What do my symptoms tell me about my injury?

Posted on October 30, 2024October 30, 2024 by intraining

What do my symptoms tell me about my injury?

By Steve Manning – Podiatrist BPod (Hons), Level 4 Coach

Injury is an unfortunate side effect of running. Every runner who trains consistently will eventually have to deal with an injury. When pain occurs bad enough for you to reduce or stop training then your niggle may have progressed to an injury.

However, you can not stop running at every incidence of aching muscles. The training principle of overload states that for adaptation to occur you need to stress your body beyond its accustomed level of stress. The result may be aches and pains.

In fact there is some evidence that “No Pain – No Gain” is true. A research study had runners sprinting downhill to cause delayed onset muscle soreness. They gave half the runners pain medication then had them do the same downhill sprint session 2 weeks later. The group who had the pain relief had the same symptoms and the group who went through the pain process had reduced pain the second time.

Another example of this is the remodeling of your bones that comes with training. When you stress a bone with an increased training load it responds by trying to make itself stronger to better cope with the increased stress in the future. This “normal” bone stress may show up on an MRI as patchy whiteness in the cortex. You may not have any pain when running but have some bone pain on palpation. However, if runners have inadequate recovery from their hard sessions then the bone stress can become pathological and cause pain when exercising. If runners ignore this pain and push through it then the bone stress becomes a stress fracture that will show white patches in the cavity inside the bone on an MRI. Continued running with a stress fracture can even lead to a complete fracture on rare occasions.

The real difficulty is figuring out when you are experiencing normal pain and when you have an injury.

What may start as normal post exercise pain can start to hurt when running and stick around and hurt at other times. The sooner an injury is addressed the less time you will have off from your normal running routine. Early, accurate diagnosis from a sports medicine professional is critical to making sure that the correct intervention is applied to get you back running ASAP.

Here are some questions you need to ask about your symptoms to determine if you can manage the injury yourself or need to seek help.

1. How did the injury start? Was there a traumatic event like a fall or sprain that proceeded it? Did it happen within 6 weeks of a significant increase in training? Did it have a sudden onset without any reason? Pain related to an acute event is more likely to need proper evaluation.

2. How much does it hurt? Is there significant pain when running that makes you start limping or forces you to stop? Does the pain wake you at night or hurt during the day? This level of pain will require an effective treatment plan to resolve.

3. Is the injury getting better or worse? All injuries have a lifecycle. Acute injuries either heal or progress to the chronic phase. With mild pain you may be able to manage it yourself with Rest, Ice, Compression and Elevation (RICE). If this self treatment has been ineffective then an accurate diagnosis will be needed.

4. How long has it been hurting? Niggles and minor injuries go away quickly with a short reduction in training. Pain that sticks around for more than 2 weeks, even if minor, should be checked out with someone who understands running injuries.

Getting help with your injuries is the first step in getting back to running and preventing future injuries. Not all injuries follow the same symptom pathway. While diagnosis is critical to creating the best treatment plan it is also important to understand the factors that led to the injury in the first place. We do not want to just cure the injury, we should also be focused on preventing it from occurring again.

Addressing injuries is crucial for returning to running and preventing further setbacks. Injuries often vary in presentation, and I frequently see runners with issues ranging from hip discomfort to foot pain. Early consultation is key to avoiding worsening conditions. Schedule an appointment with me at the intraining Clinic in Indooroopilly.

Super shoes and injury

Posted on October 16, 2024October 16, 2024 by intraining

Super shoes and injury

By Steve Manning – Podiatrist BPod (Hons), Level 4 Coach

Super shoes with their soft 4cm thick midsoles, carbon plates and rocker soles have been proven to significantly improve race times and have less Delayed Onset Muscle Soreness after long races.

This has led many people to use Super shoes for all of their training and racing. While anecdotally, these shoes may reduce post-training pain, the question is whether they reduce or increase injury risk.

There has not yet been any definitive research about training in super shoes. The main question you need to know is if you are someone who might benefit from them or someone who may get injured from using them too much.

Key Considerations:

1. Biomechanics: Super shoes change your running form. The inflexible soles and high stack height facilitate a rocking action rather than flexion at the forefoot. This shifts stress to other joints up the kinetic chain, like the hip and knee. Cadence is decreased, and stride length is increased. Changes in running form can stress certain muscles and joints differently, which might lead to injuries.

2. Training Progression: The factor with the most risk of injury is overtraining. Running in super shoes might make it easier to run faster or longer without delayed onset muscle soreness. Overuse Injury risk can then increase as runners are tempted to run harder and longer without a gradual adjustment to the increased training load.

3. Individual differences: Research on the effectiveness of super shoes identified responders and non-responders. Some runners had up to a 8% improvement in performance while others had no improvement in the same shoes. Everyone’s biomechanics and foot structure are unique; what works for one person might not work for another. One of the key factors is to do with vector forces, which is the direction of impact and propulsion forces. The soft midsoles and high distance between your foot and the ground allow a greater range of motion if your foot is not straight during foot strike or toe off. While this can result in a loss of power and performance it may also increase the risk of injury as the ankle and knee are stressed while at a poor mechanical advantage. You may have to run regularly in these shoes and experiment in racing and training to find out if you are a responder or non-responder.

4. Gradual transition: When switching to super shoes you should ease into them to allow the body to adapt. Semi-super shoes are a great transition into using supershoes. They offer some of the key components of a supershoes with extra stability, support and durability. Asics Glideride, Saucony Speed and the New Balance FuelCell SuperComp Trainer are examples of Semi-super shoes.

Steve was interviewed this week on ABC Radio about the impact of super shoes on running records set in the last few years. The segment starts at 25:15. Listen here!

Steve Manning Podiatrist BPod (Hons), Level 4 Coach

Steve Manning works from the iHealth Centre Indooroopilly as a Podiatrist specialising in running injuries of the lower limb. He is also available for footwear consultations on Thursday evenings at Athlete’s Foot Indooroopilly. Steve is the Coaching Director for the intraining Running and Triathlon Club. If you’re looking for tips and advice on super shoes, injury or an individualised running program, Steve can help with that too!

Blister prevention for Runners

Posted on October 9, 2024October 9, 2024 by intraining

Blister prevention for Runners

By Steve Manning – Podiatrist BPod (Hons), Level 3 Coach

– 6 Common blisters, causes, treatment and prevention
Blistering and black toenails are the bane of runners. It is pretty disappointing when a blister rather than inadequate training or poor tactics leads to a sub-par performance.

There are different causes of blisters. Once a blister appears you need to identify the type of blister and the variables that led to it. The location of the blister is the key to treatment and prevention.

I have listed 6 common blisters below with a description of how they occur, treatment and prevention.

1. Blister between toes
Blisters between the toes are caused by friction as the toes rub together. This fiction will increase if your shoe toebox is too pointy or your toes are overlapping. Toe socks like Injinji are one of the best ways of reducing this risk as the friction is shifted to between the two layers of socks. Matching the shape of your foot with the shape of your shoe is also important.

2. Blister on the end of toes
Shoes that are too short or too long may both increase the risk of blistering the ends of your toes. Direct pressure from pushing on the end of the shoe is the most common cause of end of toe blistering. This can be fixed by making sure there is enough room for your toes at the end of the shoe. If your little toes are longer than your big toe then that will increase the risk of getting shoes too short. Shoes that are too long or wide can make you try and grip the shoe with your toes clawing the ends into the insole. Your foot may also slide down into the end of the shoe. Proper shoe fitting is the solution to prevent toe blisters.

3. Blister under toenails
Subungual Haematoma or Black Toenails are simply a blood blister under the nail. Once the blister has formed the toenail is no longer attached to the nail bed and will eventually fall off. Black toenails hurt when there is still fluid in the blister. After 24 hours they are safe to drain and then should no longer hurt. Do not drain them before this time as you may have a direct line to your blood and have a risk of septicaemia if they get dirt in them. They are generally caused by shallow shoe toe boxes but can also be from shoes that are too short. The best prevention is to cut your toenails as short as possible a few days before a long run or race.

4. Blister on the side of big toe or 1st Mpj
This blister usually forms under a thick callus that has formed. While poor biomechanics led to the callus, the blister happens when the hard callus moves independent from the deeper tissue. Keeping the callus thin with regular treatment reduces the risk but you may have to address the biomechanics that led to it. This is usually from rolling off the inside of your foot in propulsion. This will happen if you are toeing out but most commonly is due to a block in your big toe joint flexion. When it can no longer flex then you twist during propulsion to roll off the side of your foot. This needs to be addressed by a modification of your shoes insole or by orthotics.

5. Blister in the arch
Arch blisters may be caused by direct excess pressure or from a shearing force. The arch in modern shoes is built into the midsole rather than the insole. If the arch in the shoe does not match your foot then force will be focused on one spot leading to a blister. This can happen also with orthotics that have too high an arch especially if you have a rigid flat foot that can not conform to the arch. The blister may be at the high point of the arch but is most often at the front of the arch. Treatment is usually a modification of the shoe midsole where I remove a small wedge in the lip of the midsole at the arch. This is the most common footwear modification I do and has a very high success rate. In some cases poor foot biomechanics will need to be addressed with orthotics.

6. Blister in the heel
Blister in the heel can occur around the base of the heel or at the back of the heel. Blistering around the base is from a poor fit in the width of the heel counter in comparison to your heel. This can be a heel counter that is too wide or too narrow. Shoes with the wrong amount of stability will also contribute to this problem. Blistering at the back of the heel is mainly from your heel slipping in the shoe. Unfortunately modern shoes with a stiffer forefoot increase the chance of this happening. The shape of the heel counter may not match the shape of your heel. This can lead to damage on the inside of the heel counter which then traumatises the skin on the back of your heel. The right shoe fit makes a big difference in reducing these blisters but often the risk can be reduced by changing the lacing of your shoe. In some cases the addition of a cavity inside the heel counter that is covered with a smooth material is required.

General blister prevention:

1. Fitted footwear. Poor shoe fit is the main cause of blistering. The type and location of your blisters can direct us to choose the best model of footwear to purchase. I see patients on Thursdays nights at Indooroopilly Athletes foot.

2. Anti-friction creams. Bodyglide and Premax are two effective methods of reducing the risk of blistering. They create a film between your foot and external pressure or friction. The stress then occurs within the film rather than in your skin. They are highly effective for many blisters but may lose their effectiveness during longer races.

3. Wicking fibre socks. While the fit of the shoe is critical to pressure spots causing blistering the internal environment is also important. Socks are a more significant factor than shoes in keeping your feet dry and cool. Cotton socks are very absorbent but bunch up and get abrasive when wet. Socks with a high amount of elastic will maintain their shape reducing the chance of skin trauma.

4. Address Pathomechanics. Some blisters are formed because the foot is not working properly. A block in foot function leads to extra movement that may cause blisters. Orthotics in some cases are needed to address these problems when shoes, creams and socks are inadequate.

Steve Manning Podiatrist BPod (Hons), Level 3 Coach

I have patients who come to see me before major races to make sure their feet are in the best shape possible to reduce the risk of blistering and black toe nails. If you suffer from frequent blisters you should not accept it as an unavoidable part of running - Book in to see me at intraining Clinic.
Steve Manning works from the iHealth Centre Indooroopilly as a Podiatrist specialising in running injuries of the lower limb. He is also available for footwear consultations on Thursday evenings at Athlete’s Foot Indooroopilly. Steve is the Coaching Director for the intraining Running and Triathlon Club. If you're looking for tips and advice on super shoes, injury or an individualised running program, Steve can help with that too!

