How not to get injured running

Cramps, blisters, stitch – don’t let a little niggle derail your fitness plans.

Blisters
Of all running injuries, blisters are the most common. They are caused by a combination of friction and moisture when your shoes rub against your feet, which means the top layers of skin separate. If the friction continues over many miles, fluid fills the spaces between skin layers and a blister forms.
Insider’s tip
“Avoid wearing heavy cotton socks because they simply soak up moisture and increase the friction,” says John Brewer, the head of sport, health and applied science at St Mary’s University, Twickenham, who is also a marathon runner. “And you should never wear new shoes to run a race.” A simple and effective solution is to apply paper tape – the cheap medical tape you can buy at any pharmacy – to your feet before you run. In a study of ultramarathon runners last year, researchers at Stanford University reported how such tape reduced the incidence of blisters by at least 40 per cent, producing a very “robust effect”.

Cramp
Cramps affect 39 per cent of marathon runners, the violently contracting muscle spasms often reducing them to a hobble. Science has yet to pinpoint a definite cause, with studies linking cramps to everything from excessive sweating and dehydration to too little zinc or body salts in the form of sodium and potassium.
Insider’s tip
A sports drink will help to replenish your salt levels during a long run, but many seasoned runners opt for a less palatable solution: pickle juice. Studies at Brigham Young University in Utah have shown that a few swigs of pickle juice relieves cramp 45 per cent faster than water does. Such is its popularity you can now buy it as a sports drink (from $19.99, picklepower.com).

Jogger’s nipple
Bleeding nipples are a curse of the long-distance runner. They are caused by chafing and it can feel as if you are rubbing sandpaper across your chest. It mostly affects men because female runners have the added layer of protection provided by a bra.
Insider’s tip
“Wear a tight-fitting vest and avoid heavy cotton,” suggests Brewer. Some runners swear by Nip Guards, tiny cone-shaped stick-on nipple protectors ( 12, ronhill.com), but others claim that lubrication is the best bet, with Bodyglide balm ( 10.50, wiggle.co.uk) getting the best reviews. For underarm and thigh chafing you can’t beat Sudocrem, the nappy-rash cream.

A stitch
A 2012 study at the Manchester Royal Infirmary found that drinking large amounts of fluid immediately before running was linked to a side stitch in some people, while other studies have shown that eating too close to going for a run can trigger the pain. Scientists remain unsure as to what causes a stitch, but one theory is that it’s linked to irritation of the parietal peritoneum, the layers of membrane inside the abdominal cavity. A full stomach worsens this friction, so leaving two to four hours between eating and running will help.
Insider’s tip
Avoid fruit juice and cordial before running – they were found the most likely to cause a stitch because they empty more slowly from the stomach than water and sports drinks, leaving the stomach more distended for longer. “Regulating breathing also helps some people,” Brewer says. “Try exhaling when the foot opposite the stitch pain strikes the ground to release the muscle spasm.”

Runners’ trots
Studies have shown that up to 50 per cent of runners experience some type of lower gastrointestinal (GI) distress, including diarrhoea and a sudden urge to go to the loo, during long or intense endurance runs. Tummy issues are common among triathletes; a study published in the journal Medicine & Science in Sports & Exercise reported that serious GI symptoms were experienced by 31 per cent of Ironman triathletes and open-water swimmers, some of whom pick up bugs from swimming in contaminated water.
Insider’s tip
To avoid taking pit stops, limit foods high in fibre the day before you tackle something like a 10k run or half-marathon. Some sports nutritionists advocate foods from the BRAT diet – bananas, white rice, apples, white toast – the day before a race. “If it’s really debilitating, try taking an anti-diarrhoea medication such as Imodium,” suggests the UK Athletics-qualified coach Paddy McGrath. “Just make sure you have tested it in training first.” A popular strategy among triathletes and swimmers is to sip cola immediately after getting out of the water in the belief that the phosphoric acid in the drink helps to kill off harmful bacteria in the digestive system. However, there’s no evidence it works and one of the few studies to test the bug-killing capacity of cola found it had a negligible effect on bacteria. In fact, vinegar and virgin olive oil were far more effective.

. . . And other common sports ailments you can avoid

Tennis elbow
Any racket sport or activity that involves overuse of the joint can cause tennis elbow, typified by sharp pain on the bony outer part of your elbow and tenderness in the muscles of the forearm. Symptoms can creep up gradually and are often noticed when you try to grip something such as a mug or shake someone’s hand. “If pain persists, seek treatment because with professional help it can often be cleared up in a few weeks,” says Sammy Margo, a spokeswoman for the Chartered Society of Physiotherapy.
Insider’s tip Margo recommends taping around the joint to help to relieve the strain on your tendons. “I’d also recommend something like the Aircast Pneumatic Armband [ 26.50, physiotherapystore.com], which provides support and cushioning,” Margo says. “Releasing wrist tension by using a stress ball is really helpful.” You can also perform the elbow bend exercise several times a day: stand up straight and lower your arm to one side. Bend your arm slowly upwards so your hand is touching your shoulder. Hold for 15-30 seconds. Repeat ten times.

