WHAT ARE THE TOP RUNNING INJURIES?

Runners of all abilities and ages get injured. Earlier this year I completed a clinical audit of the runners I looked after from January to March to assess what injuries I was seeing and where to plan my professional development over the next few years. This made me look into the research to see if the trends I was seeing was the same as being reported.

I found “A Systematic Review of Running-Related Musculoskeletal Injuries in Runners” which was published in 2021. I’ve made up the infographic below for you. I won’t talk about my own audit as I would require consent from my patients.

SYSTEMATIC REVIEW OF RUNNING-RELATED MUSCULOSKELETAL INJURIES IN RUNNERS.

(KAKOURIS ET AL 2021).

The chart shows that Achilles tendinopathy had the highest incidence, followed by shin splints, plantar-fasciitis, patella-femoral pain (knee pain) and the dreaded ITB related pain. Most runners will have heard of these and even more will have experienced pain in one of these areas.
-
You'll notice that the numbers do not add up to 100%. This is due to a small number of injuries not included. However if you read the study they are fully reported.
-
📌70% of all injuries reported were down to overuse!

🧠This is massive but it’s also encouraging. We can have a big intervention on overuse injuries with their treatment, management and PREVENTION. Sometimes this can be through looking over a plan for trends and sudden increases in one type of running. It might be looking at where and how you recover. It might also be measuring muscle force or endurance and looking at weak points.

📌The majority of injuries were reported below the knee.

🧠This might because the propulsion phase in the running gait is generated from the foot and the lower limb muscles and bones, which leads to increased load on these structures. This could also be why so much research is coming out about how to strengthen the lower limb in runners.
-
🏃‍♀️The authors recommend injury prevention measures to these area's to reduce the high incidence of injuries.
-
🙋🏻‍♂️In all of my sessions with runners 🏃🏿 I try to implement education on load management and how to safely increase mileage, interval and hill training. I teach you how to analyse your training plan so you reduce the risk of making a training error and cause an overuse injury. I’m a huge believer in learning how to strength train for injury prevention and increased performance.
-
I’m starting a new service where I’m offering online strength training for runners and triathletes. If you’re interested in learning how to implement strength training as part of your training to improve performance and reduce injuries then please reach out to me.

To book an appointment with me you can call my online secretary 07900363938 or email info@shauntyler.com.

Reference and read what I've read 📚
Kakouris N, Yener N, Fong DTP. A systematic review of running-related musculoskeletal injuries in runners. J Sport Health Sci. 2021 Sep;10(5):513-522. doi: 10.1016/j.jshs.2021.04.001. Epub 2021 Apr 20. PMID: 33862272; PMCID: PMC8500811.

🚨If you've just pulled your back or it's just "gone" while you were putting your socks on this morning, then you need this!
-
🙋🏻‍♂️Hi, I'm Shaun and I'm a Registered Osteopath based in Colchester, UK. Every week I have patients who see me with acute low back pain. We define acute low back pain as pain that is less that 6 weeks old. Most acute low back pain will resolve within 4-6weeks depending on the onset and severity of your symptoms. Here's six points that I find really helps my patients and will give you an insight in how I treat my patients with this condition.
-
1️⃣ Relative Activity Modification
I'll start by addressing what's causing you pain and discomfort. I rarely advocate complete rest. Complete rest is old thinking. It can lead to fatty infiltration of muscles, decondition your muscles, increase pain and can delay your recovery. That said, some people will need some sort of rest. It’s not as cut and dry as one size fits all. I will often get you to modify your work positions or bring in a pacing strategy to reduce stress on painful structures. It might be changing your exercise routine or training schedule. This is where having a clear line of communication with your therapist helps. See points 2 & 4, there should be constant feedback finding what works for the individual and what does not.
-
2️⃣ Build a Therapeutic Alliance
I want me and my patient to become a team. I want to build trust so they can approach me with any questions or queries. I will in turn advocate for you and support you along your back-pain journey. Treating and recovering from acute low back pain is not a case of ‘go away and do these exercises.” I see patients who’ve been given a list of tens of exercises and are unsure if they should be doing them because they cause pain. By regular communication whether it’s face to face, by text or email we can build trust and really individualise your treatment and recovery.
-
3️⃣ Osteopathic Assessment & Treatment
I start by listening to you (a lot), and taking a case history. We investigate different parts of your health & lifestyle because putting that plate in the dish washer should not have caused a muscle strain. There's often an accumulation of factors that snowball up to that point. I will assess you physically to see how your body is moving and functioning. This might include muscle testing and moving joints around. We will investigate what’s causing pain and what positions give you relief.