RECUPERATION in the OFF SEASON

Posted on October 1, 2024October 2, 2024 by intraining

RECUPERATION in the OFF SEASON

By Steve Manning – Podiatrist BPod (Hons), Level 3 Coach

The Berlin Marathon was on the weekend and the Melbourne Marathon is in 2 weeks. For most runners, October marks the end of the main road Running season and the start of the off-season.

You may have been carrying some niggles or injuries through the season and think it is now a good opportunity to have a good break from running. However, I would like to caution you that rest may not be the best way to vanquish your injuries.

Some injuries require stopping running completely like stress fractures. However, the vast majority of running injuries are soft tissue injuries. These often require you to have some running to achieve complete rehab. You could have 2 months off and these niggles may become even harder to resolve.

If you have been carrying some injury problems through the season, then the first step to resolution is to accurately diagnose the injury and the factors that contributed to it. Symptomatic treatment and rest may cure the pain but if the causes of the injury are not addressed then the injury will return when you start running again.

Long-term injury prevention should be the goal of your off-season efforts. A few months of easy training and focusing on gaining strength will help you start the next season refreshed and ready for your best running season ever. The reduced training allows you to work on improving your running without risking more injury.

Here are 6 key ways to recuperate during the off-season.

TRAINING in the OFF-SEASON:

1. Reduce Quantity and Frequency. You can give your body time to recover from a hard season of running by reducing the distance of most sessions and reducing the number of sessions. Long runs should be half to two-thirds of the distance and you should run them at a slower pace.

TIP: Have an extra day off or replace a running session with another activity.

2. Reduce Intensity. You should reduce the amount of intensity but maintain some high-intensity training. Speed sessions need to have shorter and fewer repetitions with extra recovery. This makes it much easier to have some higher intensity with less stress. It is also a good idea to run your speed sessions how you feel without thinking much about maintaining a particular pace.

TIP: Run unusual length repetitions or run for a set time rather than distance.

3. Address Weaknesses. Constant running especially on a flat road can lead to chronic weakness. This weakness is one of the most important causes of injury. With the extra time you have, you can fit in some strength sessions at the gym or add home pilates workouts that focus on strengthening weak core muscles. Poor balance and coordination can be quickly improved with proprioception exercises for a few minutes every second day. Try to balance on one foot and go into a calf raise to test your balance. If you have trouble getting up on your toes and can not balance for more than a few seconds then you may benefit from doing balance exercises. Running biomechanics may be a factor especially if you ran with an injury and ran differently with a compensatory gait. The motor pattern in your brain needs to be retrained with a strong efficient gait. Weekly running drills before a speed session can help you get back in the groove of running strongly. You may have to focus on a particular set of drills if you are weak in a specific area.

TIP: Look out for our next running biomechanics workshop.

4. Run on the Trails. A good way to gain strength in the off-season is to add hill training and trail running to your weekly routine. There is no better resistance training for runners than running hills. Both uphill and downhill running increase the load by simulating running biomechanics like single-leg eccentric contractions. That is very hard to reproduce in the gym. Running the trails is a great way to add hill training with the added advantage of the uneven ground improving the stability muscles in your leg. While there is an increased risk of falling on the trails in the long run it will give you better strength and control to reduce your injury risk when heading back to the roads.

TIP: Replace your road long run with a fortnightly trail long run. 20km on the trail should take about as long as 30km on the road.

5. Change it Up. Recovery during the off-season is about mental as well as physical recuperation. Set some new goals with new experiences to maintain motivation. This could be to do a trail race or triathlon. Maybe you want to do a big multi-day hike somewhere.

TIP: Mixing your running with a holiday location fights the staleness that can come from running high mileage on known routes during the road season.

6. Get Help. This may all seem a bit overwhelming. However, you can get advice on injuries from a running specialist. Now might be a good time for a running check-up to find what key areas you need to address.

TIP: Come to see me at intraining Indooroopilly and we can create an off-season plan of strength training and recuperation.

Steve Manning Podiatrist BPod (Hons), Level 4 Coach

Steve Manning works from the iHealth Centre Indooroopilly as a Podiatrist specialising in running injuries of the lower limb. He is also available for footwear consultations on Thursday evenings at Athlete’s Foot Indooroopilly. Steve is the Coaching Director for the intraining Running and Triathlon Club. If you’re looking for tips and advice on off-season training or an individualised running program, Steve can help with that too!

> You can book your appointment online here <

Create a Race Plan

Posted on May 24, 2024May 24, 2024 by intraining

Create a Race Plan and finish feeling strong

Running a half marathon or marathon is an exhilarating challenge that tests both your physical and mental endurance. However, there are TWO common mistakes many runners make: starting too fast by being caught up in the excitement of the race and having an unrealistic time goal. Either of these missteps can jeopardise your chances of achieving your best possible time and spoil what should be an enjoyable race experience.

Here’s how you can create a strategic race plan to ensure you cross the finish line strong and proud.

The Danger of Going Out Too Fast

It’s race day, and the atmosphere is electric. The adrenaline is pumping, the crowd is cheering, and you feel like you’re flying. This euphoria often leads runners to start faster than their goal pace. While it feels great initially, this burst of speed can have detrimental effects later in the race. Just 10 seconds per kilometer too fast at the start can translate to being a full minute slower per kilometer by the end. This dramatic slowdown can prevent you from reaching your potential.

Be Strategic in Choosing Your Start Pace

Knowledge is power, especially when it comes to running. Understanding your current race fitness is crucial for choosing a start pace that will set you up for success. You can gauge your fitness by calculating your recent times for shorter races like 5Ks and 10Ks, or even a recent half marathon. These times provide a realistic benchmark for what you can achieve in your upcoming race.

For example, if you recently ran a 10K at an average pace of 4:30/km, this data can help you estimate a suitable pace for a longer race. Online race pace calculators can also be helpful tools, converting your recent race times into predicted finish times for longer distances. Using these tools and your race history, you can determine a start pace that aligns with your current fitness level.

Start Slow and Build Up

To avoid the common pitfall of starting too fast, begin the race at a pace slower than your goal. If your target is to run 5 minutes per kilometer, start at a more conservative pace of 5:15/km. This might feel counterintuitive, especially when you’re full of energy and surrounded by faster runners, but it’s a crucial part of a successful race strategy

Warming Up and Settling In

By starting slightly slower, you give your body the chance to warm up and settle into a rhythm. After the first 3 to 5 kilometers, your muscles will be primed, your breathing steady, and you’ll have found your groove. At this point, you can start to pick up the pace to slightly faster than your goal pace, aiming for around 4:55/km.

Achieving and Surpassing Your Goal Pace

As you approach the halfway mark of your race, you should be on track to meet your average goal time. By running faster than your target pace during this middle section, you create a buffer that can be incredibly useful in the latter stages of the race. Maintaining this faster pace can help you finish stronger, and if fatigue sets in during the final kilometers, you’ll have a time cushion to fall back on.

The Final Push

The last stretch of any race is where your training, strategy, and mental fortitude all come together. Thanks to the buffer you’ve built in the middle of the race, you can afford to slow down slightly without worrying about missing your target time. However, if you’re feeling good, keep pushing through to the finish line. The sense of accomplishment as you complete your race, knowing you executed your plan perfectly, will be immensely rewarding.

Summary: Your Path to a Successful Race

Start Slow: Begin the race 15 seconds per kilometer slower than your goal pace.

Warm Up and Settle In: Use the first 3 to 5 kilometers to let your body adjust.

Increase Pace: After warming up, run slightly faster than your goal pace.

Create a Buffer: Maintain this faster pace to build a time cushion for the final kilometers.

Finish Strong: Use your buffer to manage the last part of the race, ensuring you hit your goal time even if you slow down a bit.

By following this race plan, you’ll avoid the common mistake of starting too fast and instead, set yourself up for a strong, steady, and successful race. Remember, patience and strategy are just as important as physical preparation.

Happy running!

Steve and Margot Manning

intraining coaches and podiatrists

Black toenails

Posted on May 24, 2024May 24, 2024 by intraining

Black toenails

One of my favourite sayings to my runners is that you know you are a real runner when you lose a toenail. Black toenails, also known as a subungual haematoma, are one of the risk factors when running long distances. They are created when you get a blood blister underneath the toenail. This article will explain nail anatomy, and discuss the causes treatment and prevention of black toenails

Anatomy of a Nail

Nails are made from Keratin, the same material as the skin and hair. The nail plate is the hard part of the nail. It grows from a line of cells underneath the skin at the base of the nail (Eponychium). Underneath the nail plate is the nail bed. This is part of the nail that the blood blister forms. The nail plate is no longer adhered to the nail bed once the black toenail has formed. A pseudo nail may form under the black toenail. In some cases the old nail falls off but with partial black toenails the damaged nail will grow out. It takes about 6 months for a big toe nail to grow from the base so that is how long it might take for a black toenail to be replaced.

Causes of black toenails

For runners the main cause of black toenails is shoes that are too tight. This can be from short shoes or more commonly shoes with a toebox that is too shallow for your toes. However some runners have a dysfunction in the flexion of their big toe. They may preflex the toe to reduce the poor flexion. This can result in them causing more trauma to their toe and they will wear a hole in the top of the toebox of the shoe. Shoes that are too loose may also cause problems if your foot slips down to jam into the end of the shoe. You may also claw your toes to try and keep the shoe on and this can cause black tonails in your smaller toes. The risk of Black toenails increases the longer you go and the more downhill running you do.

Treating Black toenails

When you first get a black toenail it will often hurt. This is caused by the trauma to the nail bed and the extra pressure from the fluid. Severe pain can be relieved by draining the fluid in the nails. I recommend you avoid draining the fluid for 24 hours after the black toenail has formed as there is a small risk of getting an infection in your blood (Septicaemia) while there is still a pathway through the blister. You may prefer to come see me at the podiatry clinic to drain the fluid if it is causing problems. Once the fluid in the blister is drained or reabsorbed the toenail should no longer hurt. Having a partially attached toenail can cause further trauma to the toe so it may need to be removed where the nail is no longer attached. If you have multiple black toenails on the same toe then the nail can get thicker and thicker. This in turn increases the chance of damaging the nail again. With repeated trauma the nail may permantely grow out thicker.

Preventing black toenails

It is not a pleasant experience for your performance in your major goal race to be affected by black toenails or blisters rather than fitness or tactics. That is why it is important to do a few things to reduce the risk of getting black toenails

1. Buy shoes that Fit. Have some extra space at the end of your shoes if you are susceptible to black toenails. This should be in the length and the depth of the toebox. However it is equally important the the middle of the shoe fits firmly so you are not slipping around in the shoes.
2. Keep your toenails short. I cut my toenails short a few days before any long race. I sometimes also thin the end of the nails down with a file. Pressure on the nail moves it against the nail bed so short nails reduces the chance of a shearing force between the nailplate and nail bed.
3. Fix damaged nails. If you have a previous black toenail or damaged nails then it is a good idea to have them treated at the clinic before any major race. I have some patients that see me every few months to make sure their nails are in good shape for their long races.

