Making People Better
Making People Better
The Runner's Guide to Injury Prevention and Boosting Endurance
Unlock the secrets to injury-free running with our latest guest, physiotherapist Matthew Riggs. A seasoned expert with a keen understanding of sports physiotherapy, tackles the 'weekend warrior' phenomenon, exposing the dangers of ramping up exercise too quickly. He doesn't just highlight the problems; he offers solutions, equipping runners with the know-how to steer clear of common mistakes.
As we lace up for this episode, Matthew imparts wisdom on the vital muscle groups every runner should focus on that could turbocharge your running resilience. So, whether you're just starting with the NHS's Couch to 5K app or you're a marathon veteran, join us for a conversation that's all about pacing yourself to peak performance and ensuring that every step is a stride toward enduring health.
Enjoy a moment of relaxing calm with the Vita Health Group well-being series of podcasts to make you feel good, keep you healthy, help you make changes to your life. Vita Health Group is an award-winning market leader and has been at the forefront of healthcare for the past 30 years. Vita Health Group Making People Better.
Speaker 2:Yes, hello and welcome, and time for another of the Making People Better podcasts with Vita Health Group. This series explores the challenges of everyday life with a focus on mental and physical health and well-being. I'm Glenn Thompson, your host on these podcasts, which we hope you find useful and informative, and I'm joined on each episode by various experts in their chosen field. I'm joined by private physiotherapist Matthew Riggs. Matthew's with us in the studio. Good to see you, matthew. How are you doing? Yeah, good thanks, glenn. Thanks for having me on Pleasure Nice to meet you. Before we get into the nitty-gritty, tell us about yourself. And you're a private physiotherapist. That sounds very grand title, doesn't it?
Speaker 3:A little bit. I went straight into the private side. So I grew up in Australia, originally moved over here about 10 years ago now. Initially I was just doing stuff which isn't even related to physio. I was just focusing on sports, working in the football industry, and then decided that I wanted to pursue more of that career sort of driven path and wanted to help people out.
Speaker 2:So physio was the one that screamed out to me the most what is the attraction of being a physiotherapist then? You're sort of dealing with all sorts of aches and pains and fractures and goodness knows what else. What's the?
Speaker 3:attraction. It sounds cheesy, but I guess you just have to enjoy helping people. Really, that's the biggest thing. Every day you see a different sort of group of patients, you see different people. You meet different people. You're trying to help people get better, no matter what that problem is. Unfortunately, sometimes we can't help everyone, but that's when we know when to send them away.
Speaker 2:I know 8th of September 2024, next year, is World Physio Day. This is something that happens every year, isn't it?
Speaker 3:I believe so. I think it's relatively recent record, but yeah, it happens yearly.
Speaker 2:Now I know you want to focus a lot on running injuries and what have you. We'll go through some of those today. But if you're out running and you sort of have a bit of an injury, you slip or you pull something what are the common causes of running injuries then?
Speaker 3:The biggest cause for running is mainly an issue with your training. So normally you're trying to overload, you're trying to do too much too quickly. So I mean, the biggest one's weekend is. We call them the weekend warriors, so all the people who they work nine to five Monday to Friday, and then on Saturday, sunday, they decide to go out and try to run a marathon over every weekend and it's just, it's just too much for the body to handle. So it's good to break it up a little bit.
Speaker 3:Generally speaking, like normally, if you have a previous injury as well, like you're more common to, to re-injure that area or areas around that as well can, sometimes at a higher risk of causing another injury. Muscle imbalances is another big one. So if you have that set, so your quads on your front are really strong and quite loose, whereas your hamstrings quite tight and and not as strong, then you get injuries that way as well. And then obviously you get the ones where you just just run and roll your ankle, just a bit unlucky, and you get all the other things like age, gender, higher BMI, those sort of things as well. So yeah, they're probably the biggest ones.
Speaker 2:Do you think it's a lot? You mentioned the people that are in the office all week. They're working all week and suddenly they go out of the weekend and have a bit of a run and what have you. Is a lot of it down to the fact that they're just not wearing the right gear, they're not prepared, so they're not doing the right sort of training beforehand the warm-up exercises. Is a lot of that attributed to the fact that they may be coming up against injuries?
