Beware New Year’s Resolution Pitfalls

We all tend to make New Year’s resolutions. Mine was too try stay away from the carbs, exercise more, lose some weight and try having a more balanced life-style. As is always the case we start with good intentions.  Seeing that I prefer running I’m going to look at it from a runner’s perspective. We wake up on the 1st of January after having 3 weeks of good eating, little exercise and over indulgence and now we going to take on the Comrades, Epic or Ironman. There are many pitfalls that wait for us during this time. I’m going to address these in order to try making the transition from out of shape, de-conditioned holiday slob to budding comrade’s runner easier.

So what we do we tend to see from a physiotherapy point of view? I call it our new year’s resolution injuries. People start training too hard, run too far, run too fast and don’t have enough rest. This tends to lead to overuse injuries which affect mainly the tendons

Let’s look at this and what can be done to avoid them.

 

Tendons:

Tendons are made up of a strong form of connective tissue called Collagen. They attach muscles to bones and act as levers to generate force through joints to ensure movement occurs.

Sure everyone has heard of the term “tendinitis”. A tendinitis is effectively an inflamed tendon and according to extensive and recent research this term is now obsolete as  tendons  have very few inflammatory mediators within the tissue. So when it comes to running, people tend to suffer from what we call  “tendinopathy”. This is a degenerative tendon where the tendon cannot stand the load it is put under and starts breaking down. We find the connective tissue it is made from, commonly known as collagen, gets infiltrated by small blood vessels and the tendon doesn’t have the ability to withstand force as well.

 

 It is important to recognise the signs and symptoms of tendinopathies.

–          Pain after exercise especially the next morning

–          Becomes less painful as the structure warms up

–          Athletes can run through the pain or the pain disappears with running

–          Initially can train with it which will later have an influence on the recovery

–          Local tenderness and swelling of the tendon

(Brukner and Kahn 2009)

 

So what do we have to do to avoid these?

The key here is to ensure :

– the structures that are being loaded are strong enough to handle the force,

– we need to limit the initial force to the structure being loaded

– ensure the structure has enough time to return to normal by giving it sufficient rest.

 

So where do we start?

Ensure you don’t try get out there and do too much. If you trained through December you are ready to get going. If not, then for every week you were off deduct 10%. So if you were off for 3 weeks deduct 30% and start there. You can then add 10%/week on distance but don’t think about increasing any speed yet until you have reached previous levels you ended off on.

If you are a novice and haven’t trained for months or years you are definitely going to have to start slow. Please don’t think you going to do Comrades after 6 months. Although it is possible, it really isn’t recommended. The body has to adapt to getting back into running. What I would once again recommend is make it a process. Set realistic achievable goals.

– A Half marathon by June

– Marathon by December

– Ultra marathon by April the following year

– Then maybe comrades that same year.

To start though I would recommend jog 1 min/ walk 1 min x10 for 3 non consecutive days for the 1st week. Then increase the jogging to 2 minutes and walk 1 minute x 8 for the 2nd week and then 3min jog and 1 minute walk x 7 for week 3.  After that you go to 5 min jog and 1 minute walk x 5. This should ensure you slowly build up distance to around 5km 3 x a week after the 1st month. Slowly increase over the next month so that by the end of February you should be able to run 20-25km/week. At this point join a running club to help you with the slow progress.

It also helps to ensure that your conditioning is correct.  Stronger tendons can handle more force. To ensure this is done correctly we recommend a good gym program consisting of eccentric loading. Eccentric loading is when the muscle is still contracting but lengthening at the same time. So if you do a calf raise and go up onto your toes that is called concentric loading. The muscle contracts and shortens. Now when you slowly come back down that is eccentric loading. It is great for strengthening tendons and we often use it if tendon injuries do occur to strengthen them up.

Your biomechanics are also important but this is a topic all on its own.

The final aspect required to avoid tendinopathies is rest.

You need at least 1 day per week of total rest. The recommendation is normally 48 hours. Which means if you train in the morning rest 1 day and train the following morning you will have sufficient rest. It is also advisable to have another period where you might have 36 hours rest. Train in the morning and then wait till the following afternoon before the next session.

 

Summary

  1. Start slow
  2. Progressively build it up
  3. Have realistic goals
  4. Plan properly
  5. Ensure you are well conditioned for what is required
  6. Ensure you rest properly

 

May it be a good 2015!

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David Milner - M. Phil (Physio) UCT

David Milner - M. Phil (Physio) UCT

David qualified at Wits in 1998 in Physiotherapy. He then went on to also complete his BSc in Physiology in 1999. He started working at Hacks Back sports rehabilitation Practise where he was for 2 years and also joined Kaizer Chiefs soccer in 1999. He has completed his MPhil in Sports Physiotherapy at the University of Cape Town and is currently on the Medical committee of the Professional Soccer League

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