Steve Manning

intraining Podiatrist and Running Coach

DIAGNOSIS OF AN INJURY

Posted on March 28, 2024March 28, 2024 by intraining

DIAGNOSIS OF AN INJURY

By Steve Manning – Podiatrist and intraining Coaching Director

Injury is the greatest risk to achieving your running goals. Around 60% of runners have injuries each year that require some time off running. If you do become injured then the goal should be to get back to running ASAP so as not to disrupt your training plan.

To reduce your time off running you need to follow the best injury protocol for your problem. The most important factor for injury resolution is an early accurate diagnosis. Because different injuries require different treatment pathways and can occur within a similar region it can be difficult to make an accurate diagnosis.

This is where advice from an experienced running health professional is critical. There are a variety of techniques that can be used to make a diagnosis:

1. Diagnose by History:

A good history can often be enough to make an accurate diagnosis. What is the nature of the injury? How would you describe the pain? Numbness and tingling and burning can be neural symptoms while sharp stabbing pains may be something ruptured. Are you limping when running or do you only notice the pain after stopping? How did the injury occur? Was it a traumatic event or did it have a gradual onset? When did the injury start and what were the contributing factors? Has it been getting better or worse? Is the pain easily localised or does it seem to move around? What treatment or interventions affects the symptoms? These are all important questions that will help us identify the cause of your injury.

2. Diagnose by Palpation

The next important technique is to find out where it hurts. This means we need to reproduce the pain. A complete understanding of the anatomy that exists under the skin is vital to knowing what structure is hurting and injured. While pushing on each tissue is the most important thing some tissues can only be stressed with special mobility tests. Sometimes athletes will need to hop or run to bring on the symptoms.

3. Diagnose from Imaging

Sometimes the clinical examination will be inadequate to differentiate an injury. This will require imaging to identify. X-rays are useful to identify fractures and some joint issues. They are less useful for soft tissue injuries. Ultrasounds are good to pick up superficial soft tissue injuries like ligament and tendon tears. They are able to keep imaging while moving a joint through its range of motion to see if the connective tissue is incompetent. MRI’s can create an image of a thin slice of anatomy. This helps significantly in narrowing down the location of a problem. An MRI shows up soft tissue problems and can identify subtle issues in bones like stress fractures and contusions.

4 . Treatment directed diagnosis

It is not always desirable to do imaging. In this case it might be better to follow the treatment protocol from the most likely clinical diagnosis. If the injury improves then the diagnosis was likely to be correct and if it fails then you can move on to the treatment protocol for the next likely injury.

5. Diagnose contributing factors not just injury

Making an accurate diagnosis is just the first factor in resolution of an injury. You must also accurately diagnose the cause of an injury. Sometimes it is obvious after having a fall and hurting something. With chronic injuries there can be multiple contributing factors such as a training error, footwear, running technique and structural/biomechanical issues. While it is important to heal an injury in the long term it is just important to make sure it does not occur again.

After a diagnosis is made we follow evidence-based medicine to create a treatment pathway for the resolution of an injury including short-term pain management, rehabilitation and then strengthening and conditioning for prevention.

If you have been struggling with a possible injury for more than 2 weeks or the injury is bad enough to stop you running then book in to see Steve at the intraining Running Centre, iHealth, Level 5 112 Coonan Street Indooroopilly. Call 3870 2525 or book online.

RUN LIKE IT IS RUMSPRINGA

Posted on February 28, 2024February 29, 2024 by intraining

RUN LIKE IT IS RUMSPRINGA

by Steve Manning – intraining Podiatrist & Lvl 4 AT&FCA Coach

“Rumspringa, (Pennsylvania Dutch: “running around”) a rite of passage and period of growth in adolescence for some Amish youths, during which time they face fewer restrictions on their behaviour and are not subject to the order”.

The “intraining method” is about becoming a master pacer. The objective of most of our sessions is about running a specific pace. This pace progresses through the year as you gain fitness. But always it is about learning perfect pace judgement.

Play Video

This includes running long runs 40 to 60 seconds slower than your goal race pace.

As we get into the season we finish off our long runs at marathon race pace for the last few kilometres. Speed sessions and Threshold sessions are designed to teach you to run at a controlled pace rather than to run as hard as you can. Our Rhythm kilometres session exemplifies this by having a different target pace for every repetition. For those on individual programs I even set different target times and strategies for the Saturday Tempo runs at Parkrun.

The goal of this pacing practice is to give you the skill to be able stick to your race pacing plan in your major goal race. Poor pacing strategies are the main reason people struggle in a race. I feel proud seeing so many intraining runners running strong at the end of major races.

However, sometimes this control makes it harder to make big leaps forward in performance when they are possible. Race times often plateau during heavy training. That is why the taper and peaking is so important. There are gains that are made from one year to the next just from the consistency of training. This can be when a race performance can surprise you.

The way to test this out is to run a race occasionally without checking your splits during it. Don’t wear a watch or cover the face with opaque tape. Even better go out too fast or surge the hills. While this strategy is not good for major goal races or longer races it can open up a realm of possibilities.

I schedule these freedom races for my athletes over 5km and 10km early in the season. They can be a lot of fun even if you are unable to maintain an even pace the whole race. Because they are shorter and in unimportant lead up races there is no anguish at a slow time.

Whatever the result, after doing these races you can then focus on what is most important and that is becoming a master racer. Sometimes it is with loftier targets in mind and other times it is with an improved appreciation of good pacing.

So why not try it out at a Saturday Parkrun over the next month? Try out a new Parkrun location so you don’t know the course or other runners. Disconnect the brakes and have a bit of fun.

BEFORE YOU GO…

Read Mike Dickson’s story HERE Mike has been a long time member of our running community. This was his story after his first year of running with us. Even if you have read this before, it’s inspirational and a great refresher for how you can apply pacing to your own running.

Come to our running groups.

We have started the preparation phase of our training program. This is a perfect time to come along and try out an intraining training session. It is 15 weeks to the Brisbane Marathon and 20 weeks to Gold Coast so plenty of time to gain fitness. You can try out the first session for free before setting up a training wallet.

6 Ways to improve running economy

Posted on February 23, 2024February 23, 2024 by intraining

6 ways to improve running economy

by Steve Manning – intraining Podiatrist & Lvl 4 AT&FCA Coach

1. Plyometrics and Running Drills

The most recognised way to improve running economy is through regular running drills. They seem to have a greater effect on Novice runners but have been shown to be one of the most effective ways to improve performance fast. Plyometrics is a muscle contraction right after you stretch a muscle under load. This includes skipping, hopping and bounding. This will strengthen the tendons and make them stiffer so that they can store more energy for return when rebounding during propulsion.

2. Improve strength

Stronger muscles will be less strained when working at sub-maximal loads like distance running. However, there may be an increased risk of injury when doing the strength training. Maximum resistance training and steep hills are the best ways to improve strength. Strength must be specific to the performance goals. Being able to do high weights when squatting or doing deadlifts will not transfer well to distance running. Pilates and core stability exercises can improve strength in the stabilising muscles which may have a better injury risk reduction than maximum strength exercises.

3. Run More

As you get more miles in your legs they will move towards better running economy. Better endurance results in less fatigue at the ends of races and you can maintain efficiency. However, excessive training may impact your ideal recruitment and coordination leading to de-training and a reduced running economy.

4. Run faster

The faster you run the better your running economy will generally become. Doing some of your training at faster speeds will eventually spur adaptation to this better technique and running economy. You should not do anymore than 20% of your training at these faster speeds and it is better to do it during repetitions rather than long time trials.

5. Weight management

Distance running requires a high power-to-weight ratio. Each kilogram of body weight is worth about 3 seconds a kilometre in pace. V02Max is calculated as the volume of oxygen absorbed per kilogram of body weight. If you are carrying extra weight then losing some weight will have an immediate impact on your performance. However, this is a big trap for many runners. You can not gain the benefits from training if your nutrition is inadequate. Relative Energy Deficiency (RED-S)will lead to systemic breakdown and eventually to reduced performances. It may also compromise your health well beyond the benefits gained from running.

Note: Find a Dietitian. IF you are planning to change your diet, or struggling to know what to do. Find a dietitian who understands running.

6. Race smart

Perhaps the least appreciated factor in running economy is smart racing. Poor pacing at the start of a long race can increase your metabolism and oxygen demands even after you have settled back to your goal race. I always tell my athletes that 10 seconds per kilometre in the first few kilometres in a marathon will result in 1 minute per kilometre slower in the final 10km. Having a realistic race goal and pace plan and sticking to it will result in better running economy. Another overlooked factor in racing smart is running the shortest possible route. This is the way courses are measured. Losing focus and wandering across the road will mean you are running farther than the race distance.

Margot and Steve are conducting a running form workshop on Saturday 2nd March.

Come along to learn how to improve your running economy.

WHAT IS RUNNING ECONOMY?

Posted on February 16, 2024February 22, 2024 by intraining

The big question many runners want answered is how can I race faster and easier with less injury risk.

Most runners think it is just about training more and training faster. However, the missing ingredient in many runners’ programs is a focus on improving running economy. There are many techniques like running drills that will help you run faster by becoming a more efficient runner.

Consistency of running training is the most significant factor in improving your running performance. How you structure your training with the progression of quantity, intensity, frequency and recovery are the main variables in maintaining consistency and avoiding injury.

Many runners are seeking the magic bullet that will boost performance like a new shoe, nutrition product or training theory. While all of these things can be significant, in the end, consistent training is the best way to improve in the long term.

For you to improve, training must be at a level greater than you are accustomed to (the principle of training overload). It should be simulating the demands of your goal race but at a lower stress level (the principle of specificity). You must also have adequate rest after hard efforts to adapt (the principle of recovery).

One of the best ways to run faster and easier is to focus on improving your running economy.

WHAT IS RUNNING ECONOMY?

With better running economy you will consume less oxygen (V02) at a given running pace. Running economy is determined by many variables both genetic and trainable.

Elite runners have a high V02Max (the maximum rate of oxygen they can utilise), high fractional utilisation (the ability to sustain a high percentage of VO₂max for an extended period) and running economy (lower VO₂ at a submaximal running velocity).

Your physical structure, running style and even the function of your cells impact your running economy. The running economy can change for different runners at different speeds. It will improve naturally as you gain experience through your running journey.

Here are a few goals to improve economy:

1. OPTIMISE INDIVIDUAL BIOMECHANICS:

There is no one best way of running, but rather each runner has an ideal running technique that suits their individual physical attributes and goals. This includes things like footstrike, arm carriage, forward lean and being calf or glute dominant in propulsion.

Your function (the way you move) must follow your structure. If you try and change your running technique without understanding your ideal technique you will increase your injury risk and reduce your performance.