Speaker 3:I mean, it's probably not necessarily down to the gear itself. We were going to talk about footwear anyway, but we can talk about it now. Yeah, the biggest thing I normally suggest with footwear, like we get that. A lot people come in. They're just like Matt look, I've been changing my shoes recently and I can't find anything that's working. I keep getting injuries. My go-to is just you need to be comfortable while you're running, really, so if your feet are feeling uncomfortable in a certain type of trainer, then it might be worth changing them. If you change shoes recently and it's causing an injury, then it might be worth changing anymore. Going back to what you were wearing. But yeah, the biggest thing and and then what the studies have suggested is, it's just all about getting footwear that's comfortable and obviously, yeah, trying to stick with a similar sort of shoe and not trying to change it up too much.
Speaker 2:And you hear about some stretching, and what have you doing the prep before you start the run? I mean, is that important?
Speaker 3:Yeah, 100%. Again, it's something that's been studied a bit more recently as well. But a lot of people like, when I give the advice to do more of an active warm-up beforehand and then stretch afterwards, a lot of people think like, oh, shouldn't I be stretching before as well? But yeah, a lot of the studies recently suggested doing stretching beforehand actually reduces muscle strength and reduces muscle endurance. So that's another thing that people like. They try to do the right thing, obviously, and they're trying to stretch and everything.
Speaker 3:But if you do more of an active warm-up beforehand so I mean if you just go on a run the simple way to do that is just start off with a brisk walk, build that up, do a few high knee raises, heel flicks, that sort of thing, and then get into your run. And then afterwards is when you focus more on that stretching and things. So I think that active warm-up is always one that tends to get missed. I see a lot of people stretching, but yeah, not not so many people doing the active warm-up. So that's probably one of the bigger ones.
Speaker 2:I guess To the warm-up's important, as is the call down at the end, I guess.
Speaker 3:Yeah, yeah. So getting all your muscles. Obviously you've just put them through a bit of a workout, so making sure they're they're able to get through that and, yeah, stretching them out, making sure they're they're feeling good.
Speaker 2:So you see a lot of injuries I'm getting in clinic. What are the most common ones you're seeing? We?
Speaker 3:see a whole, a variety. So, yeah, I treat more than just running injuries as well. But yeah, just in terms of I mean your general ones, we get lots of like unrelated to running. We get lots of like back, knee, shoulder pain. They're probably the three we see the most. And then, yeah, in terms of running itself we probably see. So you get like your anterior knee pain, which is like layman's terms, kind of like your runner's injuries, or your runner's knee tendonopathy is always a big one. So when you get pain, normally it's around your Achilles is when we see that the most. Then you get your muscle strains normally, again normally calf related, but obviously it can be, can be anywhere, so generally in the leg, so hamstring or quads as well. Plantar fascia is another one we see which it's just a real annoying one to treat.
Speaker 2:And how do you treat those man? What do you do? I mean, you know, put a cold compress on them. And what do you do exactly for the plant of Fascia?
Speaker 3:Yeah, essentially, the more you can load, the better it's gonna be. So I the way I like to describe it is almost like your muscles around it. So, yeah, your calf is always a big one which attaches into your Achilles, which then runs down underneath and then the plant of Fascia kind of like merges into that. So the biggest thing is getting your calf muscle as strong as it can be and as as flexible as it can be. In terms of the plant of Fascia itself, there's a variety of different studies.
Speaker 3:Like you can try stretching it out, you can try rolling it, you can try icing it, which I normally do suggest to do those things. But some people it works, for some people it doesn't. So I normally suggest you a try try rolling the bottom of the foot, Try icing the bottom of the foot on top of the other things that we just said. And, yeah, if it works for you it works. If not, just focus on the strength and the loading and then if that doesn't work, then we've got like some other things. So we do shockwave at one of our clinics now in Crystal Palace, so we offer that for plant of Fascia. If that doesn't work, then you kind of go down the injection route. So obviously we don't want to get to those things, but there are options out there if it is something that goes on for like Six to nine months and it's just not getting any better than. Yeah, we do have things up our sleeve that we can, we can work with run into, okay, a typical, you know average Strain or fracture.
