The Semper Fi Fund Marathon Training Program September, 2010 by Corey Petersen Preventing Injuries We are now approximately half way through your training for the marathon. During these miles you are pounding, you are exerting over 3-7 times your body weight during each step. For example, a person weighing 150 pounds can experience forces of 1000 pounds on their legs. With participants normally covering over 560 miles during training just for the marathon, it provides many miles and time for injuries to occur. You have seen my stress for importance on listening to your body when concerning training exertion but it is extremely imperative to listen when it comes to maintaining the health of your body. Running through injuries can either make the training miserable or cause the injury to worsen thus making finishing the marathon unrealistic. The typical injuries runners face are Plantar Fasciitis, Achilles Tendonitis, Shin Splints, Patellofemoral Pain Syndrome, and Iliotibial Band Syndrome. Although I am not a medical professional, I do want to provide you with a general knowledge of recognizing injury signs, treatment recommendations, and most importantly how to prevent it from occurring in the hopes it can assist you with continuing your training without having to face any issues. Let’s begin with the injury that plagued my whole running career, Plantar Fasciitis. I am a great example of what you should NOT do and what can occur if you do not listen to your body. Before I learned what you should do, I was stubborn and allowed my injury to become so severe I was reduced to having surgery on both my feet. Thus leaving me cursed to crutches for almost four months (this is a picture is my foot 4 weeks post surgery). PLEASE listen to your body and do not ignore the signals your body gives you. These include symptoms that start directly after stepping out of bed and continue during the beginning of training. This pain normally occurs in the middle of your foot on a thick band of tissue leading from the base of the toes to the heel called the plantar fascia (aka your arch). This band becomes inflamed causing pain and if not cared for can become such an issue that may require surgery as mine did. Overtraining, high arches, improper shoes, and inflexibility of calf muscles may increase the likelihood of aggravated the arch. Complementary problems may occur due to compensating for pain by changing your gate or stride in attempt to alleviate pain. Taking a few days off or reducing training miles may be required for 5-7 days with possibility of inflammatory medication needed. In addition, icing your arch (I recommend using a can of frozen pop/soda, rolling it under your foot/arch for 10-20 minutes in the morning and after training) and stretching your calf and arch. A great way to stretch your calf is by facing a wall, taking a step back with one foot (keeping your heel down) and leaning your hands against the wall. Completing this stretch before training along with your normal warm up may help in staying clear of this common injury. Moving to the heel, the Achilles Tendon can become inflamed causing an injury called Achilles Tendonitis. Noticeable pain, redness, swelling, even reduced movement with some people noticing having a cracking noise can be signs of the tendon being overwhelmed. Tightness or fatigued calf muscles caused by improper conditioning (taking on too much or too quickly) or even overpronators (those that roll inward during their gait) with flattened arches can push the tendon to be undertaking too much stress leading to the inflammation. Pain and irritation of the heel may begin in the morning, lessen as the body stretches, and then worsen as you increase the activity level. Treatment such as temporary foot inserts or orthotic devices along with self care such as resting for a couple of days, icing the area, and/or inflammatory medication can lead to decreased pain level and lessen the stress placed on the Achilles. But if self care does not translate into decreased pain after 2-3 weeks, the injury may have progressed to a more serious injury where the tendon becomes ruptured or torn. This is characterized by a failure to bend the foot down, inability to stand on your toes or walk normally. Immediate medical attention is needed if you suspect you have ruptured your Achilles Tendon. Moving on to further up the body, another classic runner’s injury is Shin Splints also known as Compartment Syndrome or Medial Tibial Stress Syndrome. This is another possible overtraining injury that has tenderness in the front of the leg (may be anterior or posterior of the shin). It is often misdiagnosed as a stress fracture. But differs by fractures in which normally pain is increased by load bearing whereas shin splints generally begin right from the start of the run and may lessen as the run