Some of the most asked questions in the Running Lean Community on Facebook are about running-related injuries. Runners just seem to get injured pretty often. In fact, more than half of all …
My name is Patrick McGilvray, and I’m an experienced marathoner, ultra runner, Sports Nutritionist, Master Life Coach, and weight loss coach for runners. I’ve dedicated my life to helping runners just like you properly fuel your body and your mind. So you can get leaner, get stronger, run faster and run longer than you ever thought possible. This is Running Lean.
Hey there and welcome to episode 92 of Running Lean. My name is Patrick McGilvray, the weight loss coach for runners. And today we’re talking about preventing and treating running injuries with Brodie Sharpe.
So some of the most asked questions that we get over in the Running Lean community on Facebook are about running-related injuries. People are constantly asking about hey, this hurts. What should I do? Or I did this when I was running? What does this mean?
Runners just seem to get injured pretty often. In fact, more than half of all recreational runners will experience an injury at some point. Why is this? Why do runners get injured so often? What are the most common injuries that runners are experiencing? How do we treat these injuries? And how can we prevent getting injured in the first place?
So in this episode of the podcast, I brought a very special guest to help answer these questions. Brodie Sharpe is an experienced physiotherapist and host of the popular Run Smarter podcast. And today he’s talking all about preventing and treating running injuries. This is going to be great. You guys are going to really enjoy this interview and this particular podcast, especially if you are worried about an injury or experiencing an injury right now.
But first, if you like this podcast, come check out that Running Lean podcast community over on Facebook, you can ask questions how what’s hurting, or anything else that has to do with running with sports nutrition with diet and exercise, weight loss, the group it goes hand in hand with this podcast, it extends the conversation.
It gives you a place where you have a voice where you can ask questions and get answers. So just search for Running Lean community on Facebook and join us. It’s fun. We have fun over there.
Here’s another five-star review of the Running Lean podcast. This one’s from Wendy and she says, “Thank you for the great podcasts. I know it’s consistency that will take us where we want to be. But it’s the motivation that gets us to start. Thank you for the motivation. You are awesome.”
Thank you very much money that was very sweet of you. And I love getting these kinds of reviews on Apple podcasts or Spotify or wherever you guys listen because it just means that the message is resonating with you. So thank you for sharing that.
And then people ask how they can work with me there are two ways number one, the Running Lean coaching group and starting in October. Oh man, October is already upon us. This episode will actually be coming out on October the first so starting the first Tuesday in October we’re going to be talking all about injury prevention and strength and flexibility.
And so the focus of our coaching and the focus of the training for this whole month is going to be on building strength becoming more flexible to prevent injuries. You know injuries are preventable, you don’t have to be injured as a runner, you don’t have to be one of the half of runners that get injured.
Okay, so I’ve got some special guests that I’m bringing in to teach us how to get stronger how to become more flexible how to stay injury-free so if you’re interested come and join us just go to runningleanpodcast.com/join.
And then the other way that you can work with me is one on one as I can be your coach this is what I do, I’m a coach. And working with me one on one is probably the best way for you to reach your goals. I mean imagine how much you can accomplish working one on one with a coach for like three months I mean, what is not possible for you now can definitely be possible for you in 90 days’ time.
Okay, so definitely think about this and you can learn all about coaching and apply and then we can have a conversation about it. Just go to runningleanpodcast.com/apply and see if coaching is good for is a good fit for you. And in addition to the one-on-one coaching, you also get access to the monthly coaching group as well when you’re a one-on-one client. Cool.
All right, let’s get into this episode because I’m excited about sharing this interview with you guys. Brodie’s a cool guy and I really enjoyed this conversation. Brodie Sharpe is a physiotherapist from Melbourne, Australia, and he’s the founder and CEO of the Run Smarter series and host of the Run Smarter podcast.
Brodie helps runners identify the common misconceptions about running and running injuries so that you can become a faster, healthier, and smarter runner. He teaches powerful injury insights from his many years as a physiotherapist.
He also interviews the best running gurus in the world on his podcast. And I was recently a guest on his podcast does that make me one of the best running gurus in the world? I don’t know. I guess I’ll throw my name that will lump it in there.
But it’s a great podcast, you definitely need to check it out. His podcast is designed for injured runners or for runners who are looking to prevent becoming injured runners or runners who just want to improve their running performance. So it covers a wide range of stuff. He interviews a lot of great people on that podcast. He has so much knowledge.
Brodie is an experienced runner himself. He’s dealt with his share of running injuries so he knows exactly how frustrating being injured can be as a runner. This is one of the reasons why he became a physiotherapist so that he could help other runners get back to doing what they love doing the most, which is running, right.
So in this episode, we talk about what are the most common running injuries, we talked about how we can prevent these injuries from happening in the first place. Brodie shares his thoughts on stretching, foam rolling, and what the science actually says about these things, and how beneficial they actually are, or are not for us as runners.
We talk about whether or not running is just bad for your knees. And if we should all just expect to have bad knees as we get older because we run a lot. And then we get into some of the common misconceptions about running injuries, and how to properly treat running injuries.