Speaker 2:I mean, I know everybody's different, but you know, in terms of repair, how long does that teach us will get better?
Speaker 3:so like muscle strain itself. You're looking at by the book, at something that's six to eight weeks. I normally be a bit more hesitant. I normally say about eight to twelve weeks, and that way if someone's better in six weeks, they're like oh, he's doing a great job, he's got me sorted earlier. So, yeah, I like to be a bit more on the safe side when getting those sort of things out.
Speaker 3:In terms of Fractures. So the biggest thing with running is stress fractures. Normally, if we suspect it, you get, we get send your straight off, get a scan done and normally then you're in a boot for I think it's about a couple of months and then after that it's just all about rehabbing after that, making sure everything's strong around it and getting you back running as quickly as you can really. So they're the normal ones. Plenty fascia that, as I said it's it's a real annoying one. It can take I mean, some people struggle with it for like 18 months, so that's more one. You have to have that chat with the patient and say like, look, it's not something that's gonna improve overnight, but we can do as best as we can really, absolutely.
Speaker 2:Let's talk about the common training errors then, matt, and tips as well on injury prevention. What can you offer?
Speaker 3:normally in terms of loading is like the biggest one. So what you want to try and avoid is essentially like sudden increase in your running. So I said like with the weekend worries there, not doing anything throughout the week, and then they're running a lot on the weekend, I guess that's also putting an extra strain on your body, isn't it?
Speaker 2:if you know, if you're sort of sitting around pretty idle or weak at a desk or something and suddenly you're going out at weekends, it's, it takes a stress on the body, isn't it?
Speaker 3:Yeah, exactly that. Exactly that, like you're putting more stress on it. It's obviously, if you're doing it, like it's fantastic to be doing exercise on the weekend, don't get me wrong. But yeah, it's about getting that little bit of a balance. And even if you're doing like your bigger runs on the Saturday and Sunday, that's fine.
Speaker 3:But if you're doing like just some smaller runs on the throughout the week as well, just to just to get yourself moving and keep moving, he's obviously a big one.
Speaker 3:So yeah, and then in terms of if you're leading up to say you're training for like a half marathon or a marathon, so you really want to be increasing at the right sort of loading as well. So obviously you don't want to be starting off running like 1k, then jumping up to 5k, then jumping up to 20k within the space of three weeks. So what I normally suggest is to try and stick to about a 10% increase in your training load per week, which we do have. I normally we've got this little calculator thing that, if I mean, some people are really, really into tracking their runs and everything like that, so we do have a little app that they can use to do that and then that gives you an idea of how much you're increasing your running plan, everything like that as well, which, yes, as I said, some people love it because they love checking it, runs and everything. Other people are just not interested at all, which is absolutely fine, but, yes, as I said, like 10% normally what we recommend, but yeah, it's always around.
Speaker 2:That is what you want to try and increase that you do see a lot of people jogging and running and this they're sort of putting up with a bit of pain, aren't they? They sort of you see them reaching down to their calf muscles, and one have you, and they've stopped off to have a bit of a drink and a a rub of the back of the leg, and one have you. But a lot of people actually do Put up with that pain, don't they? And they carry on running. What would you say to those sort of people? Get it sorted.
Speaker 3:I mean ideally you'd want to come and check it out. I mean a little aches and pains are common. Everyone gets aches and pains. So I guess it's that little bit of a when to see someone and when it's fine, which is obviously quite difficult thing to do. But if it's something that, if you just have one run and you feel, let's say, like your calf muscle just feels a little bit tight, you're able to run through it, it's fine, it doesn't really come back, then you're probably good. It probably just had a slight sort of irritation that day for whatever reason. It was a little bit tighter.
