Speaker 1: 0:00

So you're thinking about running but not sure how to take the first step. My name is Brian Patterson and I'm here to help. Welcome to Brian's Rompod. Well, welcome back to the podcast, and it's me, brian patterson, to give you an insight into all things running. Well, in the second part of our um, this episode um, with my chat with paula and molly from saint margaret's physio, we discussed the best advice for runners who suffer from overuse injuries, for instance, it, band syndrome, shin splints and others. Also, we discuss the synergy between sports massage and seeing a physio at their clinic. I really enjoyed our chat, and I know with you. So, without further ado, let's get into it. So let's get into a bit more specifics in terms of common injuries that sort of you know runners do get, in terms of things like you know it band syndrome, shin splints, something I've just suffered from recently, which is the plant of whatever is there

Speaker 2: 1:20

any completely say the whole word.

Speaker 1: 1:24

I'm not sure why, but these kind of overused injuries. I mean, is there any one thing that you would advise people who are starting on their running journey or who have regular runners that? Is it something that you say, well look, you are going to get injured at some stage, or something like that, or are there any things that you are you need to be doing regularly so you don't get injured as much?

Speaker 3: 1:51

yeah, so for many people, like most of the times, I already see the person when they are injured yeah, but if you, but if you are not yet, you're listening to this podcast and be like I want to prevent injuries in the future, then I would definitely say that, thinking about your training load and exposure right, it's like the first thing you want to think about excellent.

Speaker 3: 2:12

So understanding how much you are running, how does that make you feel? And also your recovery. So those actually come, two things come together recovery, rest, recovery and your training load, because every time when you go for a run, that's a stress to your system. Yeah, and the same as like sitting at work and having stressful deadlines or anything like that is also stressing you, like for your body. So sometimes when your running app or your running plan tells you you need to do xyz amount per week and do this run at this pace and so on, the app doesn't know you and doesn't understand, maybe, how you feel at that week.

Speaker 1: 2:48

Or that time very good point yeah, yeah, so often I know a lot of people. I mean I'm I'm guilty as one is that I do use an app whatever which is great, which is, you need a plan yeah, because I know some people like I mean especially me.

Speaker 1: 3:02

You know some people like I mean especially me. You know like I like that guidance. But you do raise a very good point that it's not like someone telling you or saying you know that the benefits of having a coach is someone who can assess you on a one-to-one and they know what you're like.

Speaker 3: 3:18

It's like a live feedback you would have with a real person, you don't have necessary live feedback, like a live feedback you would have with a real person.

Speaker 3: 3:24

With an app, you don't have necessary live feedback. So this is where, if you are using a training plan, take that as a guidance rather than a strict. You know, this is what you have to do and adjust the sessions. For many people, I usually say, repeating the same week or repeating the same workout multiple times before you move on to the next stage is a good way. How to do, how to go about it as well. Right, and then also talking about training load. Usually kind of ballpark is like increasing no more than 10 weekly than you have been running previous week, okay not jumping ahead too much, okay, just because the deadline of the run is coming up, yeah, you know.

Speaker 3: 4:06

So gradual increase of the load, a bit also thinking about strength training. So that would be another thing, yeah, yeah.

Speaker 3: 4:14

So strength training is definitely something we as runners or people as runners they need to do, because running, although it is a, you know you train yourself for the activity but it's not giving you enough stimulus to your muscle to tolerate the activity. So, yeah, you have to kind of find a level of strength training you enjoy doing and can do either at home or in the gym. So, yeah, whatever is kind of your way of training or getting the strength training in. And then another thing is thinking about your footwear yes that also.

Speaker 3: 4:51

I don't give advice necessarily about what shoes to buy and how to do it. I send them off to a person, but I always check in like, how is your footwear? Yeah, is it supporting? Is it supportive for you?

Speaker 1: 5:01

yeah, because with that is it also the thing that one thing doesn't fit everyone so you kind of have to find your shoes and also I find that well, especially now, because, although running has become quite popular, I think it, but also at the same time, you know, buying footwear is can be very confusing but also very expensive.