Osteopathic treatment might include soft tissue release & massage, dry needling, taping, stretching & spinal manipulation. The goal is to reduce pain and improve your movement, function & confidence. Most of my patients will leave confident that they have a plan to get them back to work, sport or doing what they enjoy.
-
4️⃣ Education & Communication
I really try my best to make sure my patients firstly understand what's going on with their back. I advise on prognosis as all too often back pain doesn’t go away overnight. I like them to know what they need to do to help themselves. If they understand this then they seem to have less worry, less fear avoidance and better outcomes.

5️⃣ Rehab Exercises & Return to Activity
Whether you like exercise or not, you need to be increasing your activity levels to help your back and reduce pain. I tend to tailor specific exercises to my patients to begin with. I find this builds confidence in their body and spine. Often a back injury can leave someone thinking their back is weak or degenerative. The exercises will increase your mobility and range of motion. They will also increase strength, stability & endurance. On top of this we know regular exposure to exercise has a pain modulation and relieving effect on the body. My plans are often progressive so I can have them integrate themselves back to work or activity.
-

6️⃣ Reassurance & Follow Up
Chronic low back pain can sometimes develop in a small number of patients who have acute low back pain. It's also thought that up to 80% of people will have a relapse over the following year. I educate my patients about this and keep our channels of communication open. It’s often useful to have follow up appointments to progress your exercises as your body gets stronger and moves better.

As you can see a big part of my osteopathic treatment is developing a relationship with my patient. If we can build a strong therapeutic alliance and you understand the reasons behind why we are doing or not doing certain moves or activities then you’ll be more likely to follow the plan and have long term results.

If you’d like to work with me then please get in touch.

📲07900363938
📧info@shauntyler.com

Acid reflux or heart burn is the predominant symptom of Gastroesophageal Reflux or GERD. It’s estimated that over 20% of the Western world suffer from GERD. It’s a painful and limiting condition that can effect diet, sleep, activity and work. It can lead to more serious conditions such as Barrett’s osophagus.

Sharma and Yadlapati (2021) stated that the pathogenesis of GERD is an interpaly of chemical, mechanical, psychologic, and neurologic mechanisms. Patients often present with impaired esophageal motility and lower esophageal sphincter (LES) dysfunction.

In osteopathy we are interested in the diaphragm muscle as it surrounds the osophagus, phrenic and vagus nerves. Good movement of the diaphragm ensures a change in pressure gradients in the thoracic and abdominal cavities to aid breathing and digestion. A dysfunctional diaphragm can inhibit the lower esophageal sphincter and cause contents to back wash into the osophagus.

In 2019 Eguaras and colleagues performed a randomised, double-blind placebo-controlled trial. They recruited 60 subjects suffering with GERD from a private digestive clinic in Spain. They received two sessions of a single manual osteopathic technique aimed at the patients epigastric area for 5minutes. After just one 5 minute treatment patients symptoms improved by 37.8%.

It must be pointed out that during most osteopathy treatments a variety of techniques are administered so this may lead to better improvements. The researchers had to limit the treatment to one osteopathic technique so they could clearly measure that each patient was receiving the exact same technique for same amount of time..

If you’ve been suffering from heart burn and would like to try osteopathy then please get in touch.

References:

Chen J, Brady P. Gastroesophageal Reflux Disease: Pathophysiology, Diagnosis, and Treatment. Gastroenterol Nurs. 2019 Jan/Feb;42(1):20-28. doi: 10.1097/SGA.0000000000000359. PMID: 30688703.