Here are some general goals of running biomechanics:

- Reduce wasted motion. When running with high running economy all movement should be directed towards running in one direction. If your arms are excessively crossing your body and you are swinging your feet in a sideways motion then you may be putting energy into making these movements rather than running faster. Running on a treadmill in front of a mirror can give you direct feedback on these inefficiencies. One thing you must consider is that some running form asymmetries are compensation for structural asymmetry. If you correct them you may remove the compensation causing a new injury
- Reduce vertical oscillation and lateral sway. Many sports watches now can track vertical oscillation. Your centre of mass should follow a fairly straight line in the direction of motion. You maintain this by bending your knees when your foot is on the ground and by dropping your hip as your leg swings through. A high vertical oscillation or lateral sway uses extra energy to shift the centre of mass back towards your direction of motion.
- Reduce impact forces at strike. If you make a lot of noise at footstrike (pounding) or when your forefoot contacts the ground (slapping) then you are putting energy into making that noise. Quieter running is generally more efficient but less powerful. It may also be causing an excessive breaking force that will slow your forward momentum.
- Understand vector forces. The force you can generate against the ground in propulsion needs to be in the opposite direction of gravity and your direction of motion. If you create an oblique force in propulsion then it will reduce the force that moves you in the direction you want to run.
- Improve Coordination and recruitment. You might think running is simply putting one foot in front of the other. However, efficient running requires excellent coordination balance and control. The timing of each movement needs to be in sync with the previous motion and the next motion. Otherwise you are losing the summation of forces through the gait cycle. There are agonist and antagonist muscles with each joint movement. The agonist muscles move the joint and the opposing antagonist muscles help to direct and control the joint movement. If the recruitment of the power of each muscle is not ideal then you will create too much internal resistance leading to a significant drop in efficiency.

2. INCREASE STIFFNESS

The mass-spring model of running efficiency is a mathematical calculation that shows that running efficiency increases as stiffness increases. Increased stiffness increases power and reduces ground contact time. Less energy will be lost with increased stiffness. Excessive stiffness may increase performance at the cost of increasing injury risk. Stiffness is increased by strengthening connective tissue like tendons and facia. It may also be increased by the running surface, footwear and orthotics.

3. OPTIMISE CADENCE/STRIDE LENGTH RATIO

Running speed is a function of your stride length and cadence (steps per minute). At each speed, there is an ideal ratio of cadence and stride length individual to each runner. When runners get tired at the end of long races they tend to prioritise stride length over cadence. However as you are fatigued and slow you are better off reducing stride length and maintaining efficiency to maintain your best potential running economy.

4. CAPILLARY and MITOCHONDRIA DEVELOPMENT

Training does not just result in bigger, stronger muscles. There are changes in the mitrochondria in each cell that increase the output of energy produced. Long distance running also increases the oxygen transport system by developing better and more extensive capillary networks. Together these changes may be more significant to running economy than any other intervention. The result is more oxygen and energy faster, when and where you need it. It may also benefit thermoregulation because increased core temperature is one of the key limiting factors in endurance performance.

RUNNING FORM WORKSHOP

Saturday 2nd March, 2024

Come along to learn how to improve your running economy, gain strength as a runner, and learn how to improve your running form.

Review Your Running Year

Posted on December 14, 2023February 29, 2024 by intraining

with Steve Manning – intraining Coaching Director

The number one goal you want from your running is to enjoy it. You can achieve this with 3 simple steps:

1. 1. 1. 1. Review your past year
        Set new Goals
        Create a routine

This section is to take you through each of those steps so you can continue to love your running.

Here is your first Step: Review your Running Year

Happy Running

Steve Manning

Review your Running year

With the year coming to a close it is a good time to review your running year. This is a good thing to do before setting goals for 2024.

You can start by looking at the goals you set at the beginning of 2023. Your goals may have been specific times or races however it is unusual for you to meet all your goals in a year. Which ones did you achieve and which goals alluded you?

In hindsight you should evaluate whether your goals were too easy or too hard. This can be reflected in how many you were able to achieve. This can then help you set realistic but challenging goals for next year.

Difficulty completing goals is not always within your control. Illness and injury can prevent you running. Poor weather may significantly affect realistic race times. Sometimes it is non running issues like family or work that impact your running performance.

What is important is for you to set goals that are small improvements on your current fitness. They need to be written down and reviewed as you go through the season.

When you are reviewing the previous season of running you need to consider all of the variables that impacted your performance. If some performances were not up to the standard you set then why? It is not making excuses to be realistic about your racing. This review can help you set realistic goals for the future.

Another important consideration is how successful you were at peaking for your major races. Do you run your best performances when you want to at your major goal races? Or did you run better in the lead-up races and could not reach the same standard when peaking? This may only require some tweaking to your training program, however, it is often caused by running too hard before the competition phase of training.

1. Personal Best Times and Season Best Times:

Start your review by writing down your PBs as they stood at the beginning of the year. Follow them with your best times this year

2. Major Goal race results:

Then write down your major goal races, with the satisfactory, challenging and ultimate goals you set pre-race. Then add your actual performances.

3. Top 5 performances for the year:

The next thing that you need to do is write down and rank your top 5 performances for the year. This does not just mean your fastest times as different courses may affect the times. Which races do you feel you ran closest to your maximum potential?

4. Training Review:

You should also review your training over the year. How consistent was your training? Did you have injuries or niggles to manage? Did you take your training frequency or total mileage to a new level? Did you have the best speed session or the longest run ever? How did you cope with the training load? Were you constantly tired or thriving on the training?

5. Evaluate your review:

Finally, look over the list you have created and consider where you could have possibly run better. Make notes after each list of what you think you could have done if everything went perfectly on the day.

Once you have done this review you will be ready to start your GOAL SETTING for this coming year.

If you haven’t already done so, click on the link to download your Goal Setting Checklist.

If you don’t want to think about this too much yourself, or want help with doing your review or creating your goals for next year, you can book into the intraining clinic to see me. I love creating plans for runners with target paces that also develop a progression of improvement and running strength.

Call 3870 2525 or Book here!

P.S. Don’t forget to download our Goal Setting Checklist.

Steve Manning "The Footman"

Steve has been a running shoe aficionado for the last 4 decades and as the owner of intraining Running Centre has helped thousands of runners find the perfect shoe. He is a member of the Footman Biomechanics Group of the International Society of Biomechanics and a previous President of the Qld branch of Sports Medicine Australia. As a Podiatrist specialising in running sports injury prevention he utilises footwear prescription and modification to keep you running. Contact Steve at the intraining Running Centre, [email protected] for all your footwear questions.

5 Ways orthotics help you run better!

Posted on December 6, 2023December 14, 2023 by intraining

Can you relate to any of the problems or questions below?

5 Ways orthotics help you run better!

by Steve Manning – intraining Podiatrist & Lvl 4 AT&FCA Coach

Many runners have benefitted from using orthotics. But what is an orthotic and will they help you run better? Orthotics are customised inserts for your shoes that help support your feet to improve function and reduce pain and injury. They are made to the shape of your foot with extra additions prescribed to treat specific problems.

Here are my top 5 reasons to consider orthotics:

You’ll know if you identify with one of these factors. If you have had troubles over the last year while exercising then consider the possibility of adding a customised orthotic into your shoes. You’ll be surprised at how much better your feet will feel.

1. Comfort for the difficult shaped foot: Customise the shoes to your foot.

Skinny feet, narrow feet, odd shaped feet, and one foot different than the other… These are issues that can not be fixed with just the right shoe.

Orthotics are more than just an arch support. They are able to balance out the specific structural needs of your feet. There are almost as many different prescriptions possibilities as there are feet. Orthotics for example can cater for asymmetry between your feet by offering a different prescription for each foot.

2. Pain remover: Stop localised pain by distributing Force more evenly

Do you get pain in the same location all the time? (e.g. under the ball of your foot, at the heel, under your little toe)

Orthotics work by redistributing force under your foot. Excess force in a localised area can lead to injury. By increasing the weight bearing surface area under your foot, you can reduce the peak force that could be causing injury. Orthotics can be made to off-load inflamed tissue temporarily while recovering from injury. They can also shift force away from chronic stress areas that might be causing callous or corns to form. In some cases orthotics will improve running economy by maintaining optimum muscle function. Their main goal is to reduce pathological force by maintaining good foot posture and function.

3. Blisters, callouses and corns: Improve your foot posture and reduce shearing friction forces

Thickened callous and blistering along your big toe or under the ball of your can be very painful and stop you running. But it is not a pain you have to suffer through. All skin conditions from running have definitive causes. Finding that cause, and making changes improves your foot health, comfort and stops unnecessary pain.

When orthotics support foot posture they also reduce the friction and shearing forces that can lead to blisters and skin trauma. The foot will sit better in the shoe and there will be fewer compensatory movements like twisting and rolling that create friction.

4. Strengthen your feet: Improve the mechanical advantage of your foot muscles

The muscles in your lower leg are attached to your foot and control your foots movement while walking and running. There are little muscles under your foot that help support your arch and the functioning of your toes. Poor foot posture can overload these muscles stressing them beyond their capabilities. They then will fail causing temporary injury or even a permanent change in structure. Orthotics help these muscles function within their limits and they can get stronger over time if the foot is supported. Note: There are views that orthotics can weaken your feet. Read more about that below.

5. Reduce injury interruptions: Increase training threshold before injury

Constant interruptions in your training from injury is incredibly frustrating. If it’s not from a training error or your shoes, then it’s likely to be a biomechanical problem. Orthotics can help you here by addressing your specific biomechanical and structural deficiencies. For example, if your big toe joint is stiff, enlarged or does not move adequately, your risk of injury increases as you increase your training.

By creating an orthotic to address this, not only should this lead you to improved performances, the main advantage is reducing your injury risk. That means you can train more before risking injury… added bonus!

BONUS- The perfect foot

Some people are fortunate to have the ‘perfect’ foot. Even if your foot seems perfect, you may run better with orthotics. Orthotics can reduce your foot pain and leg fatigue when running for long distances. They will make your feet more comfortable by maintaining good foot posture and increasing feedback from the ground. For some runners, orthotics can improve performance by improving foot function.

5 common questions I am asked about orthotics

1. Will orthotics weaken my feet and will I need to wear them forever?

Many people are worried that they can become dependent on orthotics. Extended use of braces and strapping may lead to atrophied muscles however orthotics do not work the same way. Rather than just blocking foot action orthotics support the foot towards a more functional dynamic pathway. Over time this should lead to a stronger foot.

How long you will need orthotics depends on the specific injury and structure of your foot. Many injuries need a short term change in support while healing. Some chronic problems may need extended use to reduce recurrence. Other people will need to always have orthotics to deal with significant structural issues.

2. How do orthotics work?

Orthotic theory has changed significantly over the years. In the past orthotics would try to block the normal movement of the foot like pronation. Now orthotics are designed to guide foot action. They increase feedback from the ground allowing improved muscle control. This can shift forces up the kinetic chain improving the posture of your whole body.

3. What happens if they create a new problem?

Orthotics change pressure patterns and muscle function. Sometimes this can create a new stress to which your body is not accustomed. Adaptation should occur over a short time but sometimes the problem persists. The full length EVA orthotics and formthotics we use are easily modified in case of blistering or pain. While this is rare it can be required for feet that change shape significantly through the gait cycle.

4. Can the orthotics work in any shoe? Do I need to get a bigger shoe size?

You should get the ideal shoe first and we will create an orthotic to complement that shoe and your foot. The orthotic should then be able to be used in other shoes as long as it fits and is supported by the new shoe. Most times a larger shoe size is not required as the orthotic replaces the shoe insole. Sometimes a shoe with greater depth or width will be needed to accomodate for orthotic prescriptions in the forefoot.

5. Should everyone have orthotics?

Orthotics customise your foot to your shoes. Most people will feel better when using orthotics however that does not mean everyone needs one. Some runners will only need orthotics in their running shoes while others will need to wear them all the time. Most people start to use orthotics when dealing with an injury. If you have a recurring problem then orthotics can be very effective in breaking that injury cycle. However orthotics are not a magic bullet that will fix everything. Effective treatment protocols should include treating acute symptoms, strengthening exercises, avoiding training errors, upgrading shoes and orthotics when needed.

