My running rehab
Updated: Jan 7, 2020
I haven’t written a blog post for far too long following the annihilation of my left leg at the Royal Parks Half Marathon. Delighted I raised £531 for Asthma UK (as a group of runners we raised £10,000 overall for the charity), less delighted I couldn’t walk for a week after and I still haven’t been able to get back to running properly.
However, my running rehab of my iliotibial band (ITB) has been a real insight and experience. I realise that I’d completely neglected the exercises that are fundamental to your mobility and strength as a runner. I also realise that I didn’t have a particularly adequate training plan in place. So, here are a round-up of my learnings since 13 October 2019 (race day) that should help you reduce your risk of injury and help you through any rehab.
Don’t ignore your hips and glutes
I limped my way to my first physio appointment five days after race day. It was here that my running rehab education began. I soon understood that it was not my ITB itself that was the root of the problem, as such (despite being known as ITB Syndrome). Instead, the agonising pain was a result of a lack of flexibility and strength in my hip and glute muscles, which coupled with overuse, had led to inflammation and irritation of the band as it crossed my knee cap. The pain is known to intensify over the duration of said activity, explaining my collapse at kilometre 17 of the half marathon. Ouch. I quickly realised how essential it was to weave hip and glute strengthening exercises into workouts. Better to learn this later rather than never.
As a result of my muscle group imbalances, I’ve been introduced to the world of resistance bands. I had always avoided them as I didn’t really know how to utilise them, specifically without pinging myself in the face. My physio showed me a range of exercises to activate my glutes and the key ones I would recommend are crab (lateral band) walks and clamshells. For crab walks, put the band around your legs, just above the knees, or just above your ankles for added difficulty. You can buy different strength resistance bands in a pack on Amazon. I bought these ones; it’s great having a variety to choose from dependent on the exercise in question. I like that you don’t need to go to a gym to do these exercises, and there are so many videos you can find on YouTube to give you guidance. Yoga is also something to try and do more of - I should probably refer back to my Sky Garden sunrise yoga class post for some renewed inspiration.
As my physio sessions progressed and so did my healing, I was allowed to start incorporating specific glute-strengthening exercises into my running rehab programme. Luckily for me, these are firm favourites for building a bigger bum, including ‘normal’ lunges, reverse lunges and curtsey lunges, ensuring proper form. Don’t forget about glute bridges, also known as hip thrusts, and using an added weight (barbell is best) when you’re capable. Of course, it’s not just about my glutes but also my quads, so I was instructed to regularly use the leg press.
Rightly or wrongly (I’m still debating), I paid £89.00 for a one off session at The Running School in The City in the midst of my running rehab, to understand how I run and, therefore, how to run better to reduce risk of recurring injury. Known as the biomechanical running analysis, I learnt a lot, including that my right stride is significantly longer than my left stride when I run and that my heels don’t kick back nearly high enough (all adding to the pressure on my left knee). This was achieved by videoing me running on a treadmill and completing some simple functional movement exercises. I do think that it’s so hard/draining to try and change your running style but worth it if you can do it. At least I’m now equipped with the theory to make improvements. It was just a bit annoying that they clearly wanted to sell me the upgrade package of six classes. I do now also find it far more interesting watching other people run. Money well spent. Perhaps.
A proper training plan
I've identified that a key reason for my injury was the speed (literally) with which I clocked up the mileage when training for my half marathon. Because I was fit enough to run longer distances, I neglected to think about the impact that it would have on my different muscle groups and joints. Going from zero to hero isn’t possible. Time is key here and using incremental increases. You’ve probably heard people recommend increasing your mileage by 10% every time you run. I didn’t really listen to those people and I ignored the mounting pain in my knee. I also had a two week holiday six weeks before race day, climbing a nearly 4000m mountain and later wondered why my post-holiday 16km run left me struggling to walk the next day.
Listening to my body would have been wiser. I genuinely thought I would be fine but once you admit that you’ve got a niggle, it’s time to take action. Try to be proactive and not reactive as it pays dividends.