Speaker 1: 5:23

You know you are looking at you know like spending like a hundred pounds or more yes so, and so it's really important that you get advice for that, because, like you said, you know, wearing the wrong footwear can obviously have a I don't know an impact on your spine it usually starts with the ankles and then it kind of like may affect your knees or hips.

Speaker 3: 5:45

Yeah, start with, but yeah, you would notice if something. You would be like oh, something is hurting because I went for a run yeah you know, with a new shoes and it just doesn't go away every time when I run kind of.

Speaker 1: 5:58

Can you explain so to the? I initiated? What is an IT band injury?

Speaker 3: 6:06

Oh, okay, it band basically we have, if you think about your thigh from the front and the side of the outside. So we have a little muscle here at the top of our hips. It's called TFL, tensor fascia lata. I think this is my anatomy knowledge but that little muscle becomes, joins into this more like a fascia like structure. It sits on on the side of our, our thigh and it goes kind of just here and crosses like kind of goes down over the knee on the side and then it sits on the side of the knee basically right, okay and so when we and it's there to support your leg, take, take the load yeah and keep things in place.

Speaker 3: 6:51

So when we run we move our hip joint and the knee joint at the same time and that can cause the friction in the it band right, okay, and then? If's irritated. You can get pain after prolonged running. Right or depending on what you're tolerant, but basically the movement will then cause the irritation.

Speaker 1: 7:14

So again, it's an overuse injury.

Speaker 3: 7:15

Yes, itb.

Speaker 1: 7:18

And so would the treatment be.

Speaker 3: 7:22

Kind of looking to you, molly but I mean, I don don't know would it be a sports match side or?

Speaker 1: 7:25

would they be. Would they be so?

Speaker 3: 7:26

we all overuse injury, so you have to understand that why it's overused. So something in your biomechanics is not quite doing enough or something is doing too much. So with it band usually I find that if people have so your knee kind of goes inwards. We call it Walgus knee, so then that can put extra pressure, extra workload on the IT band and just weakness around your glutes because you can't keep your hip straight without dipping and things like that then can cause itb, band it band syndrome again.

Speaker 3: 8:03

Okay, yeah, so massage would be optional, but it's not really. It's like a treatment.

Speaker 1: 8:10

Yeah you wouldn't necessarily go for a massage just for that sort of thing yeah, okay, but you're, basically you're, you're kind of analyzing the, you know the, the biomechanics as to why it caused that and maybe you might you know what would your prescription be?

Speaker 3: 8:28

Yeah, so basically, let's say you have this IT band syndrome. You come in and I would put you on a treadmill, ask you to run a little bit, and then in the moment I would film you and see what's kind of happening little bit. And then in the moment I would film you and see what's kind of happening and then in the slow motion, I would slow down the video just to see kind of where your, you know your feet, your knees, your hips are moving, what is your spine doing?

Speaker 3: 8:49

and and your shoulders, uh, to assess kind of what's happening with the movement when you are running yeah, and then that would then give me a opportunity to be like oh, it looks like you are doing this too much or too little.

Speaker 1: 9:07

And then working on the areas to kind of help to balance things out. And so, in terms of another question, like, as I said, for people who are like me sort of, you know, eight hours, seven, six hours sitting down at a desk typing away, and then I do three to four times a week I might go running or go to the gym or something like that. But I think as I've got older then you know I do have problems with my, my hips sort of thing, or maybe I might get sore hips after running yeah what is.

Speaker 1: 9:40

Is there anything I could be doing to help kind of alleviate that?

Speaker 3: 9:44

Yep. So again understanding, like why your hips get tight or sore. Yeah, so usually something gets tight or sore is because it's working too hard.

Speaker 1: 9:54

Yeah.

Speaker 3: 9:55

Or the muscle part has to work because the other leg is not doing enough, so it's compensating, so that builds up the muscle tension in your body. Muscle part has to work because the other leg is not doing enough. So it's compensating, so that builds up the muscle tension in your body we can live with certain amount of tension and not even notice it.