Assess your last year of running.

Think about what interruptions, if any, you had in the last year. Look at the state of your feet and try to recall if your feet were frequently in pain.

Consider if this could be avoided in the future by customising your shoes with a pair of orthotics.

At the intraining Running Centre, we create Orthotics for running, walking or any sport. They are designed to fit your shoes, be comfortable and improve your foot function. Where appropriate, we use orthotics when other treatments are not adequate

Private health cover for orthotics
If you have private health insurance with podiatry coverage, you might be eligible for new orthotics each year.
Many health funds use a calendar year schedule, so it is worth checking your cover.
Don’t waste your cover!
Book in to see us before the end of the year for your new orthotics.

Book here for a podiatry check up today!
or phone the intraining podiatry clinic on 3870 2525

intraining Running Centre Clinic has moved at iHealth Centre

Steve Manning “The Footman”

BLISTERS

Posted on September 21, 2023September 21, 2023 by intraining

By Steve Manning “The Footman” – intraining Podiatrist and Coach

There is nothing worse than blisters causing you to pull out of a race. When your training, pacing and nutrition is all going well it can be ruined by a skin issue. Luckily, there are some easy ways to make sure that blisters do not undermine a great performance.

WHAT IS A BLISTER?

Blisters are formed when an external force causes stress between the outer layer of skin and the deeper layers. What starts as red inflamed skin can progress to a blister. At this point fluid forms between different layers of skin. The five outer layers of skin have no blood supply. If the blister forms in these layers it is a clear blister. If it is between these layers and the deeper dermis layer then you will get a blood blister.

WHAT CAUSES A BLISTER?

There are two ways that blisters can form – a shearing force or a pressure force. A shearing blister causes friction and a build up of heat similar to a burn. They are formed by the foot moving inside the shoe. A pressure blister can be caused by a poor fit between your foot and the shoe or an orthotic. In this situation all of the force is localised to a single location.

WHERE DO BLISTERS OCCUR?

Blisters can form anywhere there is excessive friction or pressure. Here are three common places for blistering.

Toes: Blisters usually occur on your toes when the shoe is:
– too short, hitting against the end of the shoe
– too shallow at the end of the shoe putting pressure on the toes
– too large and your toes try and grip the ground to hold the shoe on your foot
– the wrong shape for your foot.
Not enough space in the shoe can cause blisters between your toes as they rub against each other.
TIP: Try and match the shape of the end of your toes with the shape at the end of your shoes.

Arch: Blisters in the arch are more commonly formed by pressure rather than friction. The arches in some runners flatten more as they move from their foot flat on the ground to propulsion. If the arch in the shoe is too prominent for the foot then a blister will form usually at the front of the arch or the high point of the arch. Flat feet and flexible feet are more prone to these arch blisters.
TIP: An easy modification to your shoe can take the pressure off the arch. This is our most common footwear modification. Visit one of the intraining Running Injury Clinic podiatrists for help.

Heel: Heel blisters can occur if your shoe is poorly matched to the shape of the back of your heel. This can cause slipping of the heel or pressure on one part of your heel. If your shoe is too short then it can also increase the pressure on the back of your heel leading to a blister. Some runners have a lump on the back of their heel that is susceptible to blistering.
TIP: Tie your shoes and then stand up. See if you can stick a finger down around your heel. It should be a firm fit. You may be able to lace your shoes differently to reduce movement.

WHY DO BLISTERS HURT?

Blisters hurt initially because of the inflammation like a burn. After 24 hours the pain is mainly from the fluid pressure inside the blister. Draining the fluid at this stage will stop the blister hurting. You must be very careful with blood blisters that you do not let dirt get in the wound as it can cause a blood borne infection. As the skin drys it can go hard and cut into the deeper tissues.

HOW DO I TREAT OR PREVENT BLISTERS?

My 4 top tips to prevent or treat blisters are:

Tip #1: Gradually increase your training
The best prevention for blisters is a gradual increase in training. When you first start back into running or even when you start using different shoes, your skin can be ‘soft’. With time, your feet will adapt and your skin becomes stronger.

Tip #2: File your callouses
Removing excess callous regularly will also reduce the risk of blisters as they often form between the callous and the deeper layers of skin. (shearing forces)

Tip #3: Check your shoe size and shape
Toe and arch blisters are regularly from the wrong shape, depth or size shoe. Allow space for the toes, and check that arch pressure.

Tip #4 Quality of your socks
Don’t underestimate the importance of the quality of your socks. Wicking fibres will not get abrasive and will maintain their shape and integrity. Anti-chafe wax’s and lotions are very effective for longer sessions and races.

WHAT IS A BLACK TOENAIL?

Black toenails are blood blisters under your nail. They are often formed by pressure downwards on the end of the nail rather than just a short shoe. The result is a blister under the nail and the nail is then destined to fall off. You must be careful draining black toenails and it may be better to have it treated by a podiatrist if it covers more than half your nail. You should maintain short toe nails and cut them short a few days before any long race.

You don’t want blisters

Blisters can be small, but mighty painful causing interruptions to your training or a limp in your important runs. They usually can be an easy fix, but if you have tried everything to stop them, come see our intraining podiatry team. We know how to check if the way you run and your foot shape matches your shoes, and how to make the changes to stop blisters from happening.

If you are having trouble with blisters, black toenails or calluses, book an appointment with our podiatry and team at intraining. Call iHealth on 3870 2525.

Steve Manning "The Footman"

How to manage hamstring muscle injuries

Posted on September 14, 2023September 21, 2023 by intraining

Dodgy hammy? How to manage hamstring muscle injuries

By Doug James – Physiotherapist and Podiatrist at intraining running injury clinic.

Are you dealing with a niggling hamstring injury that just won’t go away? Have you tried stretching it only to find it feels worse the next time you exercise?

Hamstring muscle injuries are well studied in elite footballers. This is partly due to the high prevalence of these injuries in football (soccer) players[4,10], but also because of the large financial cost associated with keeping players healthy (soccer superstar Lionel Messi will get paid over $92,000 per day for the next few years[1]). While this research helps to progress management and treatment of injuries in non-elite athletes, it’s worth noting that there is a key difference in the type of injuries that footballers and distance runners typically develop.

Location matters

Hamstrings consist of 4 muscles found on the back of each of your thighs. The main functions are to assist the gluteus maxiumus to extend the hip (move the thigh backwards) and (along with the calf) flex the knee. Research shows that hamstring muscle injuries typically occur in one of two locations [3,4,5,7]. In runners, hamstring muscle tears tend to occur in the distal (towards the knee) and mid portion of the lateral (outside) muscle, whereas footballers tend to develop the injury on the inner part of the upper hamstring. The difference in injury location is largely due to the different types of movement involved with each sport. Football injuries tend to occur during kicking where the muscle is forcibly overstretched [10]. By comparison, running injuries tend to occur during higher intensity running efforts where the muscle attempts to maintain length during the swing phase of gait [6]. Injuries can occur closer to the buttocks, though often this is a tendon injury – this article will focus on muscle injuries alone.

Some good news

The good news for runners is that the median recovery time for lateral hamstring injuries (dependant on relative severity) is about half that of medial/proximal hamstring muscle injuries [4].

…and some bad news

While runners (with a lateral hamstring injury) can look forward to a speedier return to sport, this injury type tends to have a greater risk of reinjury [7] with up to one-third of athletes reinjuring the hamstring within a month of returning to sport[9]. This high reoccurrence rate needs to be factored in when planning the first 4-6 weeks of training after returning from injury.

Risk factors

Given that fast paced running is a high-risk activity for hamstring muscle injuries, the logical solution would be to avoid it – though this would be a shame as high intensity running carries a number of benefits for running performance.

Muscle strength imbalance (where the quadriceps (thigh) muscles are far stronger than the hamstrings) also poses a risk. Aside from these, one of the biggest non-modifiable risk factors to getting a hamstring muscle injury is having had a previous hamstring injury [2,4,5,6].

Changes to the neuromuscular system (muscles and the nerves that supply them) are common after injury and negatively affect how the muscle functions [6,7]. Age is the next highest risk factor [2,4,5,6,8] with the risk increasing for every year past 23 [8] – this may be a confounding finding, as the older you are, the more likely you are to have had a hamstring injury at some point, though there are possible biological reasons as well. As we age, we tend to have a reduction in the flexibility and quality of cartilage in our tendons which may predispose us to a greater risk of injury.

Poor quality sleep and insufficient sleep, along with stress can lead to increased risk of injury. It’s suggested that less than 7 hours sleep can lead to a 30% increase in injury.

What about super shoes?

Super shoes (carbon fibre plated, thick soled racing shoes) may contribute to the development of injuries in this region. As this style of shoes is relatively new, little long-term research exists investigating its effect on injury. The stiff sole of super shoes means the big toe and ankle joint movements are altered which possibly puts stress on parts of the body in particular the pelvis, glutes and hamstrings. This finding is difficult to conclude given that people wearing this type of shoe are often running at a higher intensity which is a known risk for hamstring injuries.

Watch for warning signs

Athletes that develop hamstring muscle injuries often report a feeling of ‘tightness’ or ‘tenderness’ in the hamstring shortly before the injury strikes [5]. While hamstring tightness is a relatively common complaint (nearly everyone I treat complains they have tight hamstrings), noticing tightness on one side only is a particular concern. Having stiffness in your lower back or hips, or feeling stress and tried should also be treated with caution. In these cases, it would be wise not to undertake high intensity running such as speed work, hill running or races until these symptoms have been addressed.

Prevention helps (somewhat)

A large number of football-focussed studies show that hamstring strength training in the offseason can help reduce the burden and occurrence of hamstring muscle injuries during the competition period, though not completely. While this concept can translate to runners, a different series of exercises are required. Running technique can also play a role in the development of hamstring muscle injuries. Overstriding (landing on your foot too far in front of your body) is a fairly easily modified risk factor, though more difficult to control at higher speeds.

What to do if injury strikes?

A hamstring muscle injury can feel like anything from a sensation of tightness (Grade 1/mild injury) to a strong sharp debilitating pain (Grade 2-3/more severe injuries). In the less severe cases it’s often tempting to stretch your hamstring and return to running, however in cases where a muscle tear exists, these actions can greatly increase the amount of damage and likely recovery time – from what may have been a few days rest, to possibly several months off (and maybe even surgery).

As per most injuries, rest and ice packs can greatly aid your recovery in the early days. Avoiding stretching is imperative to preventing further damage and early treatment usually results in faster recovery. Seeing a physiotherapist or sports podiatrist will help you to diagnose the type of hamstring injury (location and possible severity) based on the history and clinical examination. Scans, particularly MRI, can be helpful but are usually not necessary and are unable to accurately determine amount of recovery time needed [12].

The road to recovery

Hamstring muscle injuries require a considered approach for proper rehabilitation. World renowned Sports Physician Peter Brukner proposes a seven-part management plan [8] addressing the following areas:

- Biomechanical assessment and correction
- Managing neurodynamics (nerve tension particularly in the sciatic nerve)
- Core stability
- Increasing hamstring muscle strength

- Incrementally increasing running speedwork
- Injection therapy
- Stretching/yoga/relaxation

As mentioned previously, there is a high risk of reoccurrence with hamstring injuries, and so particular caution should be taken in the first 4-6 weeks of returning to sport and running. While the injury may feel 100% better there are adaptions to the nervous system that take time to overcome [11]. It’s been found that it can take up to 2 months for an athlete to return to return to their pre-injury maximum running speed (assuming minimal fitness was lost during the recovery period)[7] and so patience is needed while overcoming this injury.

