Preparing for a marathon can be a daunting task. From scheduling training runs to ensuring you have your nutrition on point, there is lots to consider. There is a time and pace (pun intended!) for everyone, so it is is vital to take expert advice on how best to prepare yourself.
Current research has thrown up questions about our beloved running shoes. Is it better to run without them? With or without them running can still be an injury prone passion, so what can be done to help? Is Osteopathy or Chiropractic the answer?
It is not uncommon to have pain whilst running. You can expect to gain 2 to 30+ injuries per 1000 hours running. These injuries can range from the foot and ankle all the way up to the lower back. The pain can come and go, get worse during running or even later that day post run. (1)
Plantar fasciitis is a common cause of heel pain, and can be incredibly painful. Our patients typically present with pain under the heel which radiates along the underside of the foot. Quite often, the pain is worst when getting out of bed in the morning. You may also have pain when trying to stretch up. The pain is caused by tiny microtears, scarring and a breakdown of collagen where the plantar fascia attaches on to the heel bone.
Kinesiology tape has become massively popular over the past few years, gracing the torsos of Olympic athletes and sportspeople around the world- and whilst there are conflicting messages coming from the research around it, the tape appears to show promise for a range of issues. A recent review showed that there was moderate evidence to support the use of tape to reduce pain, so let’s look at how tape can help.
Properties of kinesiology tape
100% cotton, latex free tape
Medical grade acrylic adhesive which is heat sensitive allowing the tape to stick to the skin
The thickness, weight and elasticity of the tape is approximately that of skin, so most people can tolerate the tape without issue
Allows for free movement and does not restrict movement like other tapes may
The elastic properties provide support and reduce muscle fatigue
Where some tapes are stretched out to maximum capacity before being applied, kinesiology tape is less effective when fully stretched out- in fact, mastering the art of how much stretch to apply is one of the main skills to learn when using tape.
The risks of using tape are minimal, and whilst the research surrounding tape is still in its infancy, we can use it safely in clinic knowing that we’re not causing any harm and are instead likely to see great results which will help contribute further to the use of kinesiology taping.
How taping works to reduce pain
When taping for pain, inflammation, swelling or oedema, we use a technique called “space correction”. This does what it says on the tin- creates more space directly above an area of pain, inflammation, swelling or fluid build up, which helps decrease pressure by lifting the skin away from the fascia.
This has a number of effects:
Decreased pressure alleviates the irritation on chemical receptors in the underlying structures, thus decreasing pain
Increased circulation may occur in the area, allowing for increased removal of cells or fluids that can build up during the inflammatory process
Stimulating mechanoreceptors (sensory receptors in our skin that pick up pressure or distortion) can help decrease pain
The initial benefits are reducing inflammation and pain, but there are thought to be neurological benefits
too- when the tape is placed over tight muscles, it appears to reduce their response to being stretched, helping to make them feel less sore and painful. When applied over weak or injured tissues, the feedback these tissues send to the brain is altered and improved, which can help the body to stabilise the area. This is how we can then move on to use the tape for fascial correction.
In some cases, as with ankle inversion injuries (rolling over on the ankle), there is an imminent risk of further injury as the ligaments in the muscle have been stretched out and therefore aren’t able to stabilise the joint as effectively as usual. In this case, the patient’s initial injury was over 7 days ago so we have used a fan application to encourage lymphatic flow but also applied a light-stretch support around the lateral part of the foot to help stablise the injured ligaments.
Lymphatic fan taping helps to reduce fluid build-up by directing lymph fluid towards a less-congested lymphatic pathway and lymph nodes. We use the anchor of the tape to indicate where we want the lymph to flow, much like directing traffic! Whilst this is an advanced taping technique and one that would be applied by your practitioner, it demonstrates the myriad uses of kinesiology taping perfectly and shows how effective it can be in helping reduce inflammation and aid recovery at a cellular level.