Speaker 3: 10:07

It's there and it doesn't bother us, but then slowly, gradually, it will creep up and become an injury. So for you, like, if you are an early stage of like, oh, my muscles just feel tight, you can always go and see a massage therapist and then they can, like you know, just help you to, like, reduce the tension. But in the meantime, while you're doing that, you should also work on, like, strengthening your glutes, so making sure you have enough strength around your muscles, around your hips, but also full range of movement as much as possible in your hips. So the mobility of hips, so that there is a full range of movement in your hip, so the mobility of hips, so that there is a full range of movement in your hip joint as much as possible, so that when you swing legs through while you are running, yeah, you don't need to compensate yeah to get the leg through because I know when I went to a physio he said he kind of identified it being the gluteus medius, which is the yeah, yeah.

Speaker 3: 10:58

So that's a muscle sitting on the kind of like the side of your hip, and it's often it's very important muscle in a sense, because we run.

Speaker 3: 11:06

When we run, you spend quite a bit of time on one leg, single leg yeah yeah, moment of just being on one leg, and that's in that moment that glute medius muscle has to make sure that your hip doesn't drop on one side, so it works really hard to stabilize your hips. If there is weakness around that area, then you will just feel like the muscle is not supported and it has to work really hard and that's where you probably feel tension after your run stay, because they just can't tolerate the workload, what they need to be doing.

Speaker 1: 11:49

But also going back to what you were just saying is that sometimes doing less is more in a way, and that you're having to. You know, like sometimes I might not, you know, run for a week and then maybe I might go back to it and maybe not do as much, and then it doesn't yeah it doesn't hurt you know, sometimes you might think you might aim for a 10k, but actually 5k is what suits your body better.

Speaker 1: 12:05

Yeah, that day sort of thing, yeah yeah, I mean that's, I mean that's the what I'm doing, because I think what when I'm during the pandemic, I mean I was doing, maybe it's because I had the time and also the time of day I could run I can. You know, I was doing like a 10k program, but now I'm a lot older and so I'm doing like a 5k one, but I kind of enjoy it.

Speaker 1: 12:29

Yeah, that's fine, it's still. I'm still getting that variability in terms of the types of runs I'm doing, you know like tempo runs or interval training, or you know like a recovery run or that kind of thing and playing around with it. I mean, I'm not that I'm never going to be doing a marathon or half or whatever, but I'm still enjoying the running, even though it's just you know.

Speaker 3: 12:50

Yeah, yeah, and this is the thing as well for people to find the distance, what they want to run.

Speaker 1: 12:57

Yeah.

Speaker 3: 12:58

I recently had a client and he's like, oh you know, they started running as a wife and husband yeah, and they just kept running and then, when they reached like 12 mile runs, that's where they started getting injured oh right, and I'm like why are you running 12 miles? Like why are you running? And he's like I don't know, and it's not to say that you shouldn't be running that distance, obviously you, you can.

Speaker 1: 13:26

But do you need to do it every week or kind of consistently if your body is not ready for it? And especially with this these days, I don't know what it is for this ultra craze. It's a lot I don't know where people find their time. I don't know if your clients are doing it, you know, or something like that, but I don't know every other podcast running podcast I listen to. Then it's so I've done 40 miles, or you know I'm doing a 50, or something like that. So yeah, it's just yeah.

Speaker 3: 13:51

I mean, it's okay, like, as I said, running is, you know, you kind of just have to decide what fits your schedule, your day-to-day activities, like your you know body, in a sense that you don't get injured but you still can enjoy running. And then, of course, if you want to, you know, participate in competitions and run like bigger distances, then just taking the time and effort to prepare for it, all your body, not just the running, running sessions yeah, so do.

Speaker 1: 14:24

Just moving on to the next bit basically is there that crossover with some clients where they might use both of your services and sort of you collaborate. You know, because I understand you, molly, you've just been working here for like say four months, and so is there that synergy between you, you know, and how does that work?