Speaker 3:So I'd probably suggest, in terms of come to see someone, it be when you're getting Consistent pain which is sort of you going on like, say, you're running four times in a week and every day you've gone for that run. That pain is there and it's a similar type of pain. That's obviously a time when you wanna look it to try and see what that is. A lot of the times that we see people which I mean it's not too late, but essentially they've had that pain now for already like a month or two months and they've been putting up with it and obviously that the longer an injury goes on for, the slightly longer it takes them to recover, so More damage it can do as well. I guess, like if you're running on a calf strain for example, like the more load you keep putting through that, the more slight little irritation and slight sort of tears you can get in that muscle as well. So, yeah, I guess it's sort of finding that balance between something that is really painful versus something that's just a little bit irritated at the time and getting it checked out. Yeah, they're probably the biggest ones in terms of your little injuries, obviously, like the big things, the big things that we look to avoid.
Speaker 3:Particularly if someone's building up to their like a marathon or a half marathon, then you want to try to avoid those stress fractures. So they're the ones that we want to catch as quickly as we can, because then that way they'll be obviously offloading as quickly as they can as well and be back to running quicker. And I guess the biggest thing sort of with that is looking for sort of like pain that starts and gets worse during your run, like versus like a tendon pain, for example, whereas that will be probably uncomfortable initially when you're starting running and then as the muscle and the tendon warms up, the pain will probably ease and it will probably might even go away completely, and then towards the end of the run it'll be quite painful again, whereas for a stress fracture, that just gets worse pretty much throughout the run. It's there the entire time. That's one of the indicators that we look at.
Speaker 3:If you have any sort of swelling is obviously another big one. Night pain is obviously a big one as well. Like if you get a night pain, I'd probably get into see someone. You can get night pain with tendonopathy as well, but if you're getting that, it's just better to be safe, just better to check it out.
Speaker 2:Better safe than sorry. Great Thanks for that, matt. So let's talk about the importance, then, of strength and conditioning now, then in running, and also some key muscle groups and exercises that we can do.
Speaker 3:Again, I think that's a big one, a lot of runners. When people come in and they're injured, one of the first things I always ask them is about their like how far they're running, that sort of thing. But if they're doing strength and conditioning on top of that as well like a lot of the times we see people come in with injuries they're not doing enough strength and conditioning. They might be doing a little bit, but ideally you want to be doing at least probably two sessions of strength and conditioning a week. I'd say so in terms of just not like purely statistical. So there was an analysis done in I think it was 2013,. It showed that strength and conditioning in the key muscles reduced the injuries by about 50%. So it's a significant number that if we can make that a bit more well known to people that you need to do a little bit of strength and conditioning, then it's going to help people really.
Speaker 2:What about something we haven't touched on, matt, and that is we discussed footwear and what have you, and the clothing you should sort of wear, what you should eat and drink before a run? I mean, that's important as well. Don't go out on an empty stomach, but make sure you're well hydrated. So important isn't it?
Speaker 3:Yeah, exactly, I mean hydration is key for feeding muscles, similarly with food. I mean, if you look at sort of like the professional top athletes, they're probably eating carbs about two hours, two and a half hours, before they go for a run and things like that. But yeah, I'd say like the biggest thing is hydrating well before and after your run. Obviously, you sweat a lot while you're running. You're going to lose a lot of water, so it's about hydrating afterwards as well and then getting probably straight after your run, just fueling up a little bit, just whether that be like a banana or just like a breakfast bar or something like that, just to get a little bit of something back in you. But, yeah, definitely, as you said, like it's really it's important to do.
Speaker 2:I'm guessing also, you see a lot of injuries from people who literally go headstrong into it. They think to themselves, right, I need to get some exercise in, I need to start doing some running. They go headstrong into it and try to a long run. At the very start of their running career, if you like. Like anything in life, you start off with small amounts. You work up to that, to that longer run, don't you? You must see a lot of that in your, in your sort of line of work, and a lot of people come to you with injuries because they've never really run any great distance before.
