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Guidelines to injury prevention and improved trail running performance – Dr Hilton Lazar

Guidelines to injury prevention and improved trail running performance – Dr Hilton Lazar

“Running is an art, like painting a picture or composing a piece of music. For running to be like art one needs to be clear about 5 basic concepts: technique, effort, talent, inspiration and the correct structural integrity of the movement systems of the body. All this must be combined in dynamic equilibrium and fed into the body through neuro-musckulo-skeletal system to produce what should be the beauty of efficient running.

Due to our current modern day evolution into desk warriors a huge portion of our day tends to be spent in static positions which tend to become habitual, consequently affecting our movement quantity and quality. This translates into a quagmire of difficulties when stressing our bodies during a highly dynamic movement task such as trail running. The result combined with a run at all costs attitude results in injury and disappointing performance.

The most common types of running injuries are those as a result of overuse to soft tissue structures primarily tendons, ligaments, adjacent joint surfaces and joint capsules. These structures cannot meet the demands of the stress they have been exposed to as a result of excessive volume or poor mechanical function and motor control (control of the brain over muscles).
So what can be done to combat the above conundrum?

Since we can’t all be in the Chiro/Biokineticks/Physio’s rooms daily, the ideal way to maintain the body’s ability to manage the stress of trail running is a self-care program. The following standards listed below are fundamental in maintaining your body to meet the demands of the sport.

1) Happy Feet.
Making it a daily practice, whether standing, walking or running to be in a position whereby your feet are not flared out like a duck or turned inward (pigeon-toed). It may seem unrelated to think of your foot positioning as an indicator to potential injury but if for example your feet are splayed outward, the joints and surrounding soft tissue structures have to take up the additional slack with regards to gaining the correct range of motion and stabilization. What this does is puts the joints above the feet into bad positions and can slowly erode the soft tissues supporting and surrounding them eventually leading to pain and swelling (think MCL/Meniscus injuries at the knees).

2) Awesome Ankles
Range of motion at the ankles is fundamental to happy running. Limited range of motion is a huge cause of poor running form. Limited movement at the ankle is a big causative agent in 3 of the most well-known running complaints namely plantar fascitis, achilles tendonopathy and the dreaded shin splints.
So what can be done to maintain supple ankles?
A biggie is keeping the tissue upstream (above) the ankle supple, by creating slack in the tissue it provides additional slack around which the joint can move. There are a few ways this can be achieved:
1) Using a self myofascial release tool such as a lacrosse/hockey/cricket/trigger ball, by using it as a tacking mechanism and flossing the underlying tissue between the respective ball and the weight of the leg, achieving the flossing mechanism by moving the whole foot such that the toes point up and down.
2) By applying a voodoo floss compression band or an old bike tube rapped around the joint like a bandage keeps all the soft tissue around the joint supple and sliding correctly as well as adding a joint separation force opening up the ankle joint.
Below is a nice link explaining how the floss band works

3) Hips that hinge
Due to the sitting position we adopt for a large percentage of our day which results in a tight immobile hip capsule which mold to the position that we spend time in. If we consider the body as a whole host of systems functioning within a bigger system the hips can be the root cause of many dysfunctional movement mechanics throughout the body.

Increases in running volume tend to produce tight hip flexors, which then puts the knees at a mechanical disadvantage and causes havoc at the knee joints. Maintaining supple hips is vital for both the performance demands and painless running in both the lower back and the knees.

A great way to keep hip joints open and moving nicely is to apply a traction like force, which forces the joint capsule to stretch. This has a twofold effect in that the joint will be opened up and the surrounding muscles will also have to stretch.
How is this achieved?

Standard stretching poses can be performed with a power band (think big rubber elastic like band) slung around the hip joint and around a fixed point. The tension developed in the band creates the traction required to separate the ball and socket mechanism of the hip joint.

