April marks the start of the
months getting colder and therefore running season is again upon us. From 10km
runs, half marathons and full marathons, the season is filled with exciting
events coming up.
We commonly see this season bring on a unique profile of
injuries. Our primary role as physiotherapists is in injury prevention. We
would rather stop an injury occurring instead of reacting to an injury. Less
injuries mean more of a chance in successfully completing running goals. We
find the best way to avoid injuries during running season is exercise grading.
What does Exercise Grading mean?
Exercise grading is the slow and smart progression of
exercise to avoid injury. It runs on the exercise principle of progressive
overloading. With exercise grading, we aim to reduce the risk of developing any
What is Progressive Overload Principle?
This principle states that the increased demands on the body
over a period of time causes significant physiological adaptations. The key aspect
in this principle is the ‘period of time’. The time allocated should allow for
the body to adapt to the demands of the exercise so that when the exercise is
done again in future, the body can handle the stress imposed without entering
the realms of injury.
Overuse Injury Examples:
The proper term for this is medial tibial periostitis. This
is inflammation around the tendon attachment of muscles in the lower leg to the
outer layer (periosteum) of the tibia (bone). Overuse of these muscles from a
sudden increase in running with no exercise grading can result in this injury.
A Stress fracture is a unique type of fracture resulting from
overuse. They are small breakages in the outer layer of the bone (periosteum).
This injury is common among runners and can occur from a sudden change in
training – be it a drastic change in distance or time, a change of footwear; the
introduction of new terrain or inclines/declines.
A bursa is a small fluid filled sac located at the interface
of many structures – eg bone to bone, muscle to bone, tendon to bone. They act
to reduce friction between structures during movement. A bursitis is
inflammation of the bursa and this can occur from repetitive overload. Common
bursitis’ with runners include hip bursitis.
Tendonitis is the inflammation of tendons from sudden overload. This is another common issue among long distance runners who suddenly apply a change in training regime without any exercise grading. Tendinopathies are more chronic tendon issues. Common tendinopathies include achilles tendinopathies and patellar tendinopathies.
The importance of ‘Rest Days’
An important aspect of exercise grading in the incorporation
of rest days. Rest days should be implemented immediately after any increase in
training – be it any parameter (distance, time, terrain). Rest days are
important in decreasing the likelihood of developing overuse injuries because
they allow for physical and physiological repair in the body. They also have
benefits in improving mental well being. Running can be taxing even on the
mind. Therefore, rest days are needed to allow the mind to recover.
An Example of a Graded Running Programme
Note: This programme is only written for the purpose of this blog. If you are a runner and wanting proper advice to suit your specific needs, we recommend booking in to see our physiotherapists.
Goal: To run a half marathon (21km)
- Decide on a running event/date of
completion for a specific running goal.
- Start running about 6 months prior to
- Start with doing one run per week.
- Make sure it is at the same time
every week eg if it is on a Sunday, keep it on a Sunday.
- Keep it on the same time during the
day eg morning vs late afternoon. Ensure this reflects the time of actual event
eg if it is a morning event, then try to run in the mornings.
- About 3 months prior to the event,
start increasing the frequency to twice a week ensuring there are 2-3 rest days
between each run. Eg a run in the middle of the week and a run at the end of the
with a 2km run once per week, 6 months prior to the event.
to increase the running distance 1-2km weekly.
training, it is recommended never to run the full distance. Therefore, cap the
running distance during training to 18-19km.
the introduction of twice weekly runs about 3 months prior to the event, make
the middle of the week run a short distance run (less than 10km) and the end of
the week run a longer distance run (above 10km).
adequate rest days between each run (2 -3 days).
running distance down 2 weeks prior to the event – This can mean only running
once/week and keeping it less than 10km.
This blog is only a light introduction into exercise grading. For any specific exercise grading or for more information, don’t hesitate to see our friendly team at Pivotal Motion Physiotherapy. Book an appointment online or call us on 07 3352 5116.
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