Ring the changes in your running distance & pace to prevent injury

Change your distance, speed & terrain and help prevent injury. 

It sounds like an obvious thing to say but many recreational runners don't actually do this. We all fall into a routine of a set route perhaps to or from work or a set group of friends who like to play it safe and as a result, we end up recreating the same run week in, week out. 

Inevitably this will mean that you will be loading each stride in the same way and this in turn can lead to damage. However, if you change things about a bit you are less likely to end up with this problem . 

Try doing a shorter run but a bit faster, if you always road run, try an off road route or if you have the chance, if you run with a group pursued them to do try something a bit different. You might even discover you like it more!  r

With thanks to
R Mann, K Meijer, L Malisoux, R Brunner, A Urhausen, C Nuehrenboerger, D Theisen
Br J Sports Med 2014;48:632-633 doi:10.1136/bjsports-2014-093494.196
Abstracts from the IOC World Conference on Prevention of Injury & Illness in Sport, Monaco 2014

Pelvic floor control and Running

A different type of running injury! Can running cause and/or worsen pelvic floor dysfunction?

Running is a high impact activity as we all know, and for some who hit the ground hard and with poor technique this can add to their pelvic floor issues. The physical force that is associated with landing passes through the lower limb and pelvic floor rapidly as the foot strikes the ground and the ground reaction force is felt as the abdominal contents bear down on the pelvic floor. It can stretch the pelvic floor, especially if structures of the abdominal wall are not there to support it- such issues diastesis in the recti muscles (yes it can happen to men as well as woman!.)

Fortunately there are a number of steps you can take to improve your pelvic floor support for running:

*Perform regular daily pelvic floor exercises to optimize your pelvic floor strength and the support for your pelvic organs (including bladder, uterus and bowel).Increasing the tone and stiffness in these muscles leads them being able to with stand the downwards forces that running places on them.

*There are various devices on the market that your physiotherapist can help you with that can support the bladder neck and reduce leakage with exercise. Seeking guidance from a Woman’s health physio is a great start.

*Mix up the surfaces you are running on- i.e. trails and grass, as compared to cement paths or tarmac roads. More importantly changing the way you hit the ground and what your strike pattern is will have the greatest effect. More Ninja and less elephant! Shortening the stride length to reduce the amount you hit the ground in front of you and slowing down slightly.

*Avoiding running very fast down hill- as you tend to over stride and hit the ground hard, and stop running before your pelvic floor and abdominal muscles start to fatigue, putting you at risk.

*Other things that can help are managing your body weight, so there is less weight pushing down on your pelvic floor, and it always best to do a run/walk programme to start as this way your pelvic floor muscles will gradually build up to the stresses and strains you are putting in them. Look for a beginners running class to help you with this.

*Making sure the control of the deep abdominals are there, and do a class every week that makes these work to support you when you are running. Doing exercise that challenges your stomach, gluts and pelvic floor is a great adjunct to running. Running itself will not improve this group of muscles.

Lastly seek help, do not suffer in silence.


with thanks to

Jayne Nixon
Clinical Specialist Physiotherapist
Manor Clinic


Bounce at your peril!

After having a very interesting discussion the other day with one of my fitness friends about why ladies do not use their arms to run properly- I had a thought that I would try and convince a few more people to take it seriously. I do a lot of biomechanics analysis and this is something I do not take great pleasure in pointing out! – the way you swing your arms (or do not) is directly dependent on how good a bra you are wearing!!! If you are too busy holding your top box to use your arms to propel yourself you are inadvertently slowing yourself down and fixing your trunk to stop your boobs bouncing up and down.

If you need some convincing here is the research about how much you are bouncing!!

During walking, a woman’s breasts move the same amount in and out, up and down and from side to side: about 33% in each dimension.

Up the pace to a jog or a run, and the movement is split: 51% up and down, 22% side to side and 27% in and out. The overall pattern is a figure of eight (on it’s side).

Breasts move as much during a slow jog as they do during a sprint, meaning no matter what your pace, you should always wear a sports bra- and a good one at that! Two ordinary bras will not stop the motion.

If you are hitting the ground hard then you are getting a lot more vertical bounce than you would ever want- damaging breast ligaments and altering your whole body biomechanics and a lot more besides! ( AKA heading south!)

Warning- clicking here will make your eyes water! Put your size in and your sport and see how much damage you could be doing! Enough said!