Below is a nice explanation of how to perform the above

4) Warming up and cooling down
The warm is very important in that it primes the nervous system for task ahead and it warms the muscle and connective tissue systems as well as getting the correct lubrication within the joints. It allows the lymphatic and circulatory systems to serve their function. Runners that train and then don’t cool down are essentially shutting down their lymphatic system which in essence removes all the nasty by products of running and sets the stage for poor recovery and increased risk of future injury.
A great tool for warming up and cooling down is via the use of a skipping rope as the skipping action closely mimics a running action, I like to think of it as the equivalent of the rollers for a cyclist

5) Hydration:
Everybody harps on about how important hydration is but no one really seems to take it seriously. It is a delicate balance getting hydration rite in that too much or too little can hamper performance and promote injury. Considering that 80 percent of our bodies are made up of water and most metabolic process use water as the basis of which they work it makes sense that adequate hydration is very important. Considering that a sport like trail running has high metabolic demands it would make sense that water is a vital part of performing well. From a structural perspective water is a huge component of the fluids that bathe our joint surfaces which provide shock absorption and allow for smooth sliding of different muscular layers against one another. Thus if inadequately supplied it will cause a lack of shock absorption capability (think about sore knees post run) and the lack of sliding between muscular layers can setup adhesive bands (think hotspots in the muscles).

6) A supple mid-back
A lot of discussion over the last couple years has gone into core strength and stabilizing the lower back so that it doesn’t hurt when running. A big player in the cause of lower back pain is a thoracic spine that doesn’t rotate or extend properly, which intern sets up poor breathing mechanics and forces the lower back to do more work. A nice analogy is that in a normal day on average we would take approximately 10 000 steps, imagine that now the spine has to manage its functional loading and then take up the job of the mid-back. The results are going to be a tight, immobile and painful lower back which then has a knock on affect at the hips, knees and ankles. Apply the above analogy to a trail runner and the end result seems inevitable that back pain and limited movement is bound to creep in at some point.
Thoracic spine mobility drills as well as self myofascial treatment are your best bet in maintaining a healthy thoracic spine.
Below is a link by Kelly Starrett (supple leopard) and Jill Miller (Role Model) of some strategies to maintain a supple thoracic spine.

The above standards are some of the primary areas that trail runners should focus on yet in the grand scheme only a small taste of some of the homework that can be done to maintain high performance standards. Athletes have a personal responsibility to perform daily maintenance. Maybe you only have five or 10 minutes to do it, but such a dose, performed consistently, can have hugely positive effects on your performance and improving your life.
Move well and move often

Dr Hilton Michael Lazar (M-tech)(Chiro)

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Dr Hilton Lazar

Dr Hilton Michael Lazar (M-tech)(Chiro) at Ultrarunner_ZA
I graduated with a masters degree in chiropractic. My passion for the outdoors and sports translates to all areas of my life. I am passionate about trail running and the dynamic nature it and thus finding ways to provide sustainable solutions in the prevention and management of injuries encountered as a result of the sport. I am also passionate about providing solutions to my patients that allow them to take the power back and manage themselves through solid education and homecare solutions.

Dr Hilton Michael Lazar (M-tech)(Chiro)
Contact details:
Email Address: Hiltlazarchiro@gmail.com
Contact No: 072-231-7300
Practice Address: 1 Woodyatt Ave, Cnr Woodyatt and Hilson Road, Highlands North,Johannesburg 2192
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About The Author

I graduated with a masters degree in chiropractic. My passion for the outdoors and sports translates to all areas of my life. I am passionate about trail running and the dynamic nature it and thus finding ways to provide sustainable solutions in the prevention and management of injuries encountered as a result of the sport. I am also passionate about providing solutions to my patients that allow them to take the power back and manage themselves through solid education and homecare solutions. Dr Hilton Michael Lazar (M-tech)(Chiro) Contact details: Email Address: Hiltlazarchiro@gmail.com Contact No: 072-231-7300 Practice Address: 1 Woodyatt Ave, Cnr Woodyatt and Hilson Road, Highlands North,Johannesburg 2192

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