Eguaras N, Rodríguez-López ES, Lopez-Dicastillo O, Franco-Sierra MÁ, Ricard F, Oliva-Pascual-Vaca Á. Effects of Osteopathic Visceral Treatment in Patients with Gastroesophageal Reflux: A Randomized Controlled Trial. J Clin Med. 2019 Oct 19;8(10):1738. doi: 10.3390/jcm8101738. PMID: 31635110; PMCID: PMC6832476.

Richter JE, Rubenstein JH. Presentation and Epidemiology of Gastroesophageal Reflux Disease. Gastroenterology. 2018 Jan;154(2):267-276. doi: 10.1053/j.gastro.2017.07.045. Epub 2017 Aug 3. PMID: 28780072; PMCID: PMC5797499.

Sharma P, Yadlapati R. Pathophysiology and treatment options for gastroesophageal reflux disease: looking beyond acid. Ann N Y Acad Sci. 2021 Feb;1486(1):3-14. doi: 10.1111/nyas.14501. Epub 2020 Oct 4. PMID: 33015827; PMCID: PMC9792178.

💥Lumbar Disc Herniation Symptoms💥

-

😨 The lumbar area of the spine (the lower back) is the most injured area. The vertebrae are and discs are bigger than anywhere else in the spine, and this reflects its function as a shock absorber.

-

🦴A herniated disc is also known as a prolapsed disc & sometimes "slipped disc." There is damage to outer layer of the disc called the annulus fibrosis that allows the nucleus pulposis on the inside to herniate. This can compress and irritate the spinal cord & spinal nerves. This results in a multitude of symptoms that include pain, weakness, and sensory loss. This is often referred to as "sciatica."

-

Presentation:

👷Often patients will recall an incident that triggered the pain such as lifting & twisting.

💥Pain is often described as sharp, burning, electric shock or a dull ache.

⚡️ Pain can radiate in the distribution of the affected nerve root.

❄️In more serious cases this can result in a loss of sensation, numbness, pins and needles, itching,

💪 Each spinal nerve innervates certain muscles of the lower limb called a myotome which can present as weak. L3/4 weakness would present as difficulty straightening the knee. L5 issues would prevent you to push up onto your toes.

💦 In extremely serious cases there may be changes in the bladder or bowel & sexual dysfunction. THIS SHOULD BE TREATED AS A MEDICAL EMERGENCY

🤸‍♂‍Often most movements of the trunk will cause pain. Some patients present with a certain movement such as side bending to the affected side or extension.

-

📊Almost 85% of patient’s symptoms will resolve in 8-12weeks without any treatment. However, that is a long time to be in severe pain. Around 30% of patients complain of low back pain after 1 year. Chronic symptoms are also associated with mental health disorders such as depression & anxiety.

-

🚶Most patients complain of worse pain when sitting & reduced pain when walking. Current advice is to try to keep moving in small doses. This might be 2-3 5-10minutes walks each day or a specific set of mobility exercises.

-

🙋‍♂️Have you suffered from these symptoms? Please share in the comments what they were & how long it took to resolve to help someone suffering the same 👇

Living with chronic pain is disabling. For some sufferers it is the primary complaint of diseases such as fibromyalgia and for others it might be a progression of a degenerative disease such as osteoarthritis (Mao 2017).

-

It's widely accpeted that you cannot treat chronic pain the same as acute pain. Patients have to manage their lifestyles and their own expectations (and possibly the expectations of family, friends and work colleagues). A more long term approach must be taken and patients encouraged to reflect and self-manage themselves with the guide of a clinician . Too often patients with chronic pain problems are looking for a magic bullet and will hang all of their hopes on a single treatment such as steroid injections. It’s only when they start to reflect on their activities, lifestyle and stressors that they can truly manage their condition and move forwards.

I've put together a list of techniques that I use myself to help manage my chronic pain that's resulted in a total knee replacement revision. I paticularly find exercise really helps me. If I am consistent and don’t push too hard then my knee feels loose and I can manage the pain quite well. However, if I get over zealous in the gym or do a really long walk I will suffer for a couple of days afterwards.

Read through and let me know what you think. Feel free to leave your tips in the comments.