Like there are some ways of treating injuries that we’ve been kind of conditioned to do over the last few decades. And are these things still the right way to do it or not. So this is great. Like I learned so much from this interview, and I know you will, too.
So without further ado, let’s get into this awesome conversation with Brodie Sharpe. Today, I’ve got Brodie Sharpe from the Run Smarter podcast.
And Brodie, why don’t you go ahead and introduce yourself? Tell us about what you do. Let’s talk about what your jam is because I’m very interested in this topic today.
Thanks, Patrick. Thanks for having me on. My name is Brodie Sharpe. I am a physiotherapist from Melbourne, Australia. And a couple of years into my physio career I became a recreational runner, I transitioned out of team sports playing basketball, to training for a half marathon with my sister.
And a couple of things happened at that time – one I caught the running bug very quickly, two I became injured very quickly. And three, during when I was seeing patients in my clinic, I was just an employee, just a random private practice clinic see anyone under the sun.
But as soon as I’d see a runner, I’d just have this heightened passion around wanting to pull out my best self and really like help educate them as best I can, get them back to pain-free running as best I can. And it was just years and years of seeing those and self-reflecting on what my passions were, where my passion lied, and what brought out my best self what gave me energy rather than depleted my energy.
I was seeing these runners and so slowly would transition my career into still being a physiotherapist, but tailoring to only treating runners and educating runners as best I can. Because I found a big passion with educating runners recognized there were a lot of misconceptions out there, recognized that a lot of runners need to be educated on certain topics if they wanted to reduce the risk of injuries or increase their running performance safely.
And a lot of times, there’s a lot of confusion out there. If you Google something, if you type a message onto running Facebook groups and you ask you know, I have plantar fasciitis, what’s helped you, or I just want to reduce my risk of injuries. What should I do? And you just see the wide array of not only different types of answers but also contradictory answers.
Some would say you know you need to rest an injury. Some will say you know, you need to run through an injury, need to foam roll, you need to stretch you need to continue loading, you need to do all these sorts of things that perhaps sometimes contradict one another.
And so recognizing that and talking with a lot of runners and a lot of their confusions, decided to launch the Run Smarter podcast, where I help bring clarity, bring control to recreational runners try and deliver information in a way that’s easy for them to understand, kind of break down the science and bust a lot of these misconceptions.
And so that brought me to a couple of things. So venturing into online physiotherapy where I only train runners in my own business now, the Run Smarter Physiotherapy Clinic continues to build the podcast. It’s a big kind of lead generator, but also just helps people if they just want free resources, free information just to go there and help build on their own running IQs.
So it’s kind of like the long answer of where I find myself today. And there’s probably a lot of your listeners are runners and maybe have gone through that same path of being quite confused when they are injured. What caused that injury? How do I overcome it? How do I reduce the risk of it coming back? A lot of those kinds of answers. So hopefully, we delve into a lot of that today.
Awesome. And you’re so right, when it comes to like people posting, you know, questions in forums and on Facebook groups and stuff. And the Running Lean community is an awesome Facebook group. Tons of just great positive people in there.
And I always crack up when somebody says, hey, my leg hurts here. What should I do? And then you get all the answers that all contradict each other. And it’s like, what is the right answer? And I always want to just tell people, like you need to go talk to somebody that knows what they’re talking about here, you know.
So let’s, let’s get into this a little bit. What are some of the major injuries are the most common injuries that runners face? And I can think of a few off the top of my head, but what do you see as the most common injuries that runners are presented with?
I think if we were to fall back on like the research and say, what is the most common running-related injuries in the recreational population, it would be knee pain. So the most common form of that would be runner’s knee, or patellofemoral pain, which is essentially just pain around the kneecap quite hard to localize.
People point to different margins of the kneecap itself inside, it’s kind of around here. And that’s what the research would show. A lot of the runners that come to me would be plantar fasciitis, and it would be a high hamstring tendinopathy or proximal hamstring tendinopathy.
Because those two conditions really don’t get better on their own unless you have really good management and they can get quite nasty, and severe and carry over outside of running into everyday life. Like sitting for the hamstring becomes an issue or just like standing for your job becomes an issue when it comes to plantar fasciitis. They’re definitely the two most that I see.
Other ones would be shin splints, others would be like ITB friction syndrome, they’re quite common amongst the running population, then you have some stuff a bit higher up, you have like a lateral hip pain or like hip flexor type of issues.
Rarely do we see low back pain. But it can happen. Sometimes a lot of these things, someone might get low back pain outside of running, say if they’ve moved house, or they’ve done something they shouldn’t have done too much lifting beyond their capacity.
And then they try and run and it’s the running that stirs it up. But isn’t the thing that actually triggered that pain. But yeah, definitely those issues at the knee and below the knee are definitely most common.
So when people say you hear people that are not runners say this all the time, like oh, running is just gonna, it’s just bad for your knees. You know, you just it’s just bad for the knees. And do you find that to be the case? Or is that one of those misconceptions that people have about, about running injuries?
Definitely one of those misconceptions. Yes, we know that the knee is the most common area where someone might develop an injury. But it’s only the knee has developed the injury because you have had some sort of training error, or there’s been some sort of under recovering kind of aspect.
