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Have I told you about the mouse that stole the marathon medal?
There was a runner named Wendy who a couple of years ago was desperate to get a Bill Rowan at Comrades and set his sights on a good qualifying marathon. Although working in an accounting office in Johannesburg she decided to enter the Weekend Witness Marathon, as it was not only the most popular qualifier, but the gentle climbs and descents of the double lap course made for easier pacing and also it would give her a chance to drive over the Comrades route to refresh her memory of the race day challenge.
Over the festive break she started increasing her mileage to build to a peak of training for her marathon assault at the end of February. Going back to work in January Wendy was immediately faced with a backlog of work and deadlines that saw her having to put in overtime with extra hours at her desk. Although she cut back on her training, she was still able to get the sessions in and mixed the paces well.
Then one Thursday night session she was out running a sustained effort with her club mates. It was a typical club night run starting at a reasonable pace, but soon the competitive nature of the group came to the fore. One girl always tended to go to the front of the group and as her shoulder edged forward the others responded by trying to keep the lead. Soon the pace was not dictated by the schedule but rather by what it took to keep the front shoulder position.
The running speed entered the usual spiral and was now dipping under 4:45 per km even on the gradual inclines, let alone on the downhill. Wendy felt a twinge in the left calf but didn�t think much of it and after momentarily easing off worked her way back into the group.
The shoulder swapping continued as the pace held strong, and then it happened: Wendy could feel the calf tighten followed by the sudden feeling of a rope unraveling deep in her calf. She stopped to try and ease the tightened calf but could not even jog without pain. Eventually she completed the final kilometre to the clubhouse and iced the calf.
What followed was a series of trips to the physiotherapist who massaged, needled and used a variety of machines on the calf. Running was abandoned for a week with attempts to get back onto the road being impossible as after only a short run the calf would unravel again.
A three-week break was scheduled, which in some ways this worked, as it allowed her time to removed the work pressure by spending extra hours behind her computer screen.
Training time was shared between gym sessions to work on eccentric calf raises and physio appointments. Every time she returned to the road she would start with very flat-footed running that would rarely get above 6:15 per km. Each time there was initial progress until, after four or five short training sessions, she would attempt to increase the pace close to 5:40 pace, which was well below her true marathon ability, but induced the calf tightening and forced the run to be abandon before the full blown injury returned.
She was sent for scans which confirmed that it was not a major tear but a recurring strain. In the belief that there was a mechanical stride problem she went to a podiatrist who prescribed orthotics. If anything these brought the pain on sooner, and training days just kept running away.
Frustration, and depression became everyday partners in her life, and the thought Comrades, let alone a good qualifying time disappeared along with escalating medical costs.
After five months of problems I met Wendy by chance when assisting another runner with buying shoes at a Johannesburg shop. Wendy overheard our discussions and my explanation of a correct running style and why it was important to have a holistic view of running style / shoes and injuries, and how �it is not running that causes injuries!�
That was the trigger � Wendy excused herself and asked me what I meant?
�Running injuries,� I explained, �are not only self-inflicted, but are generally initiated by lifestyle.� After a few more moments of explanation Wendy made an appointment to see me at St Benedict's Physiotherapy rooms where I work when in Johannesburg.
In the hour we spent together she shared the injury history, examined her past and current shoes, and spent lots of time looking at what had changed in her lifestyle.
The combination of causes worked backwards. Wendy had been wearing the same shoes for years and had bought the latest model just before Christmas in preparation for the build up to the marathon. Everything had gone well over the festive period as most of her training had been alone or with a friend down in Cape Town where they had been on holiday.
Going back to work she had suddenly been hit with the deadlines and substantial increase in sitting behind her computer where she did significant data copying.
The long hours in the chair, the type of work and the emotional stress of meeting deadlines had initiated major tension in her shoulder and upper back muscles, which together with her chosen sitting position caused her spine, and hips to be held out of normal position.
Her Thursday night session had come after a couple of really long workdays and the combination resulted in her injury.
It wasn�t the running as such, it was the fact that her stride was imbalanced from tension around the hips, lower back, and in particular the shoulder. When you are running and putting three times your bodyweight on your muscles and joints which are now out of alignment the load distribution changes and not surprisingly it becomes too much for some muscle or soft tissue which has not had sufficient time to adapt.
The matter was exacerbated by the increased rigidity of the shoes which prevented a more natural distribution of loads.
The answer was simple: we re-arranged her desk layout, changed her sitting position, had the tension taken out of her shoulders, lower back and hips, leveled her hips, and modified then changed her shoe choice. Within two weeks she was back running and getting stronger. Not only that but the new more natural shoe choice had allowed her to adopt a more efficient running style and her began improving way beyond the requirements for a 3:40 marathon she equated to her desired Bill Rowan in Comrades.
So where was the mouse?
A very large percentage of her work was done using the computer mouse on her right hand side and combined with the sitting position this would induce substantial shoulder tension. It wasn�t the running that initiated the injury it was the sudden and prolonged increase in using the mouse that began the decay, and no matter what the physio and medics did there was going to be no relief until the cause was found and corrected.
It was the mouse that stole the marathon and the Comrades medal.
Analyzing, understanding and correcting injuries and running style is critical if you are to reduce and prevent injuries.
* Norrie Williamson is based at Kings Park Sports Medicine Centre in Durban, St Benedict's Physiotherapy in Johannesburg, and Dubai Runners Club in UAE. Contact +2783 4455200 Norrie@coachnorrie.co.za)