A case study of a patient to show the risks of increasing training capacity too much too quickly…

By Mike Davis, Physiotherapist, BSc

Lucy is a runner (although she says she is not a “real runner”). She returned to running 4 months ago  to get back into shape after the birth of her third child. She progressed from a couch to 5k walk/run routine and was quickly increasing her distance up to 10 miles with her long runs in a matter of a few weeks. She treasured her morning runs – it gave her a chance to “clear her head….and just focus on the run and connect in with the natural world”  She also started competing in 5k and 10 k races and given her competitive nature she was really keen to push herself and get as quick a time as possible.

On the advice of a running coach she introduced hill running, interval training and increased her total weekly mileage from 15 to 30 miles per week…….and then the niggling, frustrating injuries began. First it was her right calf then 2 weeks later it was her right knee. When I first saw Lucy it was on an online video consultation call 3 week ago and with a detailed assessment of her training diary I could see significant “training errors” i.e. pushing your body too hard and in Lucy’s case it was the combination of hill training, interval running and increasing her total mileage by too much and her body didn’t have time to adjust – something we call “tissue tolerance” and so we see tissue overload resulting in pain, injury and frustration.

Did you know that more than 80% of running injuries are caused by so called training errors? Some classic examples are shown above.  Does this sound like you? One of the biggest risk factors for developing an injury is too much too soon. A good rule to stick to is to do no more than a 10 % increase in your total running mileage from one week to the next. With Lucy we had to taper her training immediately right down and introduce cycling and walking to allow her body to adjust to the impact training and be able to maintain her cardiovascular fitness. With a tailor made rehabilitation program including strengthening and flexibility exercises Lucy is now well on her way to a full recovery.

So in these crazy times don’t obsess with your distance or time – remember there is plenty of scientific evidence that a moderate and gradually progressive training program will enhance your physical fitness and immunity. Your key aims at present should not be personal running records but staying healthy and resilient enough to fight infection and you only need to include a small (less than 20% of your training dairy) amount of higher intensity interval or hill based running to maintain your running speed. So avoid the frequent exhausting and hard training sessions which will leave you more vulnerable to injury (often referred to as “Boom and Bust!”).

Remember fundamentally whatever exercise we choose to do should always make us feel better and stronger. It should invigorate us and leave us feeling the healthiest we can be – and never more so than now.

For more advice on training programs or if you are struggling with an injury then don’t hesitate and get in touch with us at Bodies Under Construction where you can get help from our physiotherapy team – the exercise experts!!!

Leslie Abrahams