Before we delve into maybe I’d best describe like what causes running injuries because that would like layout the foundation for the for my actual answer. If you were to look at all running-related injuries, they’re called overuse injuries because it’s not due to direct trauma. It’s not due to a twist or rolled ankle or you haven’t got tackled or fallen to the ground.
It’s been in most cases you’re running load, what we call repetitive type of injuries. So hitting the ground with a certain striking the ground with a certain pattern and just doing that over and over and over again hundreds of thousands, tens of thousands of times if you do something that goes beyond your capacity, so every tendon, every muscle, every ligament, every joint has a certain load capacity that we need to train just below that capacity which is within in what we call your adaptation zone.
So if you train enough and foster enough loading within that adaptation zone frequently enough, it will get stronger, your adaptation zone grows, and you need to progress your training and continue following that new adaptation zone and you just get stronger and stronger.
But where these running-related injuries, these overuse injuries, these training errors happen is you have caused an abrupt shift in your training, either running too far running too fast, having an abrupt shift to your terrain.
So you might be running on flats, and then all of a sudden, you’re doing hills, and your tendons, ligaments, whatever structure fails first has said wait, that’s way too much for me, I’m not used to this type of load, it’s gone way past my adaptation zone, and it starts breaking down getting sore getting stiff, rather than building up.
And so when we talk about running injuries and around the knee, in most cases, it’s been due to some sort of training error or some sort of abrupt change, either loading it too much, or you’ve under recovered too much. So that’d be like lack of sleep, increased stress, and your body doesn’t hit this recovery mode like it once used to. And that can develop an overuse injury as well.
And so, yes, running too far, running too fast beyond your capacity, doing too many hills, if you’re used to running on the flats, that would increase the amount of load that goes through the knee, and it can start getting sore because of that.
When people say that running is bad for your knees, they kind of think if you were to run throughout your career, that your knee joint is going to slowly degrade because of too much.
Too much wear and tear too much repetition too much load constantly, throughout your running career, that it’s only going to be a finite kind of expiry date before the cartilage in your knees will start to slowly wear away, then you’ll start to get early-onset osteoarthritis, and then it’s going to be needed a replacement down the track. That’s where people tend to head towards.
However, we know that there’s research out there to show the complete opposite. If you have loading of the knee – if you strike the ground, and you hit the ground with some ground reaction force that actually stimulates cartilage growth, we actually want that stimulation, we want to keep the joint healthy, we want to keep the joint strong.
And we want to engage the lower leg, the whole entire body with some sort of ground reaction force to trigger and stimulate cartilage growth, muscle strength, tendon adaptation, all those healthy things. And we can point to really nice robust evidence.
There was one study in particular that looked at a systematic review of 123,000 people, mainly in the US, but they looked at the prevalence of osteoarthritis, and this cartilage wear and tear amongst sedentary people, amongst recreational runners and amongst elite runners. And they showed that you’re three times more likely to get osteoarthritis if you are in the sedentary population compared to a recreational runner.
And if we know anything about what I’ve just explained around – you need stimulation, you need strength, you need to trigger your body to adapt to these sort of loads – that’s why we say that that general population was around 3.5% of recreational runners have knee or hip osteoarthritis and that the sedentary population was around about 12%.
So we’re looking at those sorts of numbers. And it kind of makes sense why we do these massive studies and see the prevalence numbers if we know anything about adaptation, and so someone says running is bad for your knees, yes, it is bad for your knees. If you go out and you run a marathon when you’re not when you’re only used to running 10 K’s – yes, your knee will get sore.
But if you train sensibly if you run smarter, which is why I’ve developed the Run Smarter podcast, you will start to find out that it’s actually better for your knees if you train smart and have running longevity compared to someone who does who while definitely compared to this entry population. But we do need that constant adaptation we do need that constant trigger. So that would be my answer.
That’s awesome. And the way that I understand this and so this is why a lot of new runners I think face these kinds of issues is because they do too much too soon. And correct me if I’m wrong, but I understand that your muscles will develop pretty quickly.
And so, you know, you might develop the muscles in your legs, in your you know, feet and your hips and things like that to be able to run for longer distances. But the connective tissues, the tendons, the ligaments have not developed the load capacity like you said.
And so I think that is one of the reasons why newer runners develop these kinds of injuries because it’s not because their muscles aren’t, you know, capable or they’re doing too much pounding on the ground. What it is, is their connective tissues have not, you know, gain those the strength that they need to handle the wear and tear that they’re putting on them.
Yeah, you can just look at any kind of recreational runner in the type of injuries that develop like Achilles tendinopathy, patella tendinopathy, like a lot of these tibialis posterior, like these tendons that are kind of around the feet and the ankles, they are very prone to developing high levels of forces.
Because the tendons themselves actually have to generate or they cop a lot of load during your running. The muscles yeah, they work with propulsion a little bit, but the tendons themselves, accumulate a lot more than the actual muscles themselves. If we look at the size of them, if we look at the structure of them compared to a big kind of quadriceps muscle or those particular kinds of structures.
And then if someone’s developed an Achilles injury, they have gone, you can just assume that that capacity is a lot lower than what the muscles could have been. Because compared to the load that running is required, and you exceeding whatever capacity of whatever structure might be, if it is a tendon, that means that tendon was the weakest point.