If you are playing other sports then look below from a great piece of research from Portsmouth about bounce!


1Debbie Risius, 1Alexandra Milligan, 1Chris Mills, and 1Joanna Scurr1University of Portsmouth, Portsmouth, Hants, UKemail: Debbie.Risius@port.ac.uk, web: http://www.port.ac.uk/breastresearch


Effective sports bras that minimise breast displacement are crucial to reduce breast discomfort during exercise [1]. The majority of breast biomechanics literature centers on treadmill activity. However, until the movement of the breast is understood during different actions, optimum breast support parameters for sport specific activities are unknown. This study aimed to determine the kinematics of female breast movement during; running, jumping and an agility task, in order to inform breast support design during different multiplanar activities.METHODSTen 34D cup participants had passive markers attached to their right nipple and trunk, to calculate relative 3D breast displacement [2]. Supported and unsupported anterioposterior, mediolateral and vertical breast displacement was calculated during treadmill running (10kph), maximum counter movement jumps and an agility T-test.RESULTS AND DISCUSSIONExercise modality influenced the magnitude of breast displacement when bare breasted (p<.006) and when wearing a sports bra (p<.013). The greatest anterioposterior (57 mm) and mediolateral (67 mm) breast movement was found during the agility task, and the greatest vertical breast movement (86 mm) found during jumping (Fig. 1). Agility and running had equal distributions of movement in each direction (30% AP, 36% ML, 33% V), whereas jumping activities produced a larger distribution in the vertical direction (26% AP, 27% ML, 47% V). The sports bra was more effective at reducing anterioposterior breastdisplacement during running (51%) than either jumping (35%) or the agility task (41%), more effect at reducing mediolateral displacement during jumping (64%) than either running (47%) or the agility task (49%), and more effective at reducing vertical breast displacement during running (66%) than jumping 

Exercise modality has an impact upon the magnitude and distribution of multiplanar breast displacement, and also upon a sports bra’s effectiveness at reducing this breast movement. Sports bra manufacturers may wish to design sport specific products, as a sports bra effectiveness is influenced by the type of exercise [1].REFERENCES1. Scurr J, et al. J Sports Sci 29, 55-61, 2011.2. Scurr J, et al. J Appl Biomech 25, 322-329, 2009.

So keep up the running just not the bouncing!

Jayne Nixon

Clinical Specialist Physiotherapist

BSc HONS MSc Sports & Exercise Medicine MCSP HCPC Reg.

Sevenoaks Physiotherapy and The Running School Kent



Self-diagnosis and believe all you read- at your peril!

If you want to confuse yourself then the Internet is a great way of making mountains out of mole-hills and seeing forums of people who never get better and always have  terrible negative stories to tell about the disaster that beheld them, is a sure fire way of depressing yourself.  Medicine on the internet is a hard one, it can inform, not always correctly about what might be wrong, and what you could do to fix it. 

Don't take “so called” evidence at face value, a recent paper found woolly underwear to be effective for back pain! Analyze and appraise the evidence before making a decision- always.

The other thing that the Internet is good at is spinning research into what people want to hear! (Sounds like politics to me!)

The thing about internet and popular press is that it tends to polarize opinion- and that’s all it is- opinion- there is very little science on Twitter!!- And it’s always best to deal with good Research and cold hard facts, when dealing with medicine and rehabilitation following injury.

The popularization of research to a watered down version of what journalists or bloggers think research is saying leads to misinformation and speculation about outcomes of treatment and information.  Being able to read research and access the truth and not just the “nice” or “easy to read” parts of any research paper of article is what your Dr/Physio and professional health care givers do for a living. A good one will give you the real truth- often it’s a boring- not such a sensationalist view on something-but it will be considered and well thought through.

When you are a consumer or reader looking at things on the internet or in a magazine-they may appear either black or white but in the majority of cases they are very grey indeed! It's important to understand as much of the evidence that surrounds a topic as possible, not just what suits. These views will change as the research becomes clearer- and as more good research is completed.

But do not always believe what you read in popular press, it is much easier to make an article in a magazine interesting by polarizing the views, especially when it is to do with medicine- it makes for sensational reading. Take the opinion of someone who has a good balanced view who has the background of reading research articles all the time, to help you see the real truth.