If you’ve developed a hamstring muscle injury, or are keen to learn how to avoid it, contact the intraining running injury clinic for an appointment. Now based at I-Health Indooroopilly.

Hamstring muscle injuries – references:

[1] Source: Website: http://money.com/money/5313998/lionel-messi-net-worth/ [cited 26.8.19]

[2] Arnason A, Sigurdsson SB, Gudmundsson A, et al. Risk factors for injuries in football. Am J Sports Med 2004;32(1 Suppl):5S–16S.

[3] Askling C. Types of hamstring injuries in sports. Br J Sports Med 2011 02;45(2).

[4] Askling CM, Tengvar M, Thorstensson A Acute hamstring injuries in Swedish elite football: a prospective randomised controlled clinical trial comparing two rehabilitation protocols British Journal of Sports Medicine 2013;47:953-959.

[5] Askling CM, Tengvar M, Tarassova O, Thorstensson A. Acute hamstring injuries in Swedish elite sprinters and jumpers: a prospective randomised controlled clinical trial comparing two rehabilitation protocols. Br J Sports Med 2014 04;48(7):532.

[6] Bourne M, Opar D, Shield A. Hamstring muscle activation during high-speed overground running: Impact of previous strain injury. Br J Sports Med 2014 04;48(7):571.

[7] Brukner P. Hamstring injuries: prevention and treatment—an update British Journal of Sports Medicine 2015;49:1241-1244.

[8] Brukner P, Nealon A, Morgan C, et al Recurrent hamstring muscle injury: applying the limited evidence in the professional football setting with a seven-point programme British Journal of Sports Medicine 2014;48:929-938.

[9] Petersen J, Hölmich P Evidence based prevention of hamstring injuries in sport British Journal of Sports Medicine 2005;39:319-323.

[10] Schuermans J, Van Tiggelen D, Danneels L, et al Biceps femoris and semitendinosus—teammates or competitors? New insights into hamstring injury mechanisms in male football players: a muscle functional MRI study British Journal of Sports Medicine 2014;48:1599-1606.

[11] Tam N, Santos-Concejero J, Coetzee D, Noakes T, Tucker R. Muscle co-activation and its influence on running performance and risk of injury in elite Kenyan runners. Journal of Sports Sciences 2016; (March), 1–7.

[12] Wangensteen A, Almusa E, Boukarroum S, Farooq A, Hamilton B, Whiteley R, et al. MRI does not add value over and above patient history and clinical examination in predicting time to return to sport after acute hamstring injuries: a prospective cohort of 180 male athletes. Br J Sports Med 2015 12;49(24):1579.

Doug James – Physiotherapist and Podiatrist

Doug James is a qualified physiotherapist and podiatrist with a special interest in running and sports injuries. He combines the two treatment approaches to achieve successful outcomes for clients of all abilities from non-athletes to elite athletes. Bachelor of Podiatry (honours), Master of Physiotherapy Studies. Doug has undertaken further training in dry needling, Pilates, and Rocktape and may incorporate these as necessary during treatment. Doug is also a keen runner having completed the New York Marathon.

Understanding muscle tears

Posted on June 28, 2023June 28, 2023 by intraining

Muscle tear assessment and management for runners.

By Doug James Physiotherapist and Podiatrist

Pain is not an uncommon occurrence with running.

For newer runners (or those returning to running after time off) pain might be felt on most runs due to fatigued muscles or being short of breath.

For more experienced runners, pain usually becomes a less common occurrence and may only be felt during faster paced interval sessions, hill repeats, or long runs. Your muscles will work harder and produce an amount of discomfort during the session and possibly for a few days following – a sensation know as Delayed Onset Muscle Soreness – or DOMS. While pain can be expected in these situations (and in some ways helpful), differentiating between ‘good pain’ and ‘bad pain’ can help to keep you running.

Running fitness and conditioning is developed by running for at least twenty minutes a few times per week. Gradually this stimulus encourages improvements to your lung function making breathing feel less laboured when exercising. You will improve your muscle strength and endurance -which usually means less muscle fatigue and discomfort while running – and faster recovery afterwards. Consistent training over the course of a few months should have you feeling fitter, and running with less pain.

Unfortunately, some pain is almost inevitable.

In a 12-month period, runners have around a 70% chance of developing an injury that will prevent them running for a week or longer. Of these injuries, muscle tears are one of the more common. They can develop while running, particularly at higher intensity (faster speeds and/or steep terrain) or as we fatigue. The severity of a muscle tear is graded based on history, symptoms and/or imaging findings (such as Ultrasound or MRI) and this can help to predict the recommended treatment and amount of recovery time. There are a number of different grading systems, but the most commonly used involves a 3-point grading system.

A three point grading system for muscle tears

Grade 1

A grade 1 muscle tear (or strain) is the least severe grading. A muscle injury with this categorisation involves damage to less than 10% of the muscle, and may not be easily detected with imaging. Grade 1 injuries are often imperceptible when they occur, but may become noticeable fairly shortly after the running session has ended. They tend to be felt as a mild to medium pain when stretching the muscle or putting it under strain (e.g. calf muscle tears are often sorer when walking up stairs). There tends not to be much strength loss, and some stiffness may or may not be apparent after rest.

Grade 2

Grade 2 muscle tears are more serious, and involve between 10-50% of the muscle cross section. They are quite obvious when they occur and are acutely painful with a noticeable loss of power. Further pain and damage occurs if the athlete tries to continue running with this injury. It is possible that Grade 2 injuries start as a grade one injury that aren’t identified at the time of the injury or are poorly rehabilitated. Muscles with grade 2 injuries will have a marked reduction in flexibility and will likely feel quite stiff after rest. This is from a protective mechanism whereby the brain orders the muscle to tense or spasm to prevent movement. Trying to stretch the muscle while the protective mechanism is engaged will often result in a stronger sensation of tightness and likely more damage to the muscle.

Grade 3

Grade 3 muscle tears are far less common in long distance running, rather seen more often in sprinting and contact sports. These injuries involve damage to at least half of the cross-sectional area of the muscle and may also involve the tendon. Unless the muscle is already significantly damaged, it is unusual that a distance runner muscle will generate enough force to create this degree of damage. A muscle with a grade three tear will have significant strength deficits to the point it may not be able to generate any movement.

Muscle tear injuries require time off running.

It may be 1-2 weeks off for a grade one injury, with a progressive return to running as tolerated. Grade 2 injuries have a more variable range of recovery times, but this can be anywhere from 2 weeks to 2 months. Grade 3 injuries can take longer still, and in some cases may require surgery to enable the muscle to repair at all. Rest is an important element for the first few days of the more sever injuries, however strengthening should also be prescribed early in the rehabilitation process, with an assessment of the runner’s form and training schedule included prior to the return to running.

Understanding your pain

It should be noted that not all pain is due to muscle tears, nor is pain always the enemy. Some pain is inevitable and can help to encourage adaptions to running training. High intensity running training (such as intervals or hills) can be painful, but this pain will decrease shortly after reducing intensity. These sessions are necessary for improving your speed. As a newer runner, or an experienced runner having performed a challenging training session (or when racing) soreness in the hours or days following the session can be expected. This pain and stiffness felt after the activity is called Delayed Onset Muscle Soreness (or DOMS). DOMS has been shown to be useful as experiencing this pain once can help reduce it reoccurring after similar training, enabling better recovery.

Being able to differentiate between a muscle tear, or training related DOMS can help to optimise your training/recovery balance. Knowing when to stop during a run, or how long to rest between runs can help to maximise your training, and minimise unnecessary down time. Aside from rest, a progressive strengthening plan is essential for proper rehabilitation and future prevention of this injury.

If you suspect that you have a muscle tear and would like advice the severity of the injury and how best to rehabilitate it, contact the intraining running injury clinic for an appointment today.

Doug James – Physiotherapist and Podiatrist

How to run your best race

Posted on June 21, 2023May 22, 2024 by intraining

10 tips to help run your best race.

with Steve Manning – intraining Podiatrist and Lvl 4 Running Coach

It’s race season !!!

After weeks and months of training, it’s time to put yourself to the test and have a go at some races.

To help you out, Steve’s put together his 10 top tips to help you run your best possible and hopefully an enjoyable race.

You don’t need to use them all to help you run well, but each can give you a greater level of confidence in your ability to race well. Plus, as you practice each of these over your running journey, you will discover different racing experiences.

The most important aspect is to enjoy your racing and love your running.

Finally, and often forgotten, is your race plan. (Tip 6). If you are not sure how to do this, make sure you book in to see one of our team at the shop to help create a plan suited to where you are at with your racing now.

Have a great season of racing

Steve

1. Tapering

After months of progressively harder and longer training, you should have had a peak of mileage last week. The longer the race the longer the taper time required. Tapering is a reduction in total training load in the 3 weeks before a major goal race. This can mean no more long runs, fewer runs, shorter runs, less quantity in speed sessions.

2. Sharpening

When quantity is reducing in the taper intensity should be increasing. You run faster in speed sessions with more recovery between reps. Short time trials and races can also help stimulate your body so that it knows a big effort will soon be required.

3. Predictor Race

2 weeks before your major goal race you need to complete a shorter race that you can use to predict a realistic goal for your major goal race. It should be under similar conditions to your goal race regarding the surface, time and hilliness. If you run 10km in 45:00 minutes then you multiply that by 4.7 to get a realistic marathon time (3:31:30). You can get a half marathon time by dividing your marathon calculation by 2.1 (1:40:45). If it is your first half or full you should add an extra 5 to 10 minutes.

4. Power Session

10 to 12 days before your major goal race you do a power session. In this session, you only do 3 reps but run them much closer to maximum effort. This session should be the only time in training you run at maximum effort. They will usually be 15 to 30 seconds faster than your normally 1km rep pace. This is only possible because you have been tapering, you are only doing 3 reps and you also have maximum recovery of 4 to 5 minutes.

5. Pace Session

The Tuesday of race week we do a session where you are trying to run exactly at race pace. This should be the pace you want to run for most of the race. We normally do 3 x 1km with a 1km recovery. You cant look at your watch at all during the rep. Before you check your time after completing each rep you need to guess what time you ran. 3 seconds too fast is just as bad as 3 seconds too slow. Over the 3 repetitions you should not be out by any more than 10 seconds total. This is great practice for race day to make sure you do not go out too fast. It is also a good wake up call about how hard it is to run at your target pace.

6. Race Plan

Most people go out too fast in races. They are feeling good and get carried away with the crowd. This is a big mistake and can sometimes make it impossible to run your best potential time. 10 seconds a kilometre too fast at the start converts to a minute slower per kilometre at the end of the race. You should be running slower than goal pace the first 3 to 5km and then run slightly faster than goal pace for as long as possible. For example if your goal is to run 5 minutes per km you should start at 5:15/km. After the first few kms you should have warmed up and settled in and should be running at 4:55/km. By a bit after halfway you should be back on your average goal time but running faster then you need to achieve it. If you maintain that pace you will run even faster and if you slow the last few kms you will have a safe buffer all created in the second half of the race.