I know from my career of playing in basketball, like constantly running on my toes, constantly jumping, landing, taking off like sprint kind of things, my calf, and Achilles my Achilles, especially a quite strong, and I have, I’ve almost had every injury under the sun.
I’ve never had an Achilles injury when it comes to running, never had an Achilles issue when it comes to any other sort of training, just because I assume that the capacity of both of my Achilles are just really, really high. And I’ve just simply within my training, haven’t managed to exceed that capacity. Whereas something else like my knees, something else like my hamstring is a different story.
Yeah, I don’t know, many runners who have not experienced some sort of injury during the course of their career running, you know, so. So how do we prevent these kinds of injuries from happening in the first place? Like what are some of the things we can do as runners to prevent this stuff from happening so we’re not sidelined?
Yeah, I think it’s just following that same kind of universal principle. It’s just understanding the adaptation process, understanding your own adaptation capacity. I know in my podcast, episode one is called adaptation education. And that’s number one for a reason.
It’s the number one thing that we need to at least start with, where we need to start that conversation before we continue and start talking about more, more niche kinds of complex kinds of terms.
But if you’re a runner, and you want to try and reduce your risk of injury as much as you can, you need to understand, okay, we know abrupt changes in training will increase and elevate the risk of injury.
So running too far too fast beyond your capacity. Having abrupt changes, like I said, changes in terrain changes in surfaces. Sometimes some scenarios like if you have a change in footwear, so changing footwear is totally fine. But you need to transition gradually enough so that the body adapts to that style of running.
If you have the same type of shoe you’ve ran in for 10 years, you can continue running that shoe. If you buy a new shoe that’s exactly the same design, the exact same properties as the past shoe, then that’s fine as well. But if you want to run from a traditional kind of shoe to a minimalist type of shoe, you need a lot of time to transition into that shoe because it changes the load on your body. It changes the requirements.
And so if you just transition straight away, a lot of injuries happen. There was actually a study where they had 12 runners, no 14 runners go from a traditional shoe into a barefoot shoe. And they gave them this pamphlet. They taught them about how to transition gradually. And they just let them see how they went. They followed them for 8 weeks and 12 out of the 14 runners developed an injury and that is an enormous amount of risk.
And they interviewed them afterward and said okay, did you follow the pamphlet, not one person abided to every single transitioning rule that they provided at the start of the study. And so it goes to show – runners we get a bit of ahead of ourselves, we want to just get in there we want to try and rush our way through things. We can be a bit stubborn can be a bit impatient at times.
But if we make those training errors and we’re a bit hasty in our decisions. And we’re a bit hasty in our training. That’s where the injury risk comes into it. So that’s the adaptation side of things. That’s the external load on the body type of thing.
But we also know that recovery is key, when it comes to reducing the risk of injuries. Someone might be sleeping seven hours a day, their diet might be adequate, their stress levels moderate. And that’s totally fine for their situation that they’ve currently have placed themselves in.
But then they decide to train for a marathon. And it seems that like some way throughout their marathon training plan, where their loads are accumulated, the old recovery strategies just don’t seem to match, it needs to be this balanced equation, your recovery strategies need to match your external load.
And so if people keep to their old recovery strategies, and expect to build up their load and be fine, it just doesn’t happen. So there might get to this sort of tipping point where overuse injury happens.
And they say, Brodie, like I’ve been so gradual with my training, have followed this plan to the tee. And then you ask them, like, how’s your diet has your sleep has your stress, and they don’t score very well on those parameters. So you say, alright, you have been building up your external load, it’s time to match that with recovery because you don’t get stronger and you don’t adapt during the running.
You adapt and get stronger after the bout of running once your body is in this recovery mode. And so we need to have a discussion around maybe extending their sleep, getting better quality sleep, maybe mixing in some naps a couple of times a week, if they have that luxury of time.
Improving on nutrition, which is right in the in line with this podcast, monitoring levels of stress and all those other things.
And so it’s that balance between external load and recovery. If you’re balancing that really well, your likelihood of getting an overuse injury significantly reduces.
Yeah, and taking some time off, like runners are notorious about sticking to their training plan no matter what. And I think that’s to our detriment, sometimes, you know, it’s great that you have a run streak going, or whatever it is, you know, maybe you’re training for something, you’re running five days a week, and you know, you’re training for a marathon, and you’re gonna stick to that no matter what.
But you could be just burning yourself out, you know, and I think it’s in our best interest, I love the idea of taking naps, by the way. But I think it’s in our best interest to like, slow down sometimes and take the day off when we need it.
Because in the long run, you’re going to stay healthy, you’re not going to be injured, you’re not gonna get sidelined, you’re not going to be losing, you know, training time. But if you do get injured, then you know, the doctor is going to tell you, you know, you need to take eight weeks off of running, of course, nobody is going to do that. But you know, runners are really stubborn, right?
So it’s also like when an injury starts to surface like if there’s just a bit of stiffness, not pain or just like the initial signs of an injury occurring, the runners are more often going to just run through that and see how things go. We’re stubborn, we love running. And that’s all we want to do, for most for some cases.