References:

Mao J. Challenges of managing chronic pain BMJ 2017; 356 :j741 doi:10.1136/bmj.j741

I love treating runners. They are without a doubt my favourite patients. Probably because I’m an ex-runner myself. I say ex-runner, as I’ve had two knee replacements and dare not run anymore. I know the joy of getting out the front door and onto the road and what it can do to your mental health. I’m also more than aware of how dispiriting it is not being able to run due to pain and injury. I am passionate about running, running training, and running injuries and I make it my business to stay up to date. 

So, what is my philosophy of treating runners and how can osteopathy help? 

One of the key concepts of osteopathy is to treat every patient as an individual. I don’t care whether you’re a seasoned club runner or you’re two sessions in on the Couch25K plan. To me you’re a runner and you’re an athlete so you deserve to be treated like one with the best care in the area. I know you are at your happiest when you can run so I will do everything I can to keep you running. 

On the initial session I will take a full medical history and ask plenty of questions about your training (or lack of!). This might include, how long you’ve been running for? What are you last six weeks of training? How quickly have you increased your mileage? I will ask questions about your injury like, does your injury swell? Is it worse in the morning? Is it worse at the start or end of a run? Have you had it before? 

I will assess you biomechanically looking at posture, gait, joint range of motion and muscle balance. This will include single limb strength, quadricep to hamstring strength ratio. I will assess your joint mobility. This might include the flexion and extension of your big toe. How much dorsiflexion you have and explain to you how this relates to the Windlass mechanism and your running gait. I will try to explain things, so you understand and educate you as much as possible.

Once I’ve given you a diagnosis, we will BOTH agree on a treatment plan. Not only will this include treatment on the couch but a full progressive rehabilitation plan including strength training. We may have to talk about modifying your running frequency and intensity. 

On the couch you might be offered massage and osteopathic techniques such as mobilisation, manipulation, and neuromuscular stretching as well as dry needling and acupuncture. If you have a tricky tendon or plantar fasciitis there is access to shockwave therapy. 

Proper rehabilitation is key. We may need to implement simple exercises you can do for five minutes per day. If it’s more complex, then you might have to follow a progressive strength training plan. This is where follow up sessions come in. We’ll need to measure your progress whether it be increased strength, power endurance or increased range of motion in a joint. I will use this information to optimize and progress your current plan. 

My primary goal is to get you back on your feet and running as soon as possible. 

My secondary goal is to make you stronger, so you don’t have to come back for the same injury.

Once your injury free I have links with running coaches and clubs in the Colchester area. This can help increase your fun and commitment to running. You never know you might get a new PB!

If you consider yourself a runner and you’re experiencing pain, then it’s important to get your advice from a healthcare professional. I see so many runners of all abilities who have been in pain for months or made an injury worse as they’ve been listening to Barry the bricklayer give his “expert” advice on what worked for him when he self-diagnosed his own shin splints. Every onset of running injury is different just like we all have our own running style and DNA. Therefore, it’s important for a full assessment to be performed so we can get to the root of the problem and address it quickly. 

GET IN TOUCH

If you want to work with a friendly and knowledgeable local osteopath, then please get in touch to book and appointment. 

Call: 07900363938 or email info@shauntyler.com

Is lower back pain creeping into your life? Are you waking up with a stiff back or finding it increasingly hard to put your socks on in the morning? The clocks have gone back and we have less daylight and less time for activity. Add in a little bit of low energy and mood with a reduction of mobility and it’s no wonder you might be feeling muscles spasms or restricted joints. This short blog will give you the tips and tricks to get your back pain under control.

If it’s your first bout of back pain or you have back pain accompanied with leg pain or any paresthesia such as pins and needles, numbness, burning or shooting electrical pains or anything you’re worried about then please drop me a line to get booked in so that your back pain is properly assessed so we can rule out any sinister underlying causes. Please email info@shauntyler.com to book in with osteopath Shaun Tyler.

The below advice is for general back pain. The most effective treatment is the one that is tailored specifically for you. This will include treatment, specific advice based around your age, activity levels, job and lifestyle. It should include self management techniques and a progressive exercise plan.