Take home notes:
There isn’t a barrage of research to support the use of kinesiology tape, the papers that are available show positive and encouraging results. Every new treatment modality has to start somewhere, after all!
(Think of Louis Pasteur testing out his Rabies vaccine on a 9 year old. Sounds nuts now, but that’s where most great ideas starts from- somebody going “I wonder if….?”)
Much like any treatment, there will be an element of placebo involved, but studies like this and this have shown that the effects of kinesiology tape can’t be reproduced by placebo taping.
Simply put, the mechanisms and understanding behind how and why kinesiology tape works are grounded in scientific thinking and understanding. It’s a safe, low risk, effective way to help your body towards recovery, and whilst it’s no replacement for treatment, rehabilitation and injury management, it helps to put some of the power of recovery back into your hands.
NB: Whilst tape can be applied by anyone, it is important to have the issue diagnosed by an appropriately qualified healthcare or medical professional prior to using kinesiotape or allowing someone else to apply it. As with any form of treatment, you want to ensure the treatment is appropriate for the issue and eliminate any other underlying issues which may mean taping is inappropriate.
It may or may not surprise you to find out there’s a lot of misleading information about back pain out there- more specifically, about what to do when back pain strikes and how to prevent it from recurring. This has not only over-simplified how to treat back pain but also lead to some weird and wonderful rehabilitation strategies.
Let’s bust a few of these back pain misconceptions.
1. Sit-ups will help improve your spinal health
Did you know that the average sit-up causes compression of the lower back that almost exceeds the safe limits set by the National Institute for Occupational Safety and Health (the unified set of manual lifting recommendations based on the convergence of medical, scientific, and engineering points of view which helps determine safe work practices)
Physical fitness does have an impact on our spinal health, but it is more important that we are getting fit in the right way. Studies have shown that increasing abdominal strength through sit-ups causes stress on the discs in our back and compresses the lumbar spine- enough for researchers to conclude that sit-ups may cause problems in almost anyone.
2. “Lift with your knees, not your back”
Have you ever tried to do this? Ever tried to do it all day long? It’s almost impossible to do this every single time we go to lift something. Forget the old squat technique, instead, the way you lift should depend on what you’re lifting, where you’re moving it to, your own build, how many items you have to lift and so on.
For more information on how to lift correctly (and give your knees a break) click here.
3. Strong muscles, strong back
Not so, my friends. Muscle strength doesn’t help us predict who will or won’t get back problems, and focusing too much on strength instead of stability will be sure to cause problems. Instead, focus on muscular endurance (i.e. how long your muscles can sustain an activity for). Remember, muscles have three main properties: flexibility, strength and endurance. Any issues that results in a lack of flexibility, strength or endurance will be enough to stimulate the nerves within your muscles and start telling your brain that something’s wrong. What’s the end result of that? Pain.
4. Tight hamstrings and unequal leg lengths cause back problems.
These types of issues are often given as easy diagnoses to simplify the cause of a patients’ complaint. Don’t be fooled. Some studies have shown that in athletes with ‘tight’ hamstrings, these muscles function almost like springs, to help jump higher or run faster. It rather appears that tight hamstrings aren’t the issue, it’s how well these tight hamstrings can cope with stretching that determines whether or not you’ll have back pain. Studies have found that people with chronic back pain tend to use their hamstrings instead of their gluteal muscles to extend the hip, which can increase the amount of force on the spine during squatting- correcting this is going to be a fundamental aspect of care.
Interestingly, back pain also wasn’t found to be definitively linked with leg length discrepancies even in cases where the difference in length was 5cm!
