Preventing Running Injuries: Part 3
31 Jan 2017 by Graham Nelson
In Preventing Running Injuries: Part 2 of our series, we discussed all of the intrinsic factors that can contribute to running injuries. One of the key factors that we discussed in this report was Musculoskeletal dysfunction. We thought it was important to elaborate on this factor further as we know from research and clinical experience that musculoskeletal imbalances and dysfunction are one of the most common causes of all running related injuries. It is therefore of significant benefit to understand this concept further and how to address and manage any musculoskeletal dysfunctions you may have.
~ Did you miss Preventing Running Injuries: Part 1?
What is Musculoskeletal Dysfunction?
A dysfunction is defined as anything that is not working properly. With respect to musculoskeletal dysfunction, this can apply to any muscle, joint, nerve or movement pattern that is not functioning optimally. Let’s discuss each of these further:
A muscle dysfunction is characterised by tense, ropey, tight or thickened muscles. Muscles in this dysfunctional state do not produce the same amount of power as a healthy muscle, causing surrounding muscles to overwork. They generally also don’t have good blood flow through the muscle fibres as the tight and thickened bands of muscle impede blood flow through the smaller capillaries. This further deprives the muscle of nutrients and oxygen, causing more tension to develop, creating a “vicious cycle”. Unhappy muscles will generally be weaker and tighter than their normal counterparts.
You can see how this can potentially lead to over-strain if these muscles are put under load from running, especially with increases in speed or volume.
“Unhappy” joints are joints that are under more load or pressure within the body. They react to this extra load by becoming “stiff”, or resistant to passive movement. They may still move within a normal range, but at the end of range there is reduced movement. This extra resistance is easily measured by an experienced practitioner, such as a Physiotherapist. The amount of passive movement within a joint can be easily tested and measured, and this is an indication of how well the joint is moving. Stiff joints do not absorb and transmit load optimally, and so can become stiffer over time, potentially leading to a painful joint dysfunction if not addressed. Surrounding muscles will generally be tighter as they try to protect the joint. They are often also weaker, which may have led to the initial joint dysfunction.
Running on ‘unhappy’, dysfunctional joints may cause further strain on the joint, potentially leading to pain or injury.
Nerves are complicated structures, so let’s keep this as simple as can be. Nerves carry impulses to and from the brain - they make muscles work (motor nerves) and they carry noxious (distress) signals to the brain (sensory nerves) from virtually every organ and tissue in the body. As such, they are very important structures, and the vast network of nerves are all interconnected to some degree.
Nerves are also mobile structures that move, slide and stretch around joints in the body. If this nerve movement is restricted in any way, it can lead to pain and further dysfunction, affecting muscle activity and patterns of movement. This loss of nerve movement can be tested and treated by a skilled practitioner, which generally improves muscle function and tension.
Altered patterns of movement
This is generally a combination of the other dysfunctions already described - muscle, joint and nerve - leading to an altered movement pattern. For example, a weakness of the hip muscles on one side of the body will lead to muscle tension or “guarding” as the weakened muscles try to cope with extra demands. During running, this will cause a loss of control of the pelvis as the runner lands on that leg, creating excessive drop of the pelvis on the other side. This will cause increased pressure on joints of the lumbar spine on the weakened side, as the increased pelvic movement “jams up” the facet joints in the lower back on the same side. This will also increase pressure on the same side hip joint, and all joints affected may suffer loss of accessory movement, or stiffness, that will then affect further muscle activity. A cascade of dysfunctions can then develop, one feeding into the next, leading to altered and sub-optimal movement patterns. You can see how this can lead to injury or pain developing for the runner.
What causes musculoskeletal dysfunctions?
As discussed in Part 2, MS dysfunctions usually result from prolonged postures, repetitive movements and poor postural habits. This can then lead to altered movement patterns (as outlined above), which further contribute to the ongoing dysfunctions, if not addressed. It is particularly likely for a dysfunction to develop if there are a combination of these factors present.
Common daily activities such as:
- prolonged sitting or driving
- gardening and household chores
all place some strain on the body and can lead to dysfunctions developing. This is particularly likely if these activities are done with poor movement patterns and less than optimal postures. This places increased strain on the body and muscle, joint and nerve dysfunctions are much more likely to develop.
Essentially, all of the dysfunctions described are protective responses form the brain. When the brain senses a structure or tissue is under strain, it will create protective outputs, to help protect the area from further damage. These outputs are the muscle, joint and neural dysfunctions discussed above. They generally start at a low level, often where the individual won’t feel any discomfort. But if the strain continues to build on the structure in question, so will the protective outputs – eventually leading to pain. Further information on this Accumulative Strain model can be found here: http://www.nwpg.com.au/musculoskeletal-pain-injury.
These dysfunctions are inevitable to a large degree, and we all have them. The key is to be aware of what the main ones are in your body and learn how you can manage them to prevent strain accumulating too much and injuries developing.
Tips for minimising musculoskeletal dysfunctions
Get to know your body well by having a whole body musculoskeletal assessment with a qualified health professional, and follow through on clearing the dysfunctions to balance your body.
Make sure you are aware of good posture and how to maintain it in all positions. This will be different for each individual. More info can be found here: www.nwpg.com.au/how-to-be-pain-free-at-your-desk
Get your running technique assessed using video apps or software by a qualified health professional. This will ensure there are no obvious flaws that will place strain on your body and affect your efficiency. You will be surprised at what you may find that could really help with your performance and reduce injury risk.
Ensure strength training is an integral part of your routine. This will allow your muscles to absorb and distribute more load before they become dysfunctional and affect other structures. You can learn how to do that most effectively here: http://www.nwpg.com.au/video-gallery/7-best-strengthening-exercises-for-runners
Make sure you warm up and cool down properly after exercise and running. Some effective warm up drills for running can be found here: http://www.nwpg.com.au/video-gallery/the-hot-6-warm-up-drills
Stretching is an important part of any routine and will help prevent build-up of strain.
Having regular massage will also help greatly in minimising musculoskeletal strain from accumulating.
If you need any further information on any of the concepts discussed, or you would like help with identifying or managing any MS dysfunctions you may have, please don’t hesitate to contact us at the clinic – 9370 5654. We are here to help make sure you stay injury free and enjoy your running.
We currently have an offer to kickstart your running for the year with 65% off our running assessments. This is normally valued at $220, but until 31/3/17 the cost is only $79. For further information on running assessments, please contact Wes at the clinic or via email firstname.lastname@example.org.