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Sarah Crisp, Physio at ESPH, Harley Street

Overcoming injury to achieve marathon PB

A year of fundraising for cancer charities

Late in 2015 I had the grand idea that in 2016, I would complete a year of endurance events to raise money for Prostate Cancer UK and Macmillan. The idea was that I would complete a minimum of one event every month. The selection criteria for the events were, firstly, that each event must present a challenge both mentally and physically, and secondly, I decided to try and chose events that I had never done before. Although I am predominantly a runner by background, I decided to vary the events, rather than basing the year entirely around running events, as I thought that there would be a much greater chance of injury due to the monotonous stress on the body.

The year of events has been quite varied and to date has included; a duathlon, a half ironman triathlon, 2 marathons, an ultramarathon, a 5km swim, 3 long distance fell runs and a 56 mile very hilly bike ride. Let’s do the maths… that means I have: ran over 600 miles, cycled over 1,800 miles and swam 80kms.

Training routine & injury avoidance

sarah swim analysisTo ensure that there was structure to my training, and reduce my injury risk by doing too much or too little, I sought the advice of a coach who put together a programme for me. The programme has been quite demanding, usually involving 2 run sessions, 2 bike sessions, 2 swim sessions and 2 strength and conditioning sessions each week. All was going well until I had a period where I was left to my own devices. My Masters dissertation got somewhat neglected during the first part of the year in the build up to the half ironman. As a result, I had to discontinue the coached programme to focus on completing my dissertation. Therefore during June and July, I was doing minimal training yet still completing demanding events.

Be prepared for the challenge or face the painful after effect

Ever the optimist, I was convinced I would get away with this…but I didn’t. I did what I would advise all patients against doing and completed an event which my musculoskeletal system was not prepared for. The offending event was Race to the Stones, finish-race-to-the-stones-july-clupa 50km off road ultramarathon along the Oxfordshire ridgeway. The scenery was fantastic and the day, despite my lack of appropriate training, went seamlessly. Unfortunately it was the two subsequent training runs the following week which resulted in significant left knee pain. I was devastated. How could I be so stupid? Having made it through a marathon, a half ironman and a 25 mile off road fell run earlier in the year completely unscathed, I had started to think I was invincible! Sadly not. On a 14 mile training run, I was in pain by 5 miles and had to stop by 11 miles due to the severity of the pain. I decided to rest for a couple of weeks and then retry. No success, the pain came back within a mile. I then started to panic…there was only 2 weeks prior to the next event, a 14 miles fell race, 6 weeks until a triathlon and worse, only 8 weeks until a marathon! I couldn’t run 2 miles, never mind 26.2!

Physio insights than self-diagnosis

kneeDespite being a Physiotherapist myself, it is impossible to get a true understanding of why an injury may have developed without input from others. My colleagues at ESPH Harley Street were fantastic! I had a full physiotherapy assessment, including a running gait analysis. They confirmed that the problem was with the patellofemoral joint (back of the kneecap) and felt that it was due to a combination of my slightly pronated foot posture and weakness in my gluteal muscles. From there I was provided with advice on appropriate taping strategies, and some temporary orthoses, both of which helped immediately. I diligently carried out a daily home exercise programme of strengthening exercises and foam rolling. Kindly, our Podiatrist Scott Corthine assessed me and provided me with some suitable orthoses for my running shoes to improve the position of my foot when running.

Getting back on track with professional physio guidance

In total it took about 6 weeks for the problem to completely resolve. Sensibly, I decided to swap the 14 mile fell race to the shorter 10km option which I was delighted to complete without pain. Whilst I was unable to run, I focussed on my bike and swim sessions to ensure I continued to develop my cardiovascular fitness. I was able to make a graded return to running over the subsequent weeks and was delighted to complete the marathon knocking 6 minutes off my PB to finish in 3hr 43. Furthermore, I have achieved the London Marathon ‘Good for Age’ qualifying time which means I am pretty much guaranteed entry in 2018. I could not have done this without the fantastic input from my Physiotherapy and Podiatry colleagues at ESPH.

Training plans & physio advice to prevent injury

I have learnt a lot from this knee injury. Primarily, sufficient training is imperative to injury prevention! Secondly, seeking professional advice in the early stages of injury can often accelerate injury recovery, therefore ask for guidance regarding any aches and pains early. Thirdly, it’s important to recognise when not to push through an injury. Taking the decision to complete the 10km run instead of the 14 mile run was a very difficult decision because I had said I would complete it for charity and not completing it somehow felt like I was letting people down, or failing in some way. race_0-805070152533294

However nothing is more important than your own health and ultimately we are all responsible for making our own decisions regarding our health. Finally the benefits of cross training to maintain cardiovascular (CV) fitness should not be underestimated. Prior to the marathon I only completed two long runs of 14 and 17 miles due to the injury which is far less than recommended, however I successfully managed to continually develop my CV fitness on the bike and swim. This is something that I would look to incorporate into future marathon training to assist in reducing the degree of stress on the body that is bought about by running high mileage.

Oh, and don’t forget to have some fun too! I added the Tough Mudder into my event calendar and had a fab day with my supportive work colleagues! Thanks guys!!!

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