Speaker 3:Yeah, you're exactly right. I think, again, they're trying to do the right thing, but it's just they're trying to go too far too soon. So I mean, I use it as a recommendation for not only like running injuries, but even just returning to some sort of sport, like the catch to 5k that was released by the NHS is. It's a. It's a fantastic app and even if, like, if you're at a reasonable level of fitness already, then you can skip week one, go on to week two, if that seems a little bit easy, then go on to week three.
Speaker 3:But it's a great app because it gets that little bit of a training load mix in there as well. So you're doing a little bit of faster running, you do a bit of walking, you do a little bit of jogging, and that's important to get into your exercises as well, and it does keep that sort of incrementation as a as you're running and as you're increasing it. It keeps at a, at a level where, again, you're unlikely to pick up an injury. So, yeah, 100%, I think using something like that is important. It can help, and I do think that, yeah, some people might just be going a bit too bit too far too soon.
Speaker 2:Absolutely. I mean, you had some great training yourself, didn't you? You had a great sort of playgrounds in Australia, moved to London. What, 10 years ago, grew up in Australia, were you literally running along the coast, the Gold Coast.
Speaker 3:Yeah, sunshine Coast. I can't say Gold Coast, that's our rivals. Sunshine Coast, don't worry. When I had it out, yeah, I used to be out running from. My parents now live in a flat about five, 10 minute walk from the beach, so yeah, I used to do my little bit of a warm up as I got down there and then run up and down along the coast and then go for a light swim afterwards. This is my warm down. So, yeah, it's a fantastic setting. Absolutely Can't really get that in London, though.
Speaker 2:Okay, great Thanks, matt. Muscle groups. We haven't really focused in on muscle groups, then. What are the key muscle group areas that people should be thinking about and working on and training?
Speaker 3:Yeah, so for running in particular, it's generally going to be a lower, lower half, starting from the core down. Like the core is a really important one, so like it gets missed a lot again while you're running, but it's really important because it's maintaining your lumbar and pelvic stability so while you're running. So if you have a weak core, you're probably going to have a bit of a different running style and probably more linked to it to an injury. So that's always a big one. And then work any way down, obviously, like the glutes are really important ones, so they're like a key shock absorber in the response phase, so sort of like as you, as you're loading, working on sort of around like the lateral side of your hip as well. So it is another big one. So a lot of people do strength, sort of going just forwards and backwards, but you miss sort of those hip hip abductors as well. So that's always a big one to get in is just to help with going back to some injuries Like ITB pain is another big one which runs down the side of the leg and if you're strengthening up that area it's going to help prevent that.
Speaker 3:So that's obviously a key muscle group as well. And then comment down into the legs are more like your hamstrings and your quads. So hamstrings are important and again, it's something that's probably under trained in the way that it needs to for running, because there's a lot of the times when you're doing exercise you're exercising a muscle concentrically. So when you, when you're shortening that muscle but a hamstring while you're running, it does the most work going eccentrically because it's controlling your leg going forwards. So doing eccentric exercises to help your hamstring will will help a lot.
Speaker 3:It's supposed to be quite an easy exercise on paper but it's really quite difficult. Exercise which is a good one for the hamstrings will be the Nordic hamstring curl. So essentially you're kind of you're on your knees and you're gently just trying to lower your upper body down. So if anyone wants to give that a go at home, it's. It's a tough exercise. I'm taking my position. What laying down on the floor, is that what we do? So you want to be like on your knees, ideally if you can have someone holding your feet, or if you have something like if you just hook your feet underneath the table, like a kitchen, like a coffee table, for example, and then, yeah, you want to keep your upper body pretty straight. You just want to slowly lower your upper body down forwards.
Speaker 2:Okay, I'm not actually doing it, but I'm visualizing myself doing it. I will do it after we've recorded the podcast.
Speaker 3:Yeah, it's a tough one. It's a tough one. And how often should you do that? It depends on what you're sort of trying to load, really. So like if for runners in particular, they're going to work more on muscle endurance, so you probably want to be doing less sets but higher reps. So with any of the exercises, really, probably, if you aim to do about two sets of sort of, about anywhere between like 12 reps up, okay, it's probably a good step. But if you do find as though you feel more weak and that muscle is weaker, then you want to be loading that muscle heavier. So you want to be doing higher sets. So three to four sets and lower reps but a higher weight, trying to find out whether that muscle is weak or whether it's lacking endurance and trying to focus on that.
