Extreme cold and wet weather places greater demands upon our bodies. Dr Peter Thomson examines these demands and gives his top tips to winterproofing your body to remain on track
Try telling an athlete about how to cope with managing soreness, muscle aches and joint pains and they’ll probably show you the T-shirt. Most will tell you it’s an occupational hazard with the only alternative being to lay up for a while and wait for the injury to fully recover. This can take weeks, maybe months to put right. But, again for most, this is not really an option and you’ll carry on regardless.
Training is a way of life and perhaps the biggest fear is the need for surgery to put things right again. But this isn’t always the case. Even more serious injuries such as a torn anterior cruciate ligament can be fixed without surgery with the right course of physiotherapy when used in conjunction with other treatments. It all depends on the seriousness of the injury, of course, but let’s take a look at the most common causes and how you can winterproof your body to avoid them altogether.
This is a mild pain at the front of the knee that tends not to persist once you have stopped running. If it does persist, however, I advise you seek the advice of a sports medicine doctor or a physiotherapist to see what the problem is and what may be causing it.
It will more than likely be caused by tight quads, over-pronation and weakness around the hips and core.
If the symptoms aren’t too severe you can continue running and training but if the pain continues for 24 hours afterwards you should stop.
Problems with the achilles are a bit trickier and at the sight of a twinge you should stop running and seek further advice immediately. To avoid problems be sure not to increase mileage, hill running or speed dramatically. In addition, make sure calves are stretched regularly as weak and tired muscles can overload the tendon.
To help correct over-pronation it’s crucial to have the right footwear; a consultation with an orthotist can help you overcome any issues here.
Tight or overstretched hamstrings are common, but careful stretching will help to stop this occurring. You should also seek the opinion of a professional should the problem persist and they will be able to help you with your gait and whether an imbalance, such as stronger quads, is risking hamstring injury.
This is a very common injury and it typically causes a dull ache in the arch of the foot or heel. It’s possible to run through the pain but it could become a chronic problem if you do. Treatment often involves a break from running, with physiotherapy. To avoid it, stretch your calves, wear running shoes with a good level of support for the arch and use a golf ball to massage the underside of the foot. Shock wave therapy can also help, albeit it’s not commonly used nowadays.
This is usually caused by a sudden increase in mileage and with people who have flat feet or those who over-pronate. It can be very painful where the muscle joins the shinbone. Shin splints is an umbrella term for a range of different lower limb problems, each with its own underlying cause. But it’s always wise to rest if you have severe pain with it. Training through it is the worst option.
Make sure any increases in training and mileage are gradual and again, consult with the appropriate professionals on gait and footwear.
The Iliotibial Band (ITB)
The ITB can cause irritation and compression on the outside of the knee. Risk factors include an increase in mileage, a slight difference in leg lengths, a lot of track work or downhill running.
Running can continue with low-grade ITC but, to avoid issues, try running with a widened stance and strengthen your hip abductors and glutes. In addition, use of a foam roller can help to reduce the pain but will not cure the problem.
Finally, stress fractures can be caused by accumulated strain and show up as a hairline crack in the bone. It can be very painful – as I’m sure anyone of you who have had this will testify.
Female runners are more at risk with contributory factors being low bodyweight, poor diet and low oestrogen levels. You should not run with a stress fracture and to help avoid them build mileage up slowly and ensure you’re eating healthily.
YOUR WINTER CARE PLAN
Injuries can occur at any time of the year but in the colder months there are many more external factors that make us prone to injury. The old adage says prevention is better than cure, and in an athlete’s case it’s the key to remaining on track, or on the road, this winter. Therefore, I recommend that you:
» Have a care plan and set yourself a goal this winter. And, make sure you follow a programme to achieve that goal of injury avoidance.
» Listen to your body. A niggle can quickly turn in to something a lot worse so make sure you get a diagnosis and follow the appropriate advice or treatment.
» Avoid the thirst and plan your hydration, as dehydrated bodies are more prone to injury. It’s simple but often overlooked advice.
» Warm up thoroughly – it’s amazing how many athletes don’t do this – and set aside the early part of a run to jog more gently to ease yourself into the run.
» Wear the right gear. This is essential as technical fabrics will wick sweat away and help to stop you getting sore. Wear gloves and a hat, too, especially on those early winter mornings.
» Have an assessment to screen you for risk factors that may lead to injuries. We offer comprehensive sports specific screening and will build a personal injury risk profile and advise on how best to train to reduce risk and build on your strengths, flexibility, core stability and biomechanics.
» If you do get injured, remember RICE. This isn’t anything new and all athletes know this acronym but there’s no harm in reminding yourself you need to Rest, Ice, Compress and Elevate. The faster you can ice it the sooner the swelling will go down and you can start your rehabilitation.
» Always get a diagnosis. Especially if you believe the injury to be bad or it is not easing – don’t self-diagnose. More serious injuries may require hospital assessment, imaging with an X-ray or MRI, and on-going physiotherapy. Surgery may also be needed but starting with a professional diagnosis will go a long way to helping you on your road to recovery and give you a clear understanding of your injury.
» Dr Peter Thomson is a consultant in sports and exercise medicine at Wimbledon Clinics in south-west London. He is also an honorary NHS consultant in sport and exercise medicine at St George’s Hospital where he has worked as the lead physician in MICAS (the Musculoskeletal Interface Clinical Assessment Service) since 2004. See wimbledonclinics.co.uk