progresses. Runners may be less susceptible to this injury if they stretch and warm up proficiently. I recommend completing progressive low intensity running or dynamic movements which increases blood flow to the area you are about to use. Ballistic stretching (meaning attempting to use bouncing movements to increase the length of the stretch) is not suggested. Similar to treatment of the plantar fasciitis, icing, inflammatory medication, and reducing mileage or rest is recommended to decrease pain and further injuries. Providing proper shoes especially for flat footed or overpronators (the inward roll), proper warm up and stretching, and not increasing your mileage too quickly can lessen the susceptibility to this frequent runners injury. Advancing along, according to Runner’s World 42 percent of overuse injuries occur in the knee (Patellofemoral Pain Syndrome, August 2004). Like shin splints multiple names are given to this reoccurring pain mainly in the front of the knee. It may be called Runner’s Knee, Patellofemoral Pain Syndrome (PFPS), or Chondromalacia Patella. The knee or Patella is one of your main shock absorbers against your body weight and the ground. Although not completely understood on the causation, it could be due to high arches, flat feet, tight hamstrings and calf muscles, weak quadriceps muscles, or possibly your patella naturally sitting too high on the femoral groove. PFPS can be recognized by an achiness of the knee at the center stirring up pain after sitting, walking up/down stairs, or kneeling but it can also have a grinding feeling when extended or stiffness in the knees. Once identified, immediately back off of the mileage to see if the pain diminishes or leaves. If nonsurgical treatments such as icing, pain medication, and rest do not reduce the pain after a period of time, more aggressive medical assistance may be needed. Due to the massive stress posted towards the knee it has another common injury that occurs to the Iliotibial Band. This band runs along the outside of the knee from the thigh to the shin. Iliotibial Band Syndrome (ITBS) can be confused with Patellofemoral Pain Syndrome (PFPS) but the location of the pain is part of the key of diagnoses. Look for pain locating more on the outside of the knee. This pain can be aggravated by running downhill or uneven surfaces if overstretched. In addition, achiness may begin at the start of the run and increases with the mileage. Biomechanical issues such as being bowlegged or overpronating may cause you to be more at risk to this band to stretch or tear. Taking time off of training or exercising in non-weight bearing method (such as swimming) along with icing and anti-inflammatory medication can alleviate pain. But if pain becomes chronic, a medical professional may be needed. A common foundation of these injuries is overuse and improperly fitted shoes. I previously talked of the importance of fit and hope it was useful in assuring you wear shoes appropriate for your body. But the problem of over pushing yourself is widespread throughout the marathon training world. I highly recommend you do not increase your mileage by more than 10 percent a week. Equilibrium of overload and recovery is needed throughout your preparation. Noticing changes such as feeling consistently tired or drained of energy, general achiness, sudden decline in performance, lack of sleep, sickness, moodiness, lack of enthusiasm, and more can be symptoms of overtraining. Realizing over extending your body through training can actually decrease your running ability is vital. Your training needs to provide time for muscle recovery along with running the miles. Please use this information on Plantar Fasciitis, Achilles Tendonitis, Shin Splints, Patellofemoral Pain Syndrome, and Iliotibial Band Syndrome so an injury will not prevent you from competing in the Marine Corps Marathon. Listening to your body’s changes and signs of breakdown, this can help prevent an injury from becoming too overwhelming foiling your participation in training and completing your goal. If sensing pain, a common recommendation is to immediately decrease your mileage and follow the acronym RICE (rest, ice, compression, and elevate). Whether the goal be completion or a personal time target, adequate health is crucial. If you have any further question or concerns, please feel free to contact me at my email [email protected]. Thank you and Good luck! Corey Petersen Community Outreach Representative Semper Fi Fund 619-920-6841 phone [email protected] www.semperfifund.org “Serving those who preserve our freedom” This message may contain Injured Marine Semper Fi Fund Privileged/Proprietary information. If this email is not intended for you, and you are not responsible for delivery of this email message to the addressee, do not keep, copy or deliver this email message to anyone.