Squats, lunges and jumps are all great for strengthening the leg muscles

Golfer’s elbow
Often confused with tennis elbow, this is a different problem altogether, affecting the inside of the elbow and the muscles that run down the inner arm to the forearm. “The symptoms are similar – pain on gripping something and a tender forearm – so it is best to seek a diagnosis if it persists,” Margo says. “A physio may perform ‘dry needling’, a specific technique used to relieve muscle strain, to help relieve the pain and tension.”
Insider’s tip
Try the flexor tendon stretch: put the palm of your hand against a wall and keep your elbow straight by supporting it with the other hand. Feel the stretch along the front of your forearm. Hold the stretch for 20-30 seconds and repeat 2-3 times. To increase the stretch, slide your hand farther up the wall. “It’s also advisable to strengthen the forearm with simple exercises every day,” says Margo. “A good one is to hold a light weight or bottle of water in one hand then sit with your forearm resting on a table with your hand over the edge and palm facing up. Lift the weight up, keeping your forearm on the table then slowly lower it again. Repeat 10-12 times.”

Handlebar palsy
Although many cyclists think their knees and legs are most vulnerable to injury, it’s the wrists that are more commonly put under strain. Often, handlebar palsy – inflammation of the ulnar nerve that runs along the entire length of the arm to the hand – is the result, causing tingling, numbness or pain all the way down to the ends of the little fingers. It’s usually caused by gripping the handlebars too tightly or mountain biking over very uneven terrain, which sends shock and vibration through the handlebars, stressing the ulnar nerve.
Insider’s tip
First, check your handlebars are at the right height; ulnar distress is more likely to occur if they are too low relative to the height of your saddle. “Widening your grip will lighten the load on your forearms,” Margo says. “Try fixing bar grips to your existing handlebars to make them fatter and more comfortable to hold.” You should also stretch your forearms daily, she adds. Straighten the arm to be stretched in front out of you with your palm up (imagine a police officer stopping traffic), then cup your other hand around the fingertips and pull back until you feel a mild stretch in the forearm muscles. Release the stretch then drop your fingertips towards the floor (so that they flip through 180 degrees). Repeat the stretch using a cupped hand around the fingertips until you feel a mild stretch in the forearm again.

It’s advisable to strengthen the forearm with simple exercises every day

Yogi’s wrist pain
If your wrists ache after yoga, you are not alone. Pain in the joint is among the most common yoga injuries and is usually down to overloading the wrist repeatedly or poor technique. “People experience a similar pain when doing press-ups and other exercises that place strain on the wrists,” says Margo.
Insider’s tip
Start by taping up your wrists to provide some support. “The key is to minimise loading of the wrists as you exercise,” says Margo. “Try doing press-ups against a wall and yoga moves with fists clenched so that you are taking the weight and force through the entire clenched hand rather than a weak joint.”

Gym-goer’s lower back pain
Poor technique or attempting to lift heavy weights at the gym are a likely cause of back pain after weight training. “If a weight is too heavy, you will likely be thrown off-balance and your technique will go to pot,” says Margo. “If pain is low grade and on both sides of the back after a workout, it could be just that your muscles are aching and nothing to worry about, but a pain on one side tends to be a sign that something is wrong and that is may be time to find a chiropractor in Tulsa, or somewhere more local to you.”
Insider’s tip
Stand against a wall if you are using free weights. “By sliding your back up against the wall as you lift and lower, you resist temptation to lean forwards or backwards and harm your back muscles,” says Margo. “Using weight machines is also a good idea as they encourage a more fixed movement pattern.”

Skier’s knee
Knee pain accounts for 30-40 per cent of skiing injuries, with the twisting forces of downhill skiing placing a tremendous load and strain on the joint. “The ligaments and particularly the anterior cruciate ligament can be damaged when too much uncontrolled compression and rotation take place,” says Margo. “It can cause swelling and pain for a number of weeks.”
Insider’s tip
Treatment for skier’s knee depends on the grade of the tear, but can require surgery. Your best bet is to strengthen the muscles that support the knee in the six to eight weeks before you go skiing. “Squats, lunges and jumps are all great for strengthening the leg muscles,” Margo says. “You need to focus on all-over fitness, including abdominal and upper body strength, to reduce the risk of lower body strain and ensure you are as well-prepared as you can be for the slopes.”

Hit the road
The entry ballot for the Simplyhealth Great North Run, the world’s biggest half-marathon, on September 10 is open. Register at greatrun.org

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