5. Scoliosis= A lifetime of back issues?
Not true! We see so many adults who were abruptly diagnosed with a ‘scoliosis’ after being
asked to bend forwards and touch their toes by the school nurse back in the 1970’s. The difficulty with this is that
the tests for assessing scoliosis have a false positive rate of at least 60%, and the statistical risk of having a scoliosis that requires treatment is only 0.2%. Why are we telling you this? Because once we’re told we have a “condition” it becomes ingrained in us. Part of who we are. So time and time again we see adults who tell us they have a “scoliosis”, and have been plagued by a lifetime of avoiding activities because of their diagnosis, when mild scoliosis (less than 30 degrees deviation) may simply be monitored and treated with exercise.
6. Knees to chest- the ultimate back stretch
Sure, it feels good, lying on the floor pulling your knees into your chest. Depending on your diagnosis, it might even be the right exercise for you, but if you’re one of the many patients I see who doesn’t cope well with forward bending, this exercise isn’t ideal. Why? Because pulling the knees to the chest gives you the perception of relief from your lower back pain (because the stretch receptors in your erector spinae muscles are stimulated) but this type of exercises causes more cumulative damage to the discs, leading to increased pain and stiffness the next day. As practitioners, we know to eliminate these type of exercises and prescribe ones appropriate for your needs- in fact this bespoke rehabilitation plan is one of the main benefits of coming to see a chiropractor.
So where do we go from here?
As you can see, misleading information and advice regarding back pain can lead to us performing the very movements that worsen our back pain in our attempts to get it better. Ensuring you have an accurate diagnosis, treatment plan and rehabilitation strategy is vital to recovery.No treatment plan can be truly successful without incorporating spinal rehabilitation exercises that work to remove the faulty movement patterns that cause back pain problems. We have to work with our clients to ensure that we incorporate exercises that help you build the capacity of the muscles in your back to cope with the tasks you ask of it each day. As you can imagine, each persons’ day is different, and so your treatment plan will be too.
Throughout February we have been posting our top tips to get fit and healthy the best way possible in February. Here’s to committing to your workouts after the initial ‘New Year’ rush! Are you ready for our top tips to conquer ‘Fitness February’!? (More to be added soon!)
Protect Your Neck – Tuck your chin in and put your tongue on the roof of your mouth when you do crunches. It will help align your head properly, which helps reduce neck strain.
Don’t exercise when you’re sick – You’re better taking a day off so your body will use its resources to heal itself, not build muscle and endurance.
If you want to exercise before work but aren’t a morning person, try this trick: For a set period, let’s say 4 weeks, force yourself to get up 15 minutes earlier than normal and go outside for a quick walk. Make it so easy that you don’t even have to change into your workout clothes. As you near the end of the 4 weeks, you’ll have a new habit and will then be able to progress to either longer walks or a run in the morning!
Improve your balance – Stand one-legged on a sofa cushion and move a medicine ball (or heavy phone book) from hand to hand, side to side, and behind your head. Once you’ve mastered the move, try it with your eyes closed. This technique will improve your balance, coordination, and body control, all important athletic attributes.
Run Injury-Free – One week out of every six, cut your weekly training mileage and frequency in half. You’ll give your body a better chance to recover, and you’ll avoid permanent, nagging injuries. Find out more in our Running without pain resource.
Run Hills Faster – When running uphill, keep your head up and your eyes focused on the top of the hill. This opens your airways, making it easier to breathe than if your upper body were hunched forward. Find out more in our Training, Injury prevention and recovery resource.
Loosen Your Hips – Keep your heels on the floor when you squat. If you can’t, your hip flexors are too tight and need to be stretched out! Try this stretch: Hold onto the sides of the squat rack and lower yourself until your thighs are parallel to the ground. Hold this for 30 seconds. Return to a standing position, then repeat five times
Replace Your Shoes (Not Your Knees) – To avoid injuries, write an “expiration date” on your shoes as soon as you buy them. Shoes last about 500 miles, so simply divide 500 by your average weekly mileage to determine how many weeks your shoes are likely to last.
End Back Pain – For every set of abdominal exercises you perform, do a set of lower-back exercises. Focusing only on your abs can lead to poor posture and lower-back pain.