Monthly Archives: August 2016

Running Injuries

What running injuries present in clinic and why? This article will address three of the most common injuries seen, and give an insight as to why they occur and what can be done to prevent them.

Iliotibial band syndrome (Runner’s knee) – the iliotibial band is a thick sheath of fibrous connective tissue running from the iliac crest (pelvis) to the outer tibia (shin). As the band passes over the lateral femoral condyle (bony prominence just above knee on outer aspect), it is prone to friction as the knee is straightened during running. Pain on the outside of the knee, aggravated by (downhill) running and tightness down the side of the thigh are all symptoms of this condition. The treatment for this begins with rest, cold therapy and stretching of the tight band. Oosteopathic treatment is highly beneficial.

Anterior compartment syndrome (shin splints) – the anterior compartment of the lower leg is a group of muscles housed in a connective tissue sheath. When the muscles become too big for the compartment, this painful syndrome occurs. This can occur due to an impact injury, causing bleeding, a muscle tear, or overuse, all of which lead to swelling. Symptoms include sharp pain on the outside of the leg, muscle tenderness and pain on lifting the foot up. Again, rest, ice and compression (for 20 minutes) are necessary and osteopathic treatment is highly beneficial.

Hamstring muscle strain/tear – the hamstrings are a group of three muscles (biceps femoris, semimembranosus and semitendinosus) which act to bend the knee and extend the hip. A hamstring strain or tear (a Fernando Torres special!) usually occurs during the deceleration phase of running, as you straighten your leg and plant the foot. Osteopathy can once again be highly beneficial. Early commencement of a progressive running program is an important component of rehabilitation following injury, and a generic protocol is outlined below, which should be followed after consultation with your sports osteopath to allow modification as necessary…

  • running program starts 48 hours after injury
  • 10 minutes of gentle hamstring stretching followed by
  • 20 minute running sessions twice a day
  • commences with short stride jogging (“this new fad called ‘jogging’. I believe it’s ‘jogging’ or ‘yogging’. It might be a soft ‘j’. I’m not sure, but apparently you just run for an extended period of time. It’s supposed to be wild…” – Anchorman)
  • increase stride length and pace gradually over session as pain/ache allows
  • interval running over 100 metres, with acceleration, maintenance and deceleration phases
  • if slightest pain in hamstring felt, cease action immediately and ice area (program can be attempted again in just over 12 hours time)
  • finish with gentle hamstring stretching and apply ice to injured area for ten minutes

Whether you are an elite runner, run for fun or just run for the bus, injury can occur and it is important to take action early. If you have a running injury, it may be worthwhile coming to see us at Atlas Osteopathy (with clinics in East Finchley and Moorgate, as well as the option of home visits), where we can explain your problems to you, why they occur and whether or not you are suitable for osteopathic treatment. Often this can be done via email or on the phone.

Work it harder, make it better, do it faster, makes us stronger… Core stability exercises

Core stability exercises are those exercises by which the corset of muscles surrounding the abdomen and back are made stronger. By working these core muscles harder, a more solid base is provided, upon which all other muscles can work upon to initiate movement. Strengthening these muscles is a method by which low back pain can often be reduced and even prevented.

So, what are these core muscles? They are the muscles of the abdominal wall, pelvis, lower back and diaphragm, including the transversus abdominisinternal and external obliquesquadratus lumborum and the diaphragm.

Let’s go through the four main muscle groups in a bit more detail…

Transversus abdominis – the deepest abdominal muscle, found under the rectus abdominis, or ‘ab/six-pack’ muscles. This is the main muscle providing ‘core’ stability. The muscle connects to the individual vertebrae forming the lumbar spine (lower back) and wraps around each side, coming together in the front of the abdomen. When contracted, the muscle increases pressure in the abdomen and pulls the vertebrae tightly together, providing greater spinal stability.

Multifidis – these are the deep back muscles, found on either side of the spine, connecting to each individual lumbar spine vertrebrae. Its function is to aid extension of the back (bending backwards) as well as being an essential postural muscle, helping keep the spine upright, opposing the natural tendency of the body to flex (curl up, as in the foetal position).

Diaphragm – this is the primary muscle used for breathing, providing the ‘roof’ to the core muscles. When the transversus abdominis contracts, the diaphragm tightens, maintaining pressure in the abdomen and providing stability to the spine.

Pelvic floor – provide a sling running from back to front, from the tip of the spine to the front of the pelvis. These muscles contract simultaneously with the transversus abdominis to form the ‘floor’ of the core muscles.

Weakness in these muscles is often the root cause of low back pain. Strengthening the weak muscles and stretching shortened muscles can often relieve this pain. The core is often trained using Pilates or with a Swiss ball exercises.

If you have lower back pain, or any other muscle or joint pain, it may be worthwhile coming to see us at Atlas Osteopathy (with clinics in East Finchley and Moorgate, as well as the option of home visits), where we can explain your problems to you, why they occur and whether or not you are suitable for osteopathic treatment. Often this can be done via email or on the phone.