Prehab is better than cure

A runner normally experiences rehabilitation from injury at some stage. If  your training programme includes the things that you might expect to see in a rehabilitation programme you may reduce the chance of injury. This type of work is known as prehab.

As a runner you should consider what could lead to injury:

• Muscle imbalance/weakness
• Fatigue
• Lack of recovery
• Overtraining
• Poor technique
• Poorly fitting or improper footwear and equipment

Next  you should look at your training:

• Duration - how much training do you do?
• Intensity - how hard is it?
• Frequency - how often do you train?
• What types of movement do you carry out with repetition, speed variance, impact and stresses?

With this information you can see how much workload you subject yourself to and how much prehab you may need to do that workload. You can probably do this yourself but you could also consider working with a coach at a club or joining a Run England or jogscotland

A one-year survey on track and field injuries at Birmingham University (D D’Souza 1994) found that, out of several variables, the presence of a coach at training sessions was significant. D’Souza found that 40.4% of those athletes that had a coach present suffered an injury, compared with 81.8% of those that had no coach at all, even just to help plan their training. He stated that “when athletes tire (the commonest time for an injury to occur), concentration is diminished, and this may impair accurate assessment of the workload which they decide to subject themselves to. These workloads should be formulated before the session, with a coach watching their progress, and not ‘pushing’ them too far."

So what sort of prehab should be in your programme? The starting point may be to ask your coach for advice on any muscle imbalances, tight or short muscles and any other weaknesses they have identified. These can then be investigated to uncover the causes.  Your coach can plan sessions to strengthen anything that is weak, stretch anything that is tight and, by addressing this, may be able to correct poor biomechanics or posture.

Before you practise an exercise or drill you should learn and maintain the correct technique and then your  coach can gradually increase the levels of difficulty. Your programme might include:

•  Functional Core stability. This should encourage awareness of the core, posture, breathing and economy of movement. It should encompass movement patterns through a range that is specific to running and encourage correct posture. Functional movements are better than static exercises. Pilates may be put into the programme as this helps core stability and also uses functional movement patterns.
• Proprioception. This is the ability to keep movement going and control the body’s position prior to or during the running skill. It should be brought into your training programme early to develop kinaesthetic awareness. To begin with the exercise may be standing on one leg before bringing in an unstable surface and then other activities such as throwing, catching, batting etc.
• Hydroptherapy. Ice baths, contrast showers, whirlpools can all be used after a hard training session to stimulate blood flow and flush out waste products. This will aid a quicker recovery.
• Flexibility. Static stretching should be done after the cool down. After a hard training session the muscle will want to shorten and contract. When you are fatigued you could perform stretches for 5 – 10 seconds to avoid the muscle shortening and becoming tight but, to increase flexibility, stretching should be planned into your programme to hold the stretches for 30 seconds and do several repetitions. You should do these two or three times a day if muscles are particularly tight.
• Strength. This could include maximum strength, strength endurance and plyometrics. Once the basic techniques have been mastered, your coach may consider exercises that use the same movement patterns to running. The focus should be on making you a strong runner rather than on the muscle becoming stronger.
• Other sports. Consider taking up other sports that will give you a good work-out but use other muscles
• Recovery, nutrition and hydration. You should be aware of how the body repairs itself after training and what you need to do to optimise it. You will have a higher chance of injury if you are dehydrated, under-nourished or tired.

It is important to monitor all of the above. Keep a training diary that records your training sessions and how you feel each day. That way you will learn about your body, your levels of tolerance to training and how much recovery and prehab you need to stay healthy.