Speaker 3: 14:48

Yeah, so often before Molly joined I would do sports massage sessions myself. So I would do both physio and sports massage and then often I would have people coming in for massage therapy. But then during the session we actually, in getting into conversation, we actually realized that it's more like a long standing issue, not just like a little bit of tightness, because I started running a little bit more and then I would recommend coming in for a physio session and doing the full assessment, just seeing like what's happening.

Speaker 3: 15:16

So now, yeah, now I can use molly, I can send them towards molly and the. Yeah, so either molly, you know. Again, if she identifies that it's more like an ongoing issue.

Speaker 2: 15:28

Yeah, I can identify certain symptoms where I think, well, this is more of a Paola physio side. So, again if it's an ongoing injury or something. I know for me that it's now sort of advising have a session with Paola so that you can get better results really from that working hand in hand together.

Speaker 1: 15:45

Yeah, all right, that's fantastic. Better results, really from that working hand in hand together. Yeah, all right, that's, that's fantastic. And so I mean, are they common? You know injuries that you would deal with, or is it kind of like it, doesn't it really?

Speaker 2: 15:57

doesn't matter. Yeah, it doesn't really matter really. No, it could be anything, yeah and where do you find?

Speaker 1: 16:03

I mean, how do people find you? Is it basically they're finding you through the website, or is it?

Speaker 3: 16:10

Well, from my ad managers, I think it works from just finding online.

Speaker 2: 16:23

So when people are in pain.

Speaker 3: 16:24

They usually, you know, go physio near me or massage deep sports massage near me. There's obviously lots of local traffic when they see that there is a gym here in the physio clinic from just passing by, and then we have lots of members of the gym as well coming in 40 people.

Speaker 2: 16:37

And then, yeah, we recently have been quite active on instagram as well, so it seems to be a good one yeah, attract the just awareness of that we are here yeah, and I think also, like business, the business cards you've had made are quite useful as well. We can always hand out a business card, and sometimes people will say I actually have a colleague who needs a sports massage. Then you can sort of give them their business cards and the sign outside that says we're here, yeah, so is there?

Speaker 1: 17:02

is there one thing, molly, that people aren't sort of? If you could sort of say to somebody who isn't aware of a sports massage, is there one thing that you could you know you can put in a sentence and say sports massage is this.

Speaker 2: 17:19

So what like advertising it as they need a sports massage?

Speaker 1: 17:22

Well, it's just that sometimes people might not know what it is, you know what the what the real benefit is. I mean, I know we kind of touched on it earlier sort of thing, but it's just sometimes you, you kind of maybe some people will think I mean I've never had one, but um, I've. It's just that maybe they would have saying how, what would be the main benefit?

Speaker 2: 17:43

you know, let's say to someone, okay, yeah so yeah, I guess well, I think sometimes as well, it's once you've had the first one. I think that's when you notice the benefits so that's always that's a good thing. So a lot of people, as we stated at the start, might think, oh, sports massage a little bit too much, or another thing as well. As people say well, I don't do sports, so why would I need a sports massage?

Speaker 2: 18:02

but again I think people have to try and get that out of their head, because it's not necessarily for sporty people all the time. So I think it's also just a case of like, if you're noticing your body is feeling a bit different to how it normally is, a massage is generally going to be something that's actually very, very useful and it's sort of educating people on on the benefits, like the reduced attention, getting your sort of optimized results of better sort of training and things like that and that's when you're going to learn to sort of realize that actually having a massage works very well hand in hand with your day-to-day life, even if that's work, or if it's sort of work and doing sort of gym classes as well.

Speaker 2: 18:44

So, yeah, because a lot of people sort of even if it's not necessarily a sport injury might come because they're sat at their desk and their posture, sort of rolled their shoulders over, so much so it's all like that yeah and also another one that's quite common is like in driving a car, you know sort of the steering wheel is sort of your chairs maybe not quite in the right position.