7. Carbo-loading

Long races will come close to depleting your freely available energy reserves. It is stored as glycogen in your blood, muscles and liver. Fat can be used as an energy source but has a greater metabolic load as it needs to be converted to glycogen. Many people try to delay this depletion with gels, chews and sports drinks. However it is also important to start the race with maximum reserves. This can be achieved through Carbo-loading where you increase the amount of carbohydrate you eat in the 2-3 days before the race. You should have more refined starches like white rice, bread and pasta. In the day before the race you should reduce high fibre foods and have higher carbohydrate foods that you like to eat. I also wake up 3 hours before the race and have some carbohydrate. You will also need to increase water intake but be careful of over-hydrating or overeating.

8. Race day nutrition

On race day I have a caffeine sports drink about 20 to 30 minutes before the start of major races. This tops up my energy and the caffeine helps me be prepared for a big effort. During the race you can use sports drinks to help reduce the risk of dehydration or Hypernatremia (diluted blood and low sodium levels). Sports gels and chews can also be used to maintain blood glycogen. You should try to have some supplementation at least every hour. It is important that you like the taste of any supplement you use so that it is maximally effective and you do not get sick. Try them in training before race day to be sure they will work on the day.

9. Supershoes

Supershoes have carbon plates, co-polymer midsoles and high stack heights with a big taper to the toe. They have been shown to have up to 8% improvement in race times depending on the person. They have also been shown to be effective for runners of all levels of ability. One of the big effects runners have reported when using supershoes is that their legs are in much better shape at the end of long races. Instead of hitting the wall and cramping and entering a survival shuffle for the last few kilometres runners are running strong at the end of races. This also results in better recovery after a marathon. intraining has a big range of supershoes so you can try them on and have a run to compare. Different supershoes will be more effective for different runners so you need to let your feet tell you which one suits you the best.

10. Foot check

You should have a quick check of your feet before a long race. Make sure your toenails are short so you do not bet a blood blister under the nail. If you have an excess buildup of callus then it can move independent of the rest of the skin and lead to blistering. If you are worried about your nails or callus then you can book into the clinic for a foot tune up before race day.

A rule of thumb is to not try anything new on race day. Practice using your gels, shoes and clothing beforehand. Stay in control and stick to your race plan. Follow these 10 points before race day and you can be confident that you will run your best potential time when it is most important.

Steve Manning "The Footman"

Tibialis Anterior Injuries

Posted on June 7, 2023June 7, 2023 by intraining

Tibialis Anterior Injuries – How to treat your shin and ankle pain.

By Doug James – Physiotherapist and Podiatrist – intraining running injury clinic

If you’ve ever had shin muscle soreness, or pain on the top of your foot, there is a chance it might have been due to an injury to the Tibialis Anterior (TA).

The TA muscle has an important role in running and walking. It assists the Posterior Tibialis muscle to control from rolling inwards too quickly or too far. It also helps by lifting the foot upwards, and to control how quickly the foot is lowered from this position. Without this muscle working well, you would be far more likely to trip over.

The TA is a large muscle located on the outer side of the bony ridge running down the front of your shin starting just below the knee. At the lower third of the length of the shin the TA muscle becomes a tendon that passes over the front of the ankle, the top of the foot and then attaches to two bones on the inner side of the foot at the high part of the arch.

When considering the anatomy of the ankle, there are up to 8 muscles* that assist with plantarflexing the foot (the movement that allows us to push off when walking or push up on to tip toe)(*fun fact: the plantaris muscle is absent in 7-20% of limbs, likely becoming less common due to its decreased role in humans since evolving from our tree dwelling days). Conversely, there are only 4 muscles that help with lifting the foot upwards, however their job is relatively easier as they only need to contend with gravity rather than bodyweight. The TA is by far the largest of these muscles, and can be prone to a number of different injuries.

Compartment Syndrome

Compartment Syndrome is when excessive pressure builds up within a muscle. This is usually due to an excessive amount of blood and metabolic waste being trapped within a tight muscle fascia (wrapping) that can’t expand sufficiently, and the body unable to clear the fluid build-up adequately. This can happen in underconditioned athletes (and often new military recruits) that have dramatically increased their training. This injury is quite painful, and in some cases requires surgery to fix, particularly when circulation or nerve function is affected. Compromise to nerve function or circulation can result in temporary or permanent foot drop, which as the name suggests, results in an inability to lift the foot. There are a number of other reasons why this may happen so it is important to have this examined urgently.

Thankfully many compartment syndrome cases respond well to reduced training and a more gradual build up. Changing footwear, and use of orthotics can also help improve symptoms in some cases.

Tibialis Anterior Tendinosis

The TA is a relatively long muscle with a similarly long tendon. This muscle is active (and sometimes overactive) during a large portion of the walking and running cycle and therefore has a higher-than-average risk of overuse and injury. Athletes that are newer to running are often under-conditioned for the stress that running will place on this muscle and tendon. Poor foot strength or joint instability (hypermobile / overly flexible joints) may lead to an overreliance on the TA muscle to stabilise your arch and foot position. Also worth considering is whether your shoes are too flexible, or too stiff as these can also play a role in injury development. The amount of training undertaken, rest between sessions, and training terrain are also worth examining. Running up and down hills can lead to a dramatic increase in how much the muscle has to work, particularly on the downhill component where the TA needs to control the rate at which the foot is being lowered down.

Tendon Compression Injuries

Because the TA tendon passes over the front of the ankle and top of the foot, compression injuries such as tendinitis (inflamed tendon), tendinosis (chronically inflamed tendon), and/or tenosynovitis (inflammation of the tendon sheath) can develop from shoe laces overly tight shoe laces. Reducing the lace tightness can help, though sometimes altering the lacing pattern is necessary to better eliminate the pressure to allow the tendon to heal.

Things to watch (and listen) for

While heel striking is completely common (and normal) when running, landing on your heel a long way in front of your centre of gravity usually results in an excessive amount of both lifting and lowering required from the Tibialis Anterior muscle. As such it may be prone to overuse injuries. If you are a particularly noisy runner that makes a “slapping” sound when the front of your foot hits the ground you could be wearing shoes that don’t suit your foot and/or have a weak TA muscle. Thankfully, these things can be fairly easily remedied, and are discussed below. A stiff ankle joint may also be to blame, though this often takes some work to address.

Ways to manage your Tibialis Anterior injury

Assuming your TA injury isn’t a medical emergency (cold, limp foot, or unrelating shin pain hours after exercise – if this is you, please go to the Emergency Department at your nearest hospital) a reduction in training load is an important first step. Taping your foot and/or massaging your shin can help to give some short term symptom relief. From there it pays to improve the strength in the muscle and tendon through conditioning exercises. It’s also worth seeing a sports podiatrist to check that your running technique and footwear aren’t contributing to the issues. Simple changes here can make a big improvement in how comfortable your shins can be while exercising. If you’ve been dealing with a sore shin muscle book in to see the injury experts at the intraining running injury clinic.

Doug James – Physiotherapist and Podiatrist

Why the ASICS Kayano 29 is a good high mileage training shoe

Posted on June 1, 2023June 1, 2023 by intraining

Why the ASICS Kayano 29 is a good high mileage training shoe

By Steve Manning “The Footman” – intraining Podiatrist & Lvl 4 Coach

In a previous shop newsletter, I suggested 3 reasons to use Stability Shoes:

1. Manage injuries related to pronation
2. Better support for slower running
3. Increased shoe durability

In this newsletter, I would like to highlight a particular stability shoe the Asics Kayano 29.

For many years the Asics Kayano was the most popular running shoe sold in Australia. The reason for this popularity was the versatility and comfort of this shoe. It was a reliable shoe in the high-mileage training category. Perfect for long runs and durable enough to push past the 800km mark for many runners. Asics kept a winning formula with the Kayano rather than trying to change it for change’s sake.

However the current Kayano has benefitted by the improvements in materials technology. In particular the inclusion of FF Blast+ has improved the softness and energy return. However they have not compromised the stability thanks to the LiteTruss system which is multiple midsole densities that are greater on the medial, inside of the shoe. An external thermoplastic heel counter collar prevents deviation of the heel counter over time.

The Kayano 29 is a very plush shoe that maintains the stability that many runners need. Medial ankle pain, shin pain and knee pain can be a direct result of inadequate medial control in a shoe. The Kayano is one of the premier stability shoes available.

Because of it’s popularity there are multiple colour options. There is also a knitted upper option with a sock fit – no tongue. The Kayano Lite 3 is another option that has a softer feel and uses GuidanceLine rather than LiteTruss for its stability. A kids version of the Kayano uses FF blast and does not have the heel counter collar but incorporates all of the premier technology of the adult Kayano.

For the month of June, we are offering all Kayano 29 at a special discount of $200. This is the perfect time to try out the Kayano if you need some extra support for your feet.

Steve Manning "The Footman"

How to deal with a pain in the butt (a glute injury)

Posted on May 9, 2023May 9, 2023 by intraining

Gluteal Muscle Injuries: How to deal with a pain in the butt

By Doug James (Physiotherapist and Podiatrist)

What are “the glutes”?

The Gluteal muscles (also known as “the glutes”) are your backside muscles, found on your posterior pelvis. They play an important role in standing, walking, running and jumping. There are three different Gluteal muscles:

The Gluteus Maximus – which is the largest of the group – works with the hamstring muscles to move the thigh in a backwards movement during running. It is a large, thick muscle and can generate a lot of power particularly during sprinting, squatting and jumping.

The Gluteus Medius and Gluteus Minimus muscles – These are relatively smaller and help to keep the hip steady while standing, walking or running and can rotate the thigh and knee inwards and outwards, and move the thigh out to the side (abduction). These two muscles are found on the upper part of the hip bones towards the outside. When you place your hands on your hips, your thumbs would rest on these muscles).

Who is at risk of a glute injury?

In distance runners, a vast majority of Gluteal muscle injuries will occur to the smaller Gluteus muscles (the Medius and Minimus) or their tendons. The Gluteus Maximus may occasionally become strained or torn, but this is more likely seen in sprinters, weight lifters, or jumping athletes performing powerful explosive movements.

The Gluteus Medius and Minimus are important muscles for runners because they largely provide stabilisation on every step you take. They tend to be more likely injured in female runners and runners over the age of 40. The injuries that can develop in these muscles ranges from relatively mild injuries such as strains or slight tears; through to a full rupture of the muscle or tendon (which is more severe but thankfully much less common).

Types of Gluteal injuries

TENDONITIS:

Tendonitis usually occurs when the amount of load (training stress) is greater than the capacity (strength) and healing capability of the tendon. These types of injuries, tendonitis of the Gluteus Medius/Minimus tendons, can be slow healing and nagging as they are often ignored or poorly managed. Healing capability is also affected by a number of factors including age, overall health, nutrition, stress and sleep.

BURSITIS:

Bursas are fluid filled sacs that usually exist peacefully in the human body. They have a role in protecting tendons from rubbing on bone. Bursitis develops when the bursa becomes acutely or chronically irritated. Gluteus Medius tendinosis (the chronic form of tendinitis) can become complicated by developing bursitis (swelling) on the bony part on the outside of the hip joint called the greater trochanter. Greater Trochanteric Bursitis is usually painful to touch or lay on, and can get irritated by running.

Most injuries to the Gluteus Medius / Minimus are due to overuse or weakness.