But when an injury happens, they kind of convinced themselves, it’s not happening that convinced themselves if they continue training should be fine. And that injury gets worse and worse and worse, especially if it continues to exceed that adaptation zone.
And so it can be really tricky for some runners, if they don’t have any other cross-training alternative, say if like an injury arises in my high hamstring, I know Okay, running speed work probably isn’t the best. Maybe I’ll take a couple of days off running, but swimming is good. Cycling is okay for my hamstring. And I know strength training is fine. And I’ll come up with these alternatives.
But it’s those runners who they run for, like their mental well-being as well as their physical well-being, and they just need to run every day or most days. When they get injured and they can’t run, it’s really tough for them. That’s a real mental battle. It’s real, causing a lot of frustration. It’s causing a lot of angst.
And they’re very likely to just go out for a run. I’m just, I just need it. I need this to be done. I don’t care if I’m sore or not. And that’s where they can get into real trouble because they don’t have any alternatives.
Yeah, and that kind of brings up my next question, which is about maybe it’s prevention, maybe it’s not is so what role does things like stretching or foam rolling play in injury prevention or in like, kind of treating some of these injuries?
Yeah, we can start with stretching. Most of the research revolves around static stretching, so like that stretch and hold, sort of stretch. If someone loves running, they’re not going to like what the research shows. But there is research to show that static stretching before a run doesn’t do anything for injury prevention, it doesn’t do anything for running performance, it doesn’t increase your running performance.
And when it comes to like a cooldown afterward, physically speaking, the static stretching doesn’t do much for recovery. If there’s going to be delayed onset muscle soreness the next day, it’s not going to reduce that time, it’s not going to reduce that recovery time.
However, we know that stretching feels really good for some people. For some runners, they just love stretching. And this is often what I recommend, I recommend that runners try a whole bunch of different warm-up routines, a whole bunch of different cooldown routines, and see what best feels good for them.
In the last couple of years, I have, say, if you were to have looked at me five years ago, I wouldn’t do a lot of stretching, I would just if I was to do like a warm-up, it would be jogging on the spot, it would be just doing my first couple of minutes of running just really slow. And then just getting into my rhythm and then increasing my speed, that would be my warm-up.
If I was to do a speed session, like intervals really hard, really intense, might do a little bit of stretching, might try and increase the mobility of my hips and my ankles a little bit. And then I would be very diligent with increasing my speeds slowly when I run. That would be my routine.
Fast forward to today, I am focusing a lot more on stretching, a lot more on mobility work only because I’ve tried different routines. And I’m finding now that for some reason or whatever my stretching, and my mobility work is making me feel better before a run. And so that’s what I recommend for runners.
Try a whole bunch of routines, you might want to do a 20-minute yoga session before a run, see how you feel. And if you feel a lot better from that, then maybe implement that into your strategy if you have the time.
But if you have tried a whole bunch of different strategies, and then you go for a run, and compared to not stretching, you’re indifferent, which would be me five years ago, then maybe it’s not high on your priority list. And maybe it’s something that you might not need to implement because we know from the research, it doesn’t reduce your risk of injury doesn’t really increase your running performance. So there’s that side of things.
When it comes to recovery, though, like I said, we want the body, it’s important for the body to switch into recovery mode, after your bout of exercise. And we enhance those recovery kinds of techniques.
If foam rolling, stretching, yoga – if that is a really nice way for you to unwind, instead of you going straight into a work setting and being quite stressed, or not getting a lot of sleep if you find that you just mentally unwind with a stretch session, yoga, foam roll whatever have you – that can be your recovery strategy.
Mentally, it switches your body into recovery mode really effectively. And so that can have real benefits mentally as well as physically because if you mentally unwind, then you physically recover. And so it depends on the person, I don’t have these absolute kind of rules around Yes, you should be foam rolling, yes, you should be stretching just depends on the individual how they feel.
A lot of people say, oh, I’ve tried foam rolling, it’s not really for me, I don’t like it. It just is painful the entire time. I’m kind of a bit tense the entire time when I do it. I’m thinking about other things that I could be doing. I don’t recommend it for them. I think we can count on other strategies and other ways to unwind. So that’s kind of where we fall on to it.
We know that foam rolling doesn’t release muscles, particularly the ITB is a really big misconception out there. A lot of people think they need to release their ITB or stretch their ITB because it feels tight. You’re not doing I’m telling you now you’re not doing anything to release that structure. It is so thick, it is so fibrous, it actually bluntons the scalpel of surgeons who try and cut through it.
It is that thick, and it doesn’t have any muscle properties. So pushing a foam roller or trying to stretch it in a particular stretch might feel good for you. So continue doing it but not releasing it. So we really need to be honest with ourselves and really educate ourselves on what effect it’s actually having.
Yeah, I’m glad you sort of cleared that up, because I’ve heard the stretching argument for years. And I’ve sort of heard that too, that there really isn’t a lot of data that supports that stretching is actually doing much for you. But if it feels good, do it and I love that, you know. Because I love doing I do some foam rolling I do a little bit of stretching. I love doing a little bit of yoga. And this stuff feels good for me. And so I’m going to continue doing it.