Speaker 2:And is this something you do daily, on a daily basis, seven days a week?
Speaker 3:I normally suggest like day on, day off, so every other day, if you're doing it with your running, so it's good to have rest days as well. So I'd normally suggest to do so. Again, say, you're running four times a week, you probably want to do two strength and conditioning, so that's six days and that gives you a day off, even if you're doing like running three times a week to strengthen conditioning. Two days off, that's probably a good mix as well. So it's always important to have that day off and allow your body to rest and recover. But yeah, the strength and conditioning bits obviously important.
Speaker 2:I'm going to ask you a question that I asked my son because he's a marathon runner. He's done the London Marathon, paris, he's done Edinburgh, he's done the goodness knows where else. Got to keep marathon runner. He's a serious marathon. I ask him what makes you keep going that distance? I mean, what is your? What is your goal is obviously to finish, but what keeps you going? I mean you've obviously done this yourself. What in your mind keeps you just running all that time?
Speaker 3:You do hit a wall like everyone will hit a wall during a marathon the London marathon, for example is the crowd around you and everyone, like whenever you're starting to feel like you are hitting that wall, almost just slow down a little bit, just have a look around you and actually just realize where you are. Look at all the support that you've got, and there's always people around you to support you. Like doing a marathon, like all the runners that do it as well, they're in the same boat. If you're struggling at a point, there's probably going to be someone else struggling at the same point. So even just having a bit of a chat to them while you're, even if you have to drop back to a walk, it's fine. Even if you have to drop back to a slower run, it's fine, the wall will go, you'll knock it down and then you just keep going after that. So, yeah, it's all about having that support there and getting yourself through those tough bits.
Speaker 2:I'm on the couch to 5K at the moment. I'm not anywhere near marathons and I'm only on week three, I think, at the moment. But I've got. I'm lucky. I live on the coast so I've got the beach near me and I can run it down the beach in Kent, so it's not so bad In terms of how Vita can help people. Vita Health Group. When it comes to physio, what do you offer?
Speaker 3:Personally, I'm based out of two clinics, so I mean Crystal Palace a few times a week and then we've got another clinic in technically in bad assy, but I mean it's more club and junction and that's called physio for all. So at both the clinics, like we do running assessments, we do obviously a full assessment of injuries and things like that as well. Give everyone advice, education, any sort of tips and tricks as well, sort of as we're going. But yeah, like the running assessments are really really good one, I find it quite beneficial and again, if you're a keen runner, having a professional sort of look at your running style and give you any tips on that can help as well, Vita offering all that help.
Speaker 2:So website details coming up in just a moment If anyone wants to get in touch with you directly. Matt, what's the best route? Yeah, best route.
Speaker 3:I mean, just drop me an email which would just be Matthewrigs.
Speaker 2:so m a double t h e w dot rigs r I double g s at v h g dot, co, dot, uk All right, it's been great talking to you, matt, and hopefully we can maybe lengthen it and broaden it out to a different aspect of physio again, maybe in the future on a future podcast. Be great to talk to you again.
Speaker 3:Yeah, it's been a pleasure. Yeah, I'd love to come back on. I mean, as I said, we treat everything so I could always come back on and talk about any other type of injury Brilliant.
Speaker 2:All right. So private physiotherapist Matthew Riggs. Thanks for joining us right here on the Vita Health Group Making People Better podcast, and do check out the other episodes in this series, which include men's mental health. There's fatherhood stress management exam stress as well. We take a look at that. Also the menopause and a lot more. Simply search Making People Better where you get your podcasts. I'm Glenn Thompson. Thanks for your company Until next time. Thanks for listening.
Speaker 1:Thank you for listening to this Making People Better podcast, part of the well-being series from Vita Health Group. Improving your lives, physically and mentally, drives everything we do, and getting you back to doing what you love is our priority. Vita Health Group Making People Better wwwVitaHealthGroupcouk.