If the shoe doesn't fit, don't wear it


Continuing in his training series in the run-up to the marathon, Emmet Maloneis given some advice by physiotherapist Catherine Cradock

Ah, the summer months, good times for so many people. There are the retailers of rain gear who clean up with tourists, the people who run indoor children's activities who clean up with parents and, of course, the physiotherapists who live like kings through the marathon season.

"Well, it's certainly seasonal," laughs Catherine Cradock as she talks about the slight shift that occurs in the client base around this time of year. "Of the people who come to me for the first time around this time of year, a fair percentage of them would be training for the marathon and I'd generally tell them to bring their running shoes in with them so that we can assess whether they're contributing to the difficulties they're experiencing."

Shoes (to be dealt with in a couple of weeks) are just one of many things that can cause or contribute to injury in inexperienced runners while, as previously mentioned, doing too much too soon (zero to hero syndrome) is another common source of difficulties.

"The importance of footwear can't be overstated," she says, "because the type of footwear you choose will depend largely on the type of foot that you have. A lot of other injuries are basically down to overuse. Unlike a lot of other sports where people are prone to traumatic injuries, like twisting your knee playing football, most in running stem from pushing your body too hard, too quickly for too long.

"After that," she continues, "there is a whole range of things that come into the equation. From inadequate warm up, nutrition or hydration to biomechanical problems (such as flat feet, bad posture or even having one leg longer than the other) to environmental issues."

This last category can boil down to something as basic as running continuously on the pavement on one side of the road so that the camber leaves one foot lower than the other. Difficulties can also be caused by something like training on a small circuit, so that your stride is affected by the need to turn, sometimes constantly, in the one direction.

That sort of stuff can be easily addressed once it is identified but telling somebody that their left leg is longer than their right can prove delicate (indeed, we have had correspondence from readers on this issue).

"Yeah, well," she says, "I suppose what you're saying to people really is that there might be a slight asymmetry there. And it can be caused by a whole range of things, sometimes something as basic as people who work behind a desk all day getting into the habit of sitting or folding their legs in a particular way. The bottom line, though, is that people can get a little bit out of alignment and that needs to be addressed."

Many people fail to pay enough attention to issues like warming up, hydration, nutrition or stretching afterwards.

"One of the most common mistakes," she says, "is people using nothing but static stretching to prepare for their run. Now some small amount of static stretching might be a good thing but for the most part it is intended to cool muscles down, not warm them up. What you need to do before running is to loosen up and that can be done in a variety of ways (including a light jog)."

Looking at your overall diet is important while taking on what might be considered "fuel" before runs will be a major benefit. "Even the night before longer runs," says Cradock, "people should be trying to eat slow-release carbohydrates.

She also recommends doing some stretching exercises the night before, particularly for people suffering some stiffness. Hydrating properly before running as well as during longer outings is of major importance to avoiding muscle injuries.

"If you don't do that then the muscle fibres themselves become dehydrated and that's when you become very vulnerable. Taking on fluids after a run is obviously important but where you've been out for a prolonged period of time (45 minutes seems to be widely regarded as a threshold) then damage can already be done by then so it's important to remember that prevention is better than cure."

Stretching properly to cool down key muscles like the hamstring, calf, Achilles as well as those in your back is of critical importance. Giving ten minutes to winding down could, she says, prove to be one of the best investments you make in your entire training regime. The types of exercises you should look at are illustrated on the Irish Society of Chartered Physiotherapists, www.iscp.ie.

Next week, Cradock will takes us through the most common injuries to affect runners and how they are treated. There will also be information on stretches and on Pilates, which helps runners develop their posture, agility and strength.

Catherine Cradock is a chartered physiotherapist based at the Portobello Clinic (portobellophysio.ie or phone 01 476 3330). She is a member of the Irish Society of Chartered Physiotherapists and of its Sports Medicine Committee.

Details on how to find other chartered physiotherapists as well as advice on appropriate stretching exercises are available at www.iscp.ie (follow the marathon links) or from the society at tel: 01-402 2148.