Yeah, and it’s probably worth saying as well that stretching, foam rolling – it’s not detrimental. There are studies done to show that there’s no detrimental, it’s not gonna make you slower, it’s not going to increase your risk of injury, it’s not gonna do anything detrimental to your performance in your recovery. So if you love doing it, then it definitely should be still implemented.
Awesome. And so when it comes to certain injuries, I know that there’s this acronym RICE that we’ve all heard, you know? R, which is Rest, Ice, Compression and Elevation, right? And is this still legit? Like, do we still want to use this, this methodology when it comes to most running injuries?
No, because, as I said, at the start running injuries aren’t necessarily trauma-based. They’re not a rolled ankle where people sometimes might roll ankles if they’re on the trails, but running-related injuries refers to overuse injuries, which means there’s not there’s no inflammation, it’s not the primary driver of pain.
We know that if you develop, say tendinopathy, we know we’ve changed our terminology from tendinitis, which was 10 years ago to now which is tendinopathy because that itis refers to inflammation, inflammatory component as the primary driver. So now it’s a tendinopathy, which we know the pain signals aren’t inflammatory driven.
And so overcoming that injury, usually, if you were to roll your ankle, they would say, Okay, you need to rest definitely from any aggravating factors need to ice because there’s inflammation there, and that settles down inflammation, you need to compress because it also helps circulate that swelling, or that inflammation present and elevate because if you keep that body part above the level of your heart, there’s not that the body it has to work against gravity, and that inflammation just doesn’t seep into that area as easily.
I think that whether that method for even inflammatory driven components, like a rolled ankle that is starting to be challenged these days anyway but talking about running-related injuries, that’s not the case.
There is a very long acronym that has come out maybe about five years ago, it was called PEACEANDLOVE. And that’s a long acronym. But the peace side of it was more towards that real direct trauma kind of blunt force if you get tackled. If you twist something and there’s, it’s swollen, those sort of things.
So the peace side of it was protect, elevate, avoid anti-inflammation medication, compress and educate. So the Protect being like anything, it’s really anything that’s really irritating it best to avoid that kind of thing. Elevate Yes, getting it above your heart probably does about 5% effectiveness, but it’s still a little bit of something. Avoid anti-inflammation, especially when it comes to overuse injuries, running injuries, tendon injuries, we know that long-term anti-inflammation medication is actually detrimental to long-term recovery. So best take it for one to two days, if you must.
But you know, generally speaking, if you don’t need to take it, you probably shouldn’t. Compress the area a little bit if there’s swelling, and educate, educate about the injury, educate around the aggravating factors, exactly what you need to do. Those sort of things is really key in those inflammatory, blunt trauma, twisting, popping kind of injuries. But we’re continuing with this acronym.
So you’ve got peace, and then you’ve got love. So peace and love. And love is the one that’s more to do with definitely like day one, running-related injuries, or once you’ve passed that inflammatory phase, that primary inflammatory driver, probably three or four days moving into this kind of like recovery phase.
So LOVE – L being load. You need to find your new adaptation zone to this injury. If it’s a knee injury, you need to find how to load it that doesn’t exacerbate symptoms. So load being maybe squats, maybe wall sits, so static wall sets, maybe doing step-ups, maybe doing low levels of running, you need to find where that new adaptation zone is and train within that adaptation zone and build your way back up.
O is optimism, and that kind of comes along with education as well. It’s knowing that you can recover. It’s having a good management plan forward. It’s feeling good about your recovery. So we’re looking at the mental side of things as well.
The V is vascularisation which is just getting the heart pumping. If you have a knee injury, maybe it’s going swimming, if you have a shoulder injury, maybe it’s going for a jog or a bike ride, just getting some blood flowing. Because we know, when it comes to healing, blood flow is very, very good.
We know that for certain structures that don’t have a lot of blood supply, those recovery times are a lot longer than that of a muscle or something that has a lot of very rich blood supply. So keeping optimistic, keeping exercising can feel really good as well, if you’re injured and find another exercise alternative, then you feel really good, which is going to be the E, it’s that exercise component.
So you’ve got the vascularization mixed in with loading mixed in with just getting moving all of these really positive, proactive steps that you can take to be very active, rather than just completely resting your injury, which can actually be detrimental if you follow that particular path, which we can delve into, in a bit more detail if you want.
But that’s a bit more of a detailed explanation acronym when it comes to entry management, which I hope didn’t confuse a lot of people.
No, I think that is awesome. Because it’s just, you know, we hear these things we hear for so long, and we just kind of take them at face value. And we take them at face value for sometimes decades. And I know that there’s always, you know, new studies that are coming out or, or new ways of doing things. And so that’s why, you know, we got you here because we want to hear like what should we be doing, you know, what’s the, what’s the new methodology that’s going to help us with this kind of stuff?
Because, you know, I can’t tell you how many people I know that, you know, deal with injuries, and they don’t know what to do. You know, that kind of brings me to my next question, which is like, how do you know if you even have an injury, or if it’s just like, you’re sore, because you’ve been running.