Speaker 1: 19:03

So it's every day-to to day things that you don't necessarily think about that massage can generally help with as well as you know the common reducing the tension, etc yeah, yeah, because I think something that I've become really aware of because my my father is he has dementia and he's in the home but something that's really highlighted to me is how it's so important for us, as human beings, to be moving.

Speaker 2: 19:30

Yeah, absolutely.

Speaker 1: 19:32

And that's so because we are humans and you know we are made to be, we have arms and legs and we need to be moving.

Speaker 2: 19:53

So it's like during time, you know, although we kind of sit behind desks, it is kind of not a very natural phase or situation, is it? I think the amount of people you talk to as well always complain about their office chair not being quite right. So it's again. You're in a position, probably maybe eight hours of the day, where you might only move for an hour at lunch, if not work the lunch hour, where you're then sat in a very sort of unnatural position.

Speaker 1: 20:10

Yeah so yeah exactly, and so you're kind of helping release that.

Speaker 3: 20:15

Yeah, absolutely yeah I probably wouldn't add here. It's like the I would say if I would have to answer this question yeah massage is like a lazy way how to make your body feel better.

Speaker 2: 20:26

Oh, really yeah.

Speaker 3: 20:28

If you can take a little bit of pressure and, like you know, deal with the trigger point release.

Speaker 1: 20:34

So not only do you get the endorphins from the running, but also you can get those endorphins from…. Yeah, exactly, yeah, absolutely.

Speaker 3: 20:42

And it's just introducing a little bit more movement in the tissue and like muscles in your skin to like make you feel a little bit better. So yeah, if you don't like stretching or mobility work, then massage is one way how you can kind of crawl back in there and make your body feel a little bit better, paul.

Speaker 1: 21:01

I mean, like I asked Molly about sort of some success stories, because I know you said there was someone who was there. Anyone else from you know who you've been treating? Yeah?

Speaker 3: 21:13

So my client recently. So he did his half marathon and now he's training for a marathon coming. Well, he started his marathon training, or will start in a couple of weeks time. But yeah, he came, came in, came to me and at the time he was doing maybe like five, six k's but he wanted to do his 10k okay and then the half marathon.

Speaker 3: 21:35

I think I started working with him in in the summer, yeah. So issues with shins like he's, like this pain is outrageous. I don't think I can. I can run, I don't think it will ever go away. Yeah, you know, initially when someone says that you're like obviously my nhs trained red flags just goes up. But I was like, oh my god. But actually it again just the strength and attention related issue, which we have resolved over time. And he has done his 10k race. He did his half marathon now a couple weeks ago and he will now start training for his marathon and just learning how to do strength training. So very much running but no clue how to strength train, lack of awareness of the body. So when he did, let's say, do squats, just not quite going through the movement in the correct way, so it doesn't get the right muscles working, if that makes sense.

Speaker 1: 22:26

So yeah, that was kind of very nice to see yeah the change in his ability over time I do have one question on the strength training side. Is that, basically, is it best for someone to be doing more reps or should they be doing less reps with a with more, higher weight?

Speaker 3: 22:50

I so there recently there was a research coming out saying that actually you can benefit. The strength will increase, regardless of what you're doing okay but obviously the different muscle fibers we have, like a different yeah, slowly fighter, yeah exactly like. So it's just like which one will fire first.

Speaker 3: 23:09

I haven't read the research paper myself, so don't quote me on this but, so, yeah, the research has come out if you do any form of strength training, you will get stronger eventually, right? My general advice for people is, when you take a weight in your hands and you're using some weight, I would like you to feel on your per set so you know sets and reps when you start finishing your set. On the repetition between six and eight you should feel like I don't know if I can do the eight one then, you know you are working hard enough and you will definitely get stronger right quickly.

Speaker 1: 23:44

okay, so you say maybe a six to eight range. Yeah, yeah.