Lower Back Pain Advice

Don’t Panic… 90% of people who experience low back pain will be fully recovered by 12weeks. There is good natural history to low back pain. Back pain isn’t often caused by serious structural damage. Try to stay positive as having a good mental state will really help your recovery. However if you’re worried and you don’t feel that you’re managing the pain then please get in touch so we can help you.

Find a balance… I often refer to this as the “Goldilocks Principle.” Too much of one thing whether it be movement or rest can trigger more pain. Too little and there won’t be enough of a stimulis to help you.

Try to keep moving... Movement in the right dose will definitely help you recover quicker and manage your pain. Be mindful not to push through pain. Use the traffic light system below so you can gauge whether you’re doing too much or too little.

Try a pacing strategy… If you’ve read any of my socail media or blog posts then you’ll be familiar with this concept. Pacing is about taking a break before pain reminds you that you need one. This will take a little bit of getting used to to implement effectively. It will help you find “the just right” dose of movement to help you recover more quickly.

Try heat… Applying a heat pack on the painful area for half an hour a day is a great way to help reduce pain. It can also help improve blood flow to the area that brings with it nutrients and oxygen to help the area recover more quickly.

If you try these techniques and you’re still worried or in pain then please don’t hesitate to book in for an appointment with Shaun. You can email info@shauntyler.com or call 07900363938 to book your appointment.

In January 2020 the World Health Organisation (WHO) declared the outbreak of coronavirus (COVID-19) to be a Public Health Emergency of International Concern. Fast forward four months and in the UK, we have been in a Government imposed lock down for four weeks. How are we coping?

Personally, my children have taken it quite hard not being able to see friends or go to school. As well as a massive change in routine. The only essential travel we have is a walk to the supermarket to buy food and a drive out to Alresford to deliver groceries to elderly vunerable relatives. 

While I and my family understand the need for self-isolation for public health reasons to help stop the spread of COVID-19. What about the effect on our mental health? 

In my own work as an osteopath I normally see 10-12 different patients per day. That’s 10-12 different conversations and interactions everyday not to mention the small talk when buying a coffee, going to the gym or just seeing people in the street. Four weeks in and those interactions have disappeared. As much as I love my children the conversation isn’t exactly stimulating. 

We are bombarded with daily death tolls and failings in health and social care. People have replaced “good-bye” with “stay-safe” and this all adds to the stress we are feeling as a nation. What practical things can we do to help safeguard our mental health?

Sleep Well

Sleep is one of the most underated interventions for our health.

It’s been well documented that people who don’t get enough sleep suffer more stress and anxiety. While we’re off work it might be tempting to stay up for a couple of hours later to squeeze in another episode of that Netflix series. One night is ok, but, making a habit of late nights will have a detrimental effect on the quality of your sleep and your recovery. 

Try to get into an evening routine which is sometimes referred to as “sleep hygiene.” Stop working at least an hour before you aim to sleep. Have a hot bath or shower and put your phone on silent. I have reports from patients who use eye masks in bed and find they get off to sleep much quicker. 

Exercise Often

Making exercise a family affair and part of the daily routine ensures you can fit your workout in.

Boris has told us that we are allowed out once a day for physical activity. Make the most of it. Now is the time to dust off your trainers and get outside. It doesn’t matter if you walk or run or bike. Just get your heart rate up and keep moving for 30minutes. 

If you can get outside, the fresh air will make you feel invigorated and the exercise will pump the endorphins around your body. You’ll also feel a great sense of achievement. There is a load of scientific evidence supporting exercise to improve mental health. Only yesterday the Chief Medical Officer, Chris Whitty was advocating the use of exercise and said he couldn’t see a scenario where exercise would be bad. 

If you’d prefer to exercise indoors then YouTube is a free resource with thousands of free workouts for you to try. There’s everything from yoga to Pilates to bodyweight instructor lead workouts. You can even type in the duration of the workout you’re looking for. Personally, my favourite is the YouTube channel Yoga with Adrienne as I can choose the duration to fit in with my day. There are also local Colchester trainers who offer online workouts. For a bodyweight workout if would recommend Gabriel Beckett at GB BootCamp. The lovely super awesome Andrea Jane Evans offers fun boxing workouts suitable for just about everyone.

https://www.facebook.com/groups/538476933205618/

https://www.facebook.com/andrea.j.evans.9

The main thing is to stick to a routine. Exercise the same time each day if you can and preferably outdoors to get that zap of Vitamin D. If you can get your kids or partner to do it with you then you’ll have more chance of making it a habit and sticking to it.