Like we all run and we get sore, you know, you go on your run, and you start building up mileage, and maybe you’re training for a marathon, you run, you know, 8 miles and then you’re up to 10 or 12 miles or up to 14 miles, you’re gonna get some soreness, there’s gonna be some delayed onset muscle soreness, you know, that kind of thing?
How do you know that you’re actually dealing with an injury? At what point do we need to go and like take some more dramatic action?
Yeah, it’s a good question. There are certain pain characteristics, certain styles of pain behaviors that you can pay attention to recognize, okay, is this going to be good pain? Or is it bad pain, and let’s talk about the good pain.
So good pain is that delayed onset muscle soreness like you described, we need to, sometimes if you go to a gym, or if you do a new exercise you hadn’t done before you do a new gym class most people have experienced next day waking up and like just being completely sore.
First of all, the onset of the pain, it’s not during that class or that exercise is not straight after during that warm down, it’s the next day you wake up some maybe sometimes 48 hours later, you just feel super tired, you feel super sore. And it’s that timeframe that we also need to pay attention to.
The location of the pain. In most cases, delayed onset muscle soreness will be located throughout the muscle, it’s kind of this widespread, it’s not focal like this pinpoint kind of pain, it’s a bit more widespread than that.
And also, when it comes to the subsequent days of that we know that delayed onset muscle soreness hangs around for two or three days, if it’s really severe, might be four to five days. But then it just dissipates just goes away because that’s what the body is done. And that’s why it’s necessary.
If you do a new gym class, and you wake up the next day, and you have this delayed onset muscle soreness, that’s the body processing itself, rejuvenating yourself in order to be stronger next time. So that’s why it’s it’s called good pain.
Converse to that when it comes to bad levels of pain. We know okay, from the onset, yes, a bad pain can be the next day. So we need to be quite mindful of that. But definitely, if the pain comes on during the run and gets worse as you run if it comes on quite severely once you’ve cooled down, they are worth paying attention to.
It’s worth trying to modify your training. It’s trying to be proactive with managing that it’s like changing things in that time. Over the next couple of days, try and make sure that doesn’t happen again.
Like I said, sometimes especially with tendon injuries, they can come on the next day. But this comes back to the location side of things. If it’s a tendon injury that’s flared up the next day when you first wake up and move around, that’s usually more localized. You can point to the tendon or you can always pinpoint where that pain resides. And it’s not that widespread kind of ache through the muscles that just feels tight and stiff and sore.
And subsequent to that, like over the next couple of days, we know that delayed onset muscle soreness generally will go away in two or three days. Injuries can persist for a couple of weeks, sometimes a couple of months.
And so if you’re trying to figure out is this little niggle, this little sore spot, is this an injury, is this good pain or bad pain, but you’ve had it for two weeks? It’s definitely not good pain, it’s definitely not going to be this muscle soreness, this is going to sporadically go away unless you change something in your training.
And so it’s those kinds of things that happen. Definitely, if you have like a bad pain, we know that niggles kind of happened, we know, if you’re doing marathon training, then the foot might get sore during the run, we know that like the calf might start getting really tight and sore, at the end of your long runs. We know that it’s not delayed onset muscle soreness, but you’re just challenging your body quite a lot.
So you’re kind of on this cusp. And modifications will be needed. Like if you continue to ignore it, and continue building up your training and your speed work, and just totally ignore those symptoms, then it can tip into something very hard to manage.
But I always say on my podcast, we can’t reduce the risk of an injury down to zero, that just doesn’t happen. It’s unachievable, but we can train smart to reduce that risk of injury as much as we can.
But then if injuries do arise, if we catch it day one, day two, day three, and we be quite proactive and do all the right things, then we overcome that injury very quickly. Within like a couple of days, we haven’t lost any fitness. We continue to learn from our past mistakes, why that came up in the first place. And we can take proactive measures to interact with that.
And so that’s what I call like the real injury prevention strategies. It’s once something arises, overcome a quickly train smart, learn from it, modify and then continue progressing without losing any fitness. It’s sometimes hard to achieve. You need a lot of education, you need the right people on your team.
But that’s, that’s kind of where real life kind of falls into it. We can’t just get the injury risk down to zero. And if you’re injured, you’re like, Oh, God, I tried everything I can, what else could I possibly do? We kind of need to be a bit more realistic in that sense.
And so I mean, geez, everything you’re talking about is just so awesome. And the not overloading, not doing too much too fast seems to be like a theme that I hear. And that seems to be the cause of most of these injuries. So does the 10% rule still apply, is that’s something we should sort of stick to, or is that just kind of can we kind of debunk that one as well?
It’s a general rule that has a lot of limitations. One, if you’re just starting out as a new runner, it’s going to be extremely slow, you’re going to be progressing, getting nowhere very quickly if you have to try and increase by 10%. So there are limitations on that side. But if you’re an ultra-athlete, maybe 10% is too much for you. If you’re doing like 200 kilometers a week, that might be too much. Who knows, it depends on the individual.
So it is a very general rule that we can apply if you want. But also, the limitation lies with a lot of like intricacies – like it doesn’t incorporate spade doesn’t incorporate recovery doesn’t incorporate like terrain. So you can increase your mileage by 10% every week, but you just get faster and faster and faster, you’re just gonna break down.
