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Injury Prevention

The reversibility factor can be a thorny problem in the side of any athlete who ignores early signs and symptoms of illness or injury, indeed with planning and forethought a great deal can be done by the coach to ensure a minimum loss of training days throughout the year.

So what can a coach do?  The following list gives you an idea of some of the areas that a coach should examine so he can be wise before the event:

  • In the first instance an athlete’s past injuries need to be known
  • Close scrutiny to his running action is necessary
  • Incorrect technique - same leg lengths?
  • Running shoes require checking for uneven wear - right type worn
  • Running routes need examination for camber and suitability
  • Flexibility factor is a key area
  • Warm up procedures
  • Optimisation of muscle and tendon strength
  • Calorific intake, balanced diet
  • Dietary supplements
  • Adequate fluid intake?
  • Over training, overuse injuries
  • Insufficient rest periods
  • Recklessness - descending

Coaches must have an enlightened view on prevention of injuries, and read extensively. Detailed information must be recorded at the time of injury and illness, so that future steps can be taken to avoid making the same mistake.

Although there are those injuries that happen by chance, many injuries can be prevented.

A typical injury that occurs each year to many athletes is the Achilles tendon’s inability to cope with the stress of a quick change over from a well-cushioned road running shoe to a pair of track spikes, or a low profile fell shoe.

Then there are those athletes who ignore early signs of a cold and continue with a quality session only to find themselves losing weeks instead of days.

Fell Running Injuries

The majority of injuries in fell running are of the lower limbs - fast descents require not only a quick eye and fast feet co-ordination, but well conditioned legs, with strong quadriceps and strong but flexible ankle joints.  The compromise between the requirement of a good range of movement, and the strength to hold a joint firm, is a balance that needs to be understood.  Many fell runners find when descending that their reflexes are sometimes lacking when trying to avoid those hazardous situations that can account for ankle and knee injuries.  Account must be taken of this lack of support that tired muscles give.  The knee joint in particular is susceptible over a period of time to excessive wear, and good control of the joint is imperative if the athlete wants a long career on the fells.  The ankle joint is ever prone to injury and should be singled out for selective conditioning.

Awareness of the extremes that fell running can inflict upon the lower limbs requires a coach to mount a preventive exercise regime that hopefully can help counter such wear and tear.

So What Is Prevention?

In the first instance it is building the strength and necessary flexibility into the legs to withstand the punishing regime that fell running can impose.

The 'Strength Conditioning' course (UKA) is a good place to start; knowing about strength development is essential before establishing a programme for your athlete.

For those coaches familiar with strength conditioning, there are many avenues to pursue in developing leg strength. The body weight approach is usually sufficient at first; with single leg squats supported by the coach a good starting point.  After this initial conditioning the athlete can undertake more formal weight training, with multi gyms and free weights.  When the athlete is fully conditioned the more intense sessions of plyometrics with bounding and drop jumps can follow.  The principle to follow for fell running in particular is the acquisition of leg strength without the necessity to gain large muscle mass.  This elastic type strength is more valuable for the endurance runner.

Supplementary strength work can enhance the natural strength gains associated with regular hill running.

The principle of developing power without an increase in muscle mass was the training regime practiced by Jonathan Edwards.  The idea is to activate the greatest number of muscle fibres at any one time. This can be achieved by working above 90% of max, and keeping the reps low between one and three.  The action of the lift has to be explosive, with plenty of rest in-between reps, this type of lifting will give an athlete the necessary power, but the provision has to be made to channel this power into specific movements applicable to the running action.  This can be done with resistance training, i.e. weighted jackets, reins, or hill work.  But good conditioning of movement patterns are required to increase the efficiency of the power.  Caution must be exercised if attempting to lift weight in excess of 90% max, a good technique is essential.  Preparatory work is required for a considerable period of time before this type of lifting can take place.

The straight leg extension on a multi gym or with single legs, (preferably with ankle weights) held so that the vastus medialis is put under strain, is possibly the easiest exercise to do, and yet is probably the most effective in protecting the knee.  Keep the knee locked out with the foot in the dorsi flexion position.  Do not neglect the hamstring group with suitable curls, and certainly plenty of calf extensions, starting on two legs and moving when ready to single leg lifts.

Although the knee joint needs to be protected with good muscle and tendon strength, it is usually the ankle joint that suffers the most injuries.  'Going over' on the ankle, is a common enough term within fell running.  Little is usually done to strengthen this area even though it responds well to stretch band conditioning.  The cheapest of all exercise equipment, stretch banding can be obtained in appropriate lengths for just a few pounds.  This simple piece of equipment if used correctly can give ankles a thorough workout in about fifteen minutes.  Three sets of twenty for each of the Plantar Flexion, Dorsa Flexion, Eversion and Inversion positions using the banding as resistance can create an excellent work out.

Strapping can be a useful means of aiding an ankle that is still not fully recovered, but is no substitute for good strength conditioning.

The flexibility factor plays a major role in resisting injury or encouraging it if there is little effort made by the athlete with this aspect of conditioning.  There are conflicting opinions on just how much stretching should be done and to what limits.  My personal experience is borne from the value I have seen gained from good suppleness, and cannot recall any adverse reactions from any athlete who had gained good mobility.

Massage has a major role to play both in the prevention and treatment of injuries.  There is nothing particularly difficult about giving a good massage to the calves or quads after a heavy session or hard race, there are many books available that can give the enthusiastic coach simple advice on how to proceed.  Obviously it is better to have some level of qualification, especially when dealing with injured muscles or runners of the opposite sex.  Massage for some people still appears to carry a stigma and their opinions need to be taken into account.  As a general rule always have other runners around keep away from young athletes unless their parents are there and their permission sought.  Better still to get an enthusiastic parent to do the honours.  if you feel at all doubtful then get the athlete to do self-massage.

On the general aspect of illness care must be taken to ensure that the athlete’s enthusiasm is not a negative factor that generates periods of over training with few rest days.  The conditions of Chronic Fatigue Syndrome, Glandular Fever and ME, with their debilitating affects, are unfortunately not uncommon.  Although a considerable amount of work has been done on the Post Viral Fatigue Syndrome there is little evidence yet that a cause or cure is available.  What is known is that the likelihood of catching it is more likely when the immune system is depleted after a particularly hard session.

It is important to remember that the Glandular Fever virus is highly infectious and can be passed on through kissing.

Maintaining a balanced diet, with close attention to pulse readings and sufficient rest, goes a long way in keeping the immune system in top up form.  Eating a snack of carbohydrate within twenty minutes of finishing a session is another important factor of guarding against depletion.  There is now a trend towards supplements, such as 'L Glutamine', Echinacea and antioxidant nutrients like ACE vitamins with Selenium, to boost the immune systems tolerance to fatigue, but a sensible running schedule with its levels of intensity interspersed with recovery runs is a sound foundation.

The whole area of preventative work is not an 'add on' aspect of conditioning, but an important integral part of a coach’s training programme, which if he learns with experience can be a very important one.

Norman Matthews © 2001-2004
Head Senior Coach
Horwich RMI Harriers