Avoid injury in the run-in to the marathon

WITH just three weeks left before the London Marathon, you should have your longest run behind you. Your fitness should be good, and mentally you should be focusing on the big day. It’s vital now that you don’t get injured, so if you are suffering any of the common injuries, this is the time to do something about it.

One of the most common injuries at this point is patellofemoral pain, a knee-pain that is a result of so-called mal-tracking of the knee cap during running, where tight structures along the lateral knee pull it sideways, overriding weak structures inside. It will hurt while you are running, but then settles while you rest. Treatment includes strengthening of the medial quadriceps muscle, for example with lunges, or trying to reduce overpronation (when the feet roll inwards) while running.

Another typical problem is runner’s knee, technically known as Iliotibial Band (ITB) Syndrome. This tends to be worse when you are running downhill, especially when the knee is at a 20 degrees angle. The simplest treatment is to rest, stretch the lateral muscles and the gluteal muscles. Anti-inflammatory drugs could also help, and if it doesn’t sort itself out by the time of the marathon, then cortisone injections might be your friend.

For those who have been engaged in a strenuous training regime, tendonitis could be a problem. This is a heightened sensitivity of the tendons – especially the Achilles and knee-cap tendons. The classic exercise to correct it is the heel drop. Otherwise, RICE (Rest, Ice, Compression and Elevation) can help.

And finally, shin splints – or medial tibial traction periostitis for the Latinists among you. This is an inflammation of the soft tissue structures along the medial border of the tibia, and is characterised by pain that subsides with warming up but worsens following the run. In the long-term, changing your running style to make it smoother helps, and ensuring that you have supportive footwear – shin-splints are caused by flat-footedness. Simply, though, make sure you massage the area, and stretch well before you run.

Remember, good preparation and early intervention for any injury is paramount.

Clive Pereira, Specialist Sports Physiotherapist Pure Sports Medicine,