If you go from doing flats to doing hills, you’re gonna break down. So what I like to do with a lot of my runners that I work with, is have these arbitrary exercise units. And so you train for the amount of minutes, and you train. And you rank on average, how intense that was out of 10.
And so 10 is like this max out sprint, you cannot last for very long at that level, a 2 or a 3 is just, you could just go for hours, just jogging at a really low intensity, do that for hours. And then you kind of just rank yourself on okay, my session went for 30 minutes, my intensity was like a 4 out of 10. And then you just combine that to give you, you multiply those two numbers to give you these arbitrary exercise units. And you want to make sure that that doesn’t increase by more than 10 or 15% per week.
And I’ve actually followed this myself quite diligently and seeing really good results with it because you’re incorporating distance or duration, so in minutes, but you’re also incorporating intensities or speeds or those sort of kind of workouts and can be really nice for a structure for someone to follow.
It covers plenty because you could be running at the same speed. But all of a sudden, you’re running at that same speed up the hill, and just feels really intense. So speed itself can have its limitations, because it depends on the terrain or the elevation, but you feel really bad.
But also, we also know if you’re under-recovered, we know that an easy 5K run can feel quite challenging at times. Whereas if you are well-rested, well recovered, training well with the right intensities, a 5K run might be a 5K, slow run might feel really easy.
So it’s in the moment as well how your body’s feeling how you’ve recovered, you might say, look, I went really slow with that 5K. But I feel like that was a bit of a workout, maybe it was more of a 4 or 5 out of 10 rather than a 2 or a 3, and then you’re incorporating that into these arbitrary exercise units as well.
So it’s this internal process, listening to the body, listening to your recovery, a lot of things that just really work well. So people can do that, rather than just following a general kind of mileage 10% rule as well.
I love that. That is solid advice right there, Brodie. Thank you for that. Anything else you want to add? This has been really, really awesome. We’re gonna have to get you back on here and have a more in-depth conversation about some other specific topics, because there are so many things that are kind of coming to mind now that it’s like we could just talk all day about this stuff.
Yeah, I think just as a general takeaway, as well, if people want to delve deep into these sorts of topics, then they always listen to the podcast. But resting in injury, like the complete rest of an injury can actually be detrimental. You need to continue to stay active, sometimes even run, but just pay attention to symptoms along the way.
If there’s an increase in your symptoms during the run, after the run, or the next day, like a significant kind of flare-up, then we know that’s way too much. But sometimes poking into a little bit of pain in order to stay active and stay strong and keep your capacity quite strong is the way to go.
And I can talk about that topic for another 40 minutes. But it’s still a really key message for a lot of runners to hear. And it resonates a lot with a lot of runners as well. But you do need to be smart, maybe have the right guidance if you’re not too sure.
If you continue to flare up an injury because you’re returning too quickly or doing something you might not then maybe having a running coach or a health professional to guide you through that process. But that’s something I often see people say there, they get a sore knee and they’re like, Oh, damn, I’ve overdone myself, let me just take a week off and let me try running again next weekend and see how things go. And then it comes back that next weekend, that next weekend, I think, damn, maybe I need more time off.
And so they take two weeks off, and all of a sudden, this knee is completely weak. It’s completely painful. It’s completely sensitized and just can’t tolerate any sort of loading. And so that’s something that we need to be really proactive about, have a lot of education about and yeah, in order to overcome these injuries quite quickly and without losing fitness either.
Love it. So where can people find you and learn more about all this stuff?
I always recommend going to the podcast first if they are one for like that audio format. My first 10 episodes of the Run Smarter podcast covers 10 universal principles to overcome any injury. I think number seven talks about this pain, rest, weakness downward spiral, which delves a bit more in detail of what I was just describing with this complete rest is an injury.
If you don’t like the audio format, or if you want to just read and watch things, I am quite active on Instagram as well. So @runsmarterseries is my handle quite active on that. Releasing, like reviewing articles, reviewing like papers around running and overcoming injuries, blogs, and exercise examples, all those sorts of things. So if they want to digest a bit more of that, that sort of information, they can go there.
Awesome. This has been really interesting. And I just want to say thanks, Brodie, for coming on here and sharing all this stuff with us. And I know that people are going to be really interested in this topic because it’s a hot topic – injury prevention. And just like what do we do when we get injured? It’s like one of the top things people ask about. So we’ll get you back on here again, but thanks so much for being here today, I appreciate it.
I’d love to come back on. Thank you very much.
Wasn’t that good? Brodie is such a cool guy and he has so much knowledge to share. Definitely check out the Run Smarter podcast. He shares a ton of great info on there to help you keep running injury-free.
And then remember October is injury prevention strength and flexibility month over in the Running Lean coaching group. The focus all month is going to be on building strength, building flexibility, and staying injury-free. And I’ve got some special guests coming in to share their thoughts and ideas and teach you how to get stronger and be more flexible and keep running without getting injured.
Just go to runningleanpodcast.com/join. And I really hope that you got something out of this episode today. I know you did. And if you did, please consider sharing it with a friend. That’s all I got. Love you all keep on Running Lean. Talk to you soon.
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