper trapezius, neck flexor muscles.

Follow by strengthening the weak muscles with resistance exercise:

  • Ankle Dorsiflexion with Cable or Tube Resistance
  • Barbell or Dumbbell Deadlift
  • Bridges
  • Dumbbell Rows with Shoulder Blades Squeezed (this exercises will reduce middle and upper back pain and soreness from long rides)
  • Neck Extension in a Quadruped Position (It will reduce neck pain from prolonged forward head position)
  • Planks
  • Side Planks

Brace your abdominals with every exercise. To perform an abdominal brace, pull your bellybutton toward your spine, tighten your abs without moving your body (as if you were about to be punched in the stomach).

Perform each exercise for 2 sets of 12-20 repetitions for muscular endurance.

Current research recommends that to increase cycling performance heavy strength training at maximal velocity[2] should be performed with multiple leg exercises for periods of greater than 6 weeks [3]. During a cycler’s off-season, high volume strength training should be performed two to three times a week and each exercise should be done for two to three sets for four to ten repetitions. You should rest two to three minutes between sets. Maximal results usually occur after an 8-12 week cycle of training. During competitive season your training volume should be reduced to 1 session a week with a lower volume of exercises but with the same high intensity to maintain strength gained from your off-season program[4].

Pick a heavy weight with each exercise and move as fast as you can during the concentric phase (lifting phase) and slow down during the eccentric phase (lowering phase of the exercise).

Off-Season Routine

  • One-Legged Squat
  • Barbell DeadliftDumbbell lunges
  • Standing Calve Raises
  • Barbell Rows
  • Seated Calve Raises
  • Chin-Ups
  • Bench Press
  • Barbell Shoulder Press
  • Dips
  • Dumbbell curls
  • Back Extensions
  • Planks
  • Side Planks

Competitive Season Routine

  • Barbell Front Squat
  • Standing Calve Raises
  • Barbell Rows
  • Bench Press
  • Dips
  • Dumbbell Curls
  • Planks

[1] http://link.springer.com/article/10.1007/s00421-013-2586-y
See Reference Page for article citation

[2] http://link.springer.com/article/10.1007/s00421-013-2586-y
See Reference Page for article citation

[3] https://www.ncbi.nlm.nih.gov/pubmed/23914932
See Reference Page for Article citation

[4] http://link.springer.com/article/10.1007/s00421-010-1622-4
http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0838.2009.01035.x/abstract;jsessionid=8DA506016E22EA58C549B269A3F70D81.f03t03?deniedAccessCustomisedMessage=&userIsAuthenticated=false
See Reference Page for Article citation

Strengthening and Conditioning for a Marathon

The right strengthening and stretching program is important when preparing for a marathon. Strength training has been shown to improve running economy, prevent injuries, and improve body composition and resting metabolic rates. Strength training is particularly important for older runners. Endurance exercise, like running, does less to protect against age related loss of lean muscle tissue than strength training.

When training for a race runners should perform one to two full-body strength sessions per week. Your workouts should be staggered around your key running workouts for the week. Avoid combining your strength workout with a hard speed session or long run on the same day. Research shows it could compromise your running workout and recovery[1]

Your strengthening routine should focus on two goals. First you must focus on correcting any imbalances in your movement patterns like over-pronation or over-supination. Read my last blog post on Plantar Fasciitis for the right exercises and stretches. Research has shown that a 1:1 strength ratio between your hamstrings and quadriceps is related to optimal running economy[2]. When performing leg exercises you can compare how much weight you can lift on the leg extension exercise versus leg curls. You need to strengthen the weaker of the two muscles. Most people have stronger quadriceps than hamstrings and will usually do only the leg curl, instead of both leg curl and leg extension exercises in a workout.

In addition to corrective exercises, your workout should aim at overall strengthening throughout the body to improve running economy and endurance muscle fibers. The following is a sample workout that incorporates both :

Lower Body

If you over-pronate during running do:
-Ankle Inversions with dorsiflexion using resistance tubing,
If you over-supinate, during running do
-Ankle Eversions with plantarflexion using resistance tubing

If your Quadriceps are stronger than your hamstrings do
-Leg Curls

If your Hamstrings are stronger than your Quadriceps do
-Leg Extensions
-Hip Adduction
-Hip Abduction
-Dumbbell Front Squat
-Barbell Deadlift

Upper Body

-Bench Press
-Dumbbell rows
-Dumbbell press
-Barbell Curls
– Planks(hold 30-60 seconds)
-Side Planks (hold 30-60 seconds)
-Do 2 sets of each exercise of 8-12 repetitions

For each upper and lower body exercise start with a weight heavy enough to allow you to reach 8 repetitions per set. Try to increase the reps every week. Once you can perform 12 repetitions with a certain weight, you can increase the load enough to allow you to do 8 repetitions again. Use the routine alongside your running training 1 to 2 days a week.

Provided by Ivan Garay LMT CPT
References

Eur J Sport Sci. 2014;14(2):107-15. doi: 10.1080/17461391.2012.726653. Epub 2012 Oct 3.
The acute effects intensity and volume of strength training on running performance.
Doma K1, Deakin GB.

Journal of Strength & Conditioning Research:
doi: 10.1519/JSC.0000000000000376,
Post Acceptance: January 28, 2014
Relationship Between Functional Hamstring: Quadriceps Ratios and Running Economy in Highly Trained and Recreational Female Runners.
Sundby, Øyvind Heiberg; Gorelick, Mark

[1] http://www.ncbi.nlm.nih.gov/pubmed/24533516
See references for specific citation information

[2] http://journals.lww.com/nsca-jscr/Abstract/publishahead/Relationship_Between_Functional_Hamstring_.97501.aspx
See References for specific citation information