Get a good diagnosis, and a good face-to-face opinion- from some one real and then you are more likely to get a good outcome!

Jayne Nixon

Clinical Specialist Physiotherapist( Internet lover/hater.)

BSc HONS MSc Sport Ex Medicine MCSP HCPC reg.


Running into difficulties

Running is all about getting fit and healthy as well as having fun along the way.  Occasionally someone may run into difficulties (literally!) which takes the fun out of the equation. 

One of the hurdles people may face while running is breathing problems. 

There are many different causes of breathing problems, but the treatment aims are the same for all, so worthwhile knowing about.  Firstly, ask the casualty if they know what is happening.  They may have a diagnosed condition and therefore possibly medication and know how they need to be helped. 

It is vital to listen to your casualty both for clues to their treatment but also so they feel reassured and have confidence that you are working ‘with them’ and not ‘on them’.  Help them into a comfortable sitting position. 

People with breathing problems often feel their chest feels restrained even more if made to lie down.  Someone with asthma may be further helped by leaning forwards on a support.  If they have medication, now is a good time to help them find it.  Don’t be tempted to wait to see how things progress, inhaled medications rely on the casualty still being able to get a reasonable breath in, so don’t hang about. 

Give them lots of reassurance, eye contact and privacy - but never leave them on their own.  If at any point you feel concerned that their medication is not working, or if they do not have a diagnosis and things are not improving quickly, call for an ambulance. 

Sometimes the situation may deteriorate and the casualty may become unconscious.  If this happens, check if they are breathing normally.  If they are breathing normally they need to be rolled carefully onto their side into the Recovery Position to maintain a clear airway.  If they are not breathing normally, you will need to start CPR immediately. 

In either case, an ambulance needs to be called urgently.  If you would like to book on a first aid course to learn and practice these life saving skills please check out our web site – www.peakskills.co.uk or email office@peakskills.co.uk.

Do you suffer from Calf Pain?

Are you getting calf soreness with no history of trauma to the area?

Non-traumatic calf pain usually follows a fairly predictable pattern – the pain develops when running and gradually worsens as the run continues. The calf may feel tight and even stop you from going any further. It may even tear slightly. After running the pain subsides a little but the calf often continues to feel tight for a day or so. When not running symptoms are generally not there. Walking is normally pain free.

There are a few possible diagnosis for this, but what I see in clinic is simply fatigue of the calf muscles, which leads to micro tearing of the calf muscle and often then Achilles' tendon pain.

This leads to the question of why are my calf muscles becoming fatigued?

Every muscle has it’s different level of strength and endurance, exceed that level and it will usually start to become painful and tight. The answer to why this happens usually has 2 parts to it;

  1. The calf and tendon are being overloaded                                                                                   And/Or
  2. The calf muscles are weak or lack endurance.

Overloading the calf

The first question here may be what’s changed recently that coincides with your calf problems?

1. Have you started hill or speed work, increasing weekly mileage and increasing training intensity. It’s also very common for people transitioning to barefoot or minimalistic running to have calf pain. Running barefoot often involves landing on the forefoot and this usually loads the calf muscles and achilles tendon more than running in shoes. Another factor is exercise you do in addition to running – if you’ve started to introduce gym sessions and running on the same day, or the following day, the calf may already be somewhat fatigued before you start.

2. Have you started to run off road on soft ground? Balance is key when you run off road and if the ground underfoot changes due to weather so will the demands on your balance and control and your calf muscles.

3. Have you changed the way you run? Or do you know what your running technique is? Do you know how you hit the ground? Running on you tip toes or forefoot for too long will give you calf pain, overloading your calf muscles and tendon leading to pain and injury.

Is your calf up to it?

You should have adequate strength and plyometric control of the calf, this means that you should be able to heel raise easily up to 40 times in a row and be able to hop and land easily again and again with control.

This protects against calf overload and gives you a spring in your step and allows you to control the loading of landing whilst running. This is vital to remain injury free.


Key points:- Non-traumatic calf pain is often a case of doing too much or having weakness in the calf muscles (or a bit of both!). From hitting the ground hard in the less than efficient way.

So-Have your running assessed by a professional and make sure you cross train, and not just run and strengthen your calf.

If you have any additional symptoms such as severe pain, swelling, skin redness, pins and needles or numbness consult your Physiotherapist or GP.


Happy injury free running!!

Resident expert Jayne Nixon