Overtraining by dramatically increasing the distance of a run, or the number of times each week that you run will cause your muscles to fatigue and become sore. Due to their relatively small size, the Gluteus Medius and Minimus are likely to fatigue earlier than the Gluteus Maximus, Hamstrings and Quadriceps (thigh) muscles. As these muscle fatigue, they can become damaged, and the risk of knee and ITB injuries increases.

Muscle imbalances can also increase the risk of Gluteal muscle injuries. Tight hip flexors and weak Gluteal muscles may cause the pelvis to tilt forward putting strain on muscles and joints in the hips and lower back. In some cases excessive foot pronation (rolling in) or incorrect footwear may contribute to Gluteal muscle injuries.

WHAT ELSE COULD IT BE?

While the gluteal muscles and tendons are a common source of discomfort in distance runners, there are a number of other conditions that can be occur. Deep Gluteal Syndrome or Piriformis Syndrome are complex conditions that affect a different group of muscle and nerves in the gluteal region. These syndromes tend to be felt deeper and lower in the glutes (further towards the hamstrings) and may have referred pain and numbness into the back of the thigh or legs.

Bone stress injuries to the pelvic bones, sacrum (lowest part of the spine) or the neck of femur (where the thigh bone become the hip joint) are rare but shouldn’t be overlooked, particularly if pain becomes worse with running and lingers for days afterwards.

How to deal with a pain in the butt?

There are three key strategies to manage gluteal injuries.

1. Calm the injury.

2. Rebuild strength

3. Sports specific conditioning

The mainstay of most sporting injuries is to initially calm an injury down, rebuild the strength in the affected and surrounding tissue, then focus on sport specific conditioning. If you are suffering a muscle or tendon injury, this may mean a relatively short period of reduced running volume before resuming regular training. With these ‘soft tissue’ type injuries, as long as some rehabilitation exercises are being undertaken, these shouldn’t significantly impact your running. If however you are suffering from a bone stress injury, this can take a number of weeks, to possibly months to heal particularly if adequate rest doesn’t occur in a timely manner.

The key here is to getting the correct diagnosis early, which can be achieved with clinical testing, and if necessary, an MRI scan (a Physiotherapist can refer you for this if deemed necessary).

For most hip and glute injuries, preventing these injuries involves making sure that the hip stabilising muscles (namely the Gluteus Medius and Minimus) are strong and have good endurance. Strengthening these muscles, along with your core (e.g. through Pilates type exercises) can not only help to reduce Gluteal muscle injuries but also reduce your risk of hamstring, ITB, and knee injuries. Making sure your hip flexor muscles are sufficiently flexible may also help. Having a proper biomechanical assessment of your running technique, footwear and hip strength and flexibility can identify risk factors and give insight into how to avoid or fix Gluteal injuries.

COME IN AND SEE OUR TEAM

Like any niggle, the sooner you get this checked and treated, the better outcome you will have. The intraining running injury clinic can help diagnose and treat your Gluteal (and other) injuries. Running shoe and biomechanical assessments can be performed by the experienced podiatrists and physiotherapist to help get you back running sooner.

Call today for an appointment with out team: 3367 3088.Re

Doug James, Physiotherapist and Podiatrist

Do You Need a Trail Shoe?

Posted on May 3, 2023May 4, 2023 by intraining

Three reasons why trail shoes make a difference

By Steve Manning “The Footman” – intraining Podiatrist & Lvl 4 Running Coach

Trail running has become more popular over the last few years as is shown by the success of the intraining Trail tribe sessions and trail events. Most weekends there are now multiple trail races you can run.

If you have considered trying out the trails then the first question you might have is whether you need to get a specialist trail shoe. The answer depends on the trail you want to run. Many of Brisbane’s trails are well maintained and will be Ok to use a road shoe for an occasional run. However many trails are too rough and you may risk injury if you do not have a trail-specific shoe.

Below, I’ve given you three reasons why trail shoes can make your runs much more enjoyable than if you ran with road running shoes.

1. DESIGN: How are they different from running shoes?

2. BENEFITS: Why should you use trail over road shoes?

3. ADVANTAGES of Trail running for you

If you have any questions, make sure you come into intraining Running Centre and chat with our running team. Or you can drop us an email at [email protected], or call our team on 33673088.

How are trail shoes different to running shoes?

DESIGN: The structure of trail shoes have:

Larger lugs on outsole.

- Trail shoe outsoles must deal with loose or muddy ground. The higher profile lugs on the outsole help to improve traction on these surfaces. This is perhaps the most important and most obvious difference between road and Trail. On the road trail outsoles may have decreased traction and the lugs will wear off more quickly than a road shoe.

Lower stack height and heel drop.

- The uneven ground on trails have a greater risk of tripping or spraining an ankle. The thicker the midsole the greater the instability and more risk of a sprain. Trail shoes thinner midsoles are more responsive and will give you a better feel for the road.

Tougher toe caps.

- There is a risk of kicking a stick or rock running on trails. Most trail shoes have some extra protection in the toes to reduce the chance of tearing the upper. This also helps protect your toes.

Rock Plates.

- Many trail shoes have a forefoot plate that will stop a sharp rock from piercing the sole and cutting your foot. This may reduce forefoot flexion however it is not the same function like a supershoe that is designed to stop forefoot flexion.

Neutral only.

- Trail shoes must deal with more lateral movement than road shoes. For this reason almost all trail shoes are neutral. That means they have the same support on the inside and outside of the shoe. About half of the road running shoes are neutral as the extra support on the inside of stability shoes helps control excessive pronation.

Water resistance.

- Some trail shoes have Goretex uppers that are waterproof. However, most trail shoes have a layer of waterproofing around the base but are more water resistant in the rest of the upper. This keeps your feet relatively more dry if you are running through wet grass and puddles.

Why should I get trail shoes?

Here are 3 key reasons:

#1 Durability.

The most important reason to get a trail specific shoe is that your shoes will last longer. Each shoe is designed with regards to the specific type of stress they must endure. Outsole components may be torn off a road shoe when they run over rocky terrain. A road shoe midsole is less protected and softer so will degrade quicker on trails. The softer upper materials can be easily damaged by rocks and sticks.

#2 Better traction.

Running on trails has an increased risk of falls. This is increased significantly if you have diminished traction. It is also very frustrating slipping around on loose surfaces. Even calf and hamstring tears will be greater if you are slipping as you push off and slip.

#3 Improve stability.

The midsole upper and outsole combine to offer better stability running on trails. You are trading softer midsoles and anti-pronation features in road shoes for a firmer ride of a trail shoe.

Advantages of trail running:

Aside from the enjoyment factor, adding some trail running into your routine can give you additonal strength for your road running goals.

Here’s how:

Increased strength

Running on uneven ground works the little stability muscles in your feet, legs and core. This creates greater strength outside of the limited range of motion from road running. This then leads to reduce risk of overuse injuries.

Changing Body Stresses

If you are having to manage a degenerative injury like osteoarthritis, you may find that you are able to run further with no pain on the trails. The constantly changing stress helps distribute the strain away from the damaged area offering a level of relief.

Focus on effort rather than pace

Running off road means you can commune with nature rather than dodging cars. Because of the changing surfaces and hills the emphasis is off of your pace and more on your effort. This creates a sense of being in the moment that is similar to the benefits of meditation.

Getting the right shoe specific trails lets you truly maximise these advantages.

For shoes: You will want to come talk with our team instore. They will take you through the shoes available and of course let you test run them in-store. Like any shoe, it’s good to run in them while choosing the one for you.

For training: intraining Running Centre has a thriving trail community with midweek and weekend sessions for all abilities. You can find more information about this HERE and contact our trail coach Tracy Baker if you need more information.

Happy running!

Steve

Steve Manning "The Footman"

Steve has been a running shoe aficionado for the last 4 decades and as the owner of the intraining Running Centre has helped thousands of runners find the perfect shoe. He is a member of the Footman Biomechanics Group of the International Society of Biomechanics and a previous President of the Qld branch of Sports Medicine Australia. As a Podiatrist specialising in running sports injury prevention, he utilises footwear prescription and modification to keep you running. Contact Steve at the intraining Running Centre, [email protected] for all your footwear questions.

What do my symptoms tell me about my injury?

Here are some questions you need to ask about your symptoms to determine if you can manage the injury yourself or need to seek help.

Super shoes and injury

Key Considerations:

Steve Manning Podiatrist BPod (Hons), Level 4 Coach

Blister prevention for Runners

General blister prevention:

Steve Manning Podiatrist BPod (Hons), Level 3 Coach

RECUPERATION in the OFF SEASON

Here are 6 key ways to recuperate during the off-season.

TRAINING in the OFF-SEASON:

Create a Race Plan and finish feeling strong

Here’s how you can create a strategic race plan to ensure you cross the finish line strong and proud.

The Danger of Going Out Too Fast

Be Strategic in Choosing Your Start Pace

Start Slow and Build Up

Warming Up and Settling In

Achieving and Surpassing Your Goal Pace

The Final Push

Summary: Your Path to a Successful Race

Black toenails

Anatomy of a Nail

Causes of black toenails

Treating Black toenails

Preventing black toenails

DIAGNOSIS OF AN INJURY

1. Diagnose by History:

2. Diagnose by Palpation

3. Diagnose from Imaging

4 . Treatment directed diagnosis

5. Diagnose contributing factors not just injury

RUN LIKE IT IS RUMSPRINGA

Come to our running groups.

6 ways to improve running economy

1. Plyometrics and Running Drills

2. Improve strength

3. Run More

4. Run faster

5. Weight management

6. Race smart

Margot and Steve are conducting a running form workshop on Saturday 2nd March.

Come along to learn how to improve your running economy.

WHAT IS RUNNING ECONOMY?

Here are a few goals to improve economy:​

1. OPTIMISE INDIVIDUAL BIOMECHANICS:

2. INCREASE STIFFNESS

3. OPTIMISE CADENCE/STRIDE LENGTH RATIO

4. CAPILLARY and MITOCHONDRIA DEVELOPMENT

RUNNING FORM WORKSHOP

Saturday 2nd March, 2024

Come along to learn how to improve your running economy, gain strength as a runner, and learn how to improve your running form.

Review your Running year

Steve Manning "The Footman"

Can you relate to any of the problems or questions below?​

5 Ways orthotics help you run better!

by Steve Manning – intraining Podiatrist & Lvl 4 AT&FCA Coach

5 common questions I am asked about orthotics

Steve Manning “The Footman”

By Steve Manning “The Footman” – intraining Podiatrist and Coach

There is nothing worse than blisters causing you to pull out of a race. When your training, pacing and nutrition is all going well it can be ruined by a skin issue. Luckily, there are some easy ways to make sure that blisters do not undermine a great performance.

WHAT IS A BLISTER?

WHAT CAUSES A BLISTER?

WHERE DO BLISTERS OCCUR?

WHY DO BLISTERS HURT?

HOW DO I TREAT OR PREVENT BLISTERS?

My 4 top tips to prevent or treat blisters are:

WHAT IS A BLACK TOENAIL?

You don’t want blisters

If you are having trouble with blisters, black toenails or calluses, book an appointment with our podiatry and team at intraining. Call iHealth on 3870 2525.

Steve Manning "The Footman"

Dodgy hammy? How to manage hamstring muscle injuries

Location matters

Some good news

…and some bad news

Risk factors

What about super shoes?

Watch for warning signs

Prevention helps (somewhat)

What to do if injury strikes?

The road to recovery

Here are a few goals to improve economy:

Can you relate to any of the problems or questions below?