Eat Healthy

Try to aim for a diet that is colourful and packed with nutrients.

If there’s one excuse I’ve heard over and over then it’s “I’ve not got time to make healthy food.” Now is the time to make that fruit salad with your breakfast or that smoothie as a snack. Eating a healthy diet is like exercise. You need to build it up slowly. Start by drinking a bit more water and a few pieces of fruit and vegetables per day. Your digestive and immune system will really thank you for it. There’s nothing sexy or complicated about this advice but its evidence based and most people I see don’t hit five portions of fruit or vegetables per day. When we make healthier food choices then we begin to feel better with ourselves. 

Embrace Stillness

Taking a few minutes out for ourselves allows us to recharge out batteries.

We have been constantly bombarded with articles in the media about making the most of the time to learn a new skill. If you’re lucky enough to find ten minutes in the day to sit still and relax then embrace this time. Take time to be mindful of your thoughts and what you’re telling yourself. Don’t let this internal dialogue run away and cause you to catastrophise over something you cannot change. 

At the same time I’m promoting movement and exercise try not to fall into the dark guilt trap. It takes a lot of motivation to get up and get moving. Especially if you’re in pain or have a mental health problem. If you miss a planned workout don’t sweat, it and beat yourself up. Be kind to yourself and try again tomorrow. 

Reach Out If Required

Be brave and reach out to someone if you need help.

If you are feeling down, lonely or isolated then don’t be afraid to reach out. Mental health issues do not define you and it isn’t who you really are. The sooner you make contact with someone the sooner you will be on the road to recovery. You are not weak or a failure. In fact, by asking for help you are being braver than you can ever imagine. Talking is a powerful tool in rationalising mental health problems. 

You may want to speak to a close friend or someone you can trust. They can help sign post you to the right person. Often with mental health people don’t think they are worthy of a GP appointment. They can help book appointments for you and even accompany you for moral support. 

Be brave and talk. 

Stay Social

Humans are very social creatures - stay in touch.

 Social interactions are part of every day life. However, with this lock down we are distancing ourselves from most physical contact. . There is a human need to be part of group and accepted in society. Dysfunctional social behaviour has been implicated with depression and other mental health disorders. This is the time where we really do need to make the effort to pick up the phone or FaceTime that person who’s fell off the radar. If someone is telling you they’re fine but their behaviour contradicts this then keep an eye on them. Offer them an invitation to an online chat or quiz night but also be patient if it takes time for them to take you up on an offer.

It’s so important that we don’t just look after ourselves physically but mentally too. By practicing these simple self-care tips you can not only improve your own health and well being but you might just help somebody else too.

These are questions patients often ask. 

1. Do I need to get undressed?

At Shaun Tyler Osteopath I always try to protect your modesty. I often ask patients to bring shorts to change into if they have low back pain or hip, knee or ankle injury. If it is a neck or upper back problem I ask for you to change into a vest. 

2. What is the cost?

The cost of each session at Shaun Tyler Osteopath is £45 per session. The first session is 60minutes and follow up sessions are 45minutes. We accept cash or card. 

3. I'm a little nervous can I bring someone with me?

Of course anything that makes you feel more relaxed. Shaun actively encourages patients to bring along a friend or relative. 

4. Will I be expected to do exercises?

In a nut shell, yes. Every patient Shaun see's is given an exercise and a plan to follow. Shaun is a big believer in self-care and empowering his patients to manage themselves. Advice might be about taking breaks from your desk to manage neck pain to using eccentric exercises for Achilles tendinopathy, to adjusting your load and frequency while training for a marathon. You'll be given a written plan that you can download to your phone with video’s on how to follow the exercises. 

#colchester #osteopath #abbeyfields #essex #colchesterosteopath#physio #runninginjury #lowbackpain #shoulderpain #painmanagement