Reaching the finishing line

Just under 2 months away is one of Perth’s most popular community fun run events, the Chevron City to Surf. Giving you the option of 4km, 12km, 21km (half marathon) or 42km (marathon), the City to Surf attracts thousands of runners each year. But unfortunately, the weeks after the run seem to be a busy time for physiotherapy clinics around Perth. Often, post City to Surf injuries can be traced back to inappropriate training regimes leading up to the event.

Below are some factors to account for in your training regime, to help decrease the risk of you suffering an injury either in your training, or as a result from the event itself.

Training load

There has been a number of studies published in scientific literature lately showing a strong link between sub-optimal training loads as a risk factor for exercise related injury. A number of these studies are based on team based sports, but the same principles can be applied for running training. Studies looking into this idea, many authored by renowned sport scientist Tim Gabbett, have discussed the idea of an ‘acute:chronic workload ratio’ being able to be used as a predictor of injury risk¹ . This ratio is determined by dividing the training load of the most recent week, by the average weekly training load of the previous 3 or 4 weeks usually. It is essentially a formula that gives us more objective and specific information to the week to week changes in a training program. When trying to plan a running program, the workload of one session (without fancy and expensive GPS data), can be calculated by the total distance run multiplied by the RPE of the session. The RPE or (rate of perceived exertion)  is how hard you perceived the training session to be out of 10, with 10 being the hardest (you can use goal time of run to help you plan what you expect a RPE of a certain session to be).

For example, if in 1 week I complete:

Session 1: 5km with an RPE of 5/10 (longer, slower run – 5×5 = 25

Session 2: 3km with an RPE of 7/10  (shorter, quicker run- 3×7=21

                                    My acute training load for that week = 25 +21 = 46

If I were to complete exactly the same sessions for 3 weeks (for ease of making the point clear)

                                    My chronic training load for those 3 weeks would be 46×3/3 = 46

Therefore, my acute:chronic workload ratio = 46/46 = 1.00

i.e. there is no week to week changes over 3 weeks so the total ratio = 1.

These scientific studies have found that if the acute: chronic workload is too low or too high, i.e. not doing enough training or doing too much training, injury risk is increased. Specifically, recent evidence has found that if this ratio is between 0.8 – 1.3, your risk of injury during training is decreased¹. This principle is very important to consider when planning your running program leading up to the event.

It is also very important to utilise this principle in determining whether or not you are ready to run a certain distance yet. For example, if you are planning to run a marathon but the furthest you have run in your training is 15km, it is likely that your “ratio” will be much higher than the recommended values if you try to run the marathon, and some type of injury is likely to be around the corner.

It is also important to period-ise your training program, meaning you are not always doing more each week over the period of a few months to build your running capacity. It is important to schedule in lighter weeks every so often, to allow your body to replenish and reenergise, so it can tolerate another upcoming hard training block.

Biomechanics/previous injury history

This is a physiotherapist’s favourite talking point. One of our main roles in injury prevention is assessing someone’s biomechanics (how the body moves) in different areas of the body. We have the skills to determine if a certain area of the body is stiff, or not as strong as the other side, which may place you at increased risk of developing a certain injury. In relation to running training, I believe it is very important to watch someone run to see if there are any obvious biomechanical faults. But often in the clinic, it is hard to replicate the fatigue the runner would normally be under when running longer distances (when biomechanical faults are likely to become more obvious), so there are a number of different screening tests we use to assess specific faults.

We also know, that if someone has had a previous musculoskeletal injury, they are much more likely to suffer that same injury, or injury to a nearby area later down the track ² . This is an important consideration as a physio screening someone, to ensure there are no  weaknesses or stiffness related to the previous injury, but also leads into the next point very well.

Strength training

Get in the gym and get strong! It has been shown in the literature that strength training is a really important strategy for decreasing injury risk in athletes³. Including 1-2 strength training sessions a week into your program will not only decrease your injury risk, but likely improve your running time too. Physiotherapists are in a good position to write up a program for you, that is specific to your needs as a runner. Technique is very important to start to build on those movement patterns that will hopefully transfer over to the pavement and improve your running efficiency. It is also important to time these sessions in relation to your runs throughout the week, to ensure your body is getting the adequate recovery it needs between exercise sessions.

Nutrition

**I am by no means an expert in this area, but the following tips should help maximise the energy you receive from the foods we eat throughout the day**

Carbohydrates will be your best friend during training, particularly throughout those periods where volume and intensity of training are high. These involve foods such as breads, cereals and starchy vegetables. Intake of carbohydrates after training sessions can help to restock muscle energy levels more quickly, where including protein dense foods such as red meats and eggs can help build muscle and repair muscle after exercise sessions.

Fluid replenishment is also an important consideration. Basically, runners should aim to drink enough fluids to replace those fluids lost during a day. Getting fluids back in after a run doesn’t have to happen immediately, it is recommended to do so over a few hours post run instead.

Planning for the race is also very important nutrition wise. It is recommended by Sports Dieticians Australia, that 30-60g of carbohydrate per hour is consumed for those running the half or full marathon. This is to ensure muscle fatigue does not get out of control. This can be achieved through gels, drinks, energy bars etc.

For more information, this fact sheet is a great resource! https://www.sportsdietitians.com.au/factsheets/food-for-your-sport/food-for-your-sport-distance-running/ ⁴

Sleep

Lastly, but potentially most importantly, you cannot underestimate the importance of getting enough sleep during your training regime. There are many studies that exist that show that not enough sleep can increase your chances of getting injured or getting sick^5,6. This risk occurs due to nervous and immune system imbalances that occur with poor sleep patterns⁵.  Most experts recommend between 7-9 hours of sleep for healthy adults, but if you are in a heavy training block, you may need even more than that to allow your body to replenish its fuels. Some runners find it difficult to get to sleep due to soreness and other reasons during intense training blocks, so you may need to schedule in a short nap throughout the day every now and then.

Hopefully these few tips can help you on your way to getting to the finish line safely in a couple of months of time. If you feel as though you need some further guidance, don’t be afraid to give us a call on 9335 7733 and team at Lifecare Fremantle will be more than happy to help out. Otherwise see you out on the pavement!

Written by: Samuel O’Neill, Physiotherapist

Hulin BT, Gabbett TJ, Lawson DW, et al. The acute:chronic workload ratio predicts injury: high chronic workload may decrease injury risk in elite rugby league players. British Journal of Sports Medicine 2016;50:231-236.

Fulton J, Wright K, Kelly M, et al. Injury risk is altered by previous injury: a systematic review of the literature and presentation of causative neuromuscular factors. Int J Sports Phys Ther. 2014;9(5):583–595.

Lauersen, J. B., Andersen, T. E., & Andersen, L. B. (2018). Strength training as superior, dose-dependent and safe prevention of acute and overuse sports injuries: a systematic review, qualitative analysis and meta-analysis. Br J Sports Med, bjsports-2018.

Sports Dieticians Australia. Distance Running. Factsheets. Available from: https://www.sportsdietitians.com.au/factsheets/food-for-your-sport/food-for-your-sport-distance-running/

Fullagar, H.H.K., Skorski, S., Duffield, R. et al. Sports Med (2015) 45: 161. https://doi.org/10.1007/s40279-014-0260-0.

Copenhaver, EA. Diamond AB. The Value of Sleep on Athletic Performance, Injury, and Recovery in the Young Athlete. Paediatric Annals (2017) 46: 106-111. https://doi.org/10.3928/19382359-20170221-01

Image: https://city2surf.com.au/