Speaker 3: 23:48

I mean, there's again, like everyone you know can do different things. And there is lots of research out there of all sorts of things, yeah, but just what I recommend usually to clients in terms of when they do strength training somewhere between six and eight. And then you want to finish your set feeling like, wow, that was hard.

Speaker 1: 24:05

Right, or like I your set feeling like wow, that was hard right. Or like I really have to. You know, and should they be doing, let's say you know, like compound exercises, yeah.

Speaker 3: 24:13

So for runners, what I always would do is do single leg movements for lower body okay so focusing like not just squat or deadlift, but single leg rdls, bulgarian split squats, because you do spend time on one leg when you run. So it's you know you need to make sure that both legs are strong. But what we tend to do when we do double leg movements like squat or deadlift, you will always unconsciously just use your stronger legs slightly more, because those are the muscle fibers which fires quicker and takes the load a little bit more, even if it's like two percent, but over repetitions, what you are doing in dazana. So you want to really isolate each leg as much as possible throughout the reps and the exercise you are doing so there could be single leg extensions.

Speaker 3: 25:03

Yeah yeah, exactly, single leg extensions. My favoritesites are Bulgarian split squat doing walking lunges like curty lunge, so basically where you have to use one leg to push through or like step ups if you start incorporating. You know, depending on your experience and like level of strength where you are in terms of your strength training journey. You can make things more complicated once you start bringing things overhead movements, especially for runners, to engage your core and kind of core control okay which then helps as well and have you found that to me?

Speaker 1: 25:36

that's a question to both of you is do do people sort of ignore although I know that they're running and they use the legs but do they kind of ignore the, the core?

Speaker 2: 25:48

I would say so, yes yeah, okay, okay, yeah I guess, because, yeah, they're kind of focusing on, like you said, using the legs, it's maybe the rest of the body slightly gets a little bit forgotten about yeah, okay, okay just the control of like still, you know, holding your midsection and then using your legs at the same time to have that control of the movement.

Speaker 1: 26:13

So that's kind of what you want to aim for is well, it's well, it's all connected as it is exactly especially when you move in a motion.

Speaker 3: 26:21

Yes, when you you run, it makes it a little bit more harder.

Speaker 1: 26:26

Right, is there anything you would like to to say apart from what we've covered already? Because I mean, you've been very kind, you know, giving your time sort of thing, nearly coming up to an hour, so that you'd like to sort of, at least, you know, tell our audience.

Speaker 3: 26:43

From the physio perspective, I would say you know, if you'd like to sort of at least you know tell our audience From the physio perspective, I would say you know, if you do like running or you want to get back into running, yeah. But you feel like either someone has said to you that you can't run, yeah, or you feel like you can't run because you have this injury always and forever. It comes up in certain, you know, when you get to certain distance. I think you should like. That's when you should go to a physiotherapist and be like I really want to get back into running and just take a faith of leap that it will work and just stick with it and then, yeah, instead of just say I can't do it, hence I'm never gonna run.

Speaker 2: 27:22

yeah, yeah, yeah and I think, like adding on to that, it's like it can work part and parcel. You know, you can get that result that you do want. If you kind of like panacea, don't be afraid to come and have a chat and, you know, even if it doesn't necessarily mean we perform a massage, you can still have that conversation to help give advice so that runners or or anyone really can come along and think, okay, actually a massage might actually help, so I will give it a try.

Speaker 2: 27:45

Or or physio will maybe help me to get to a point where I feel like, yes, I can run, even though someone said I couldn't sort of things. So it's sort of having that and I think it's.

Speaker 1: 27:55

It's not just about you know, if you're a runner, then you know you either do strength training, but also to think about all these other support services you know, like I mean, I've interviewed a pilates teacher and someone who does body movement and and that kind of thing. But it's always worth thinking about other areas that can help you know, enhance, or you're running, or just think about doing other things. It's not just about the, about the running as well.

Speaker 1: 28:25

Yeah, exactly so I was going to ask you, molly, just one more thing. Is that, because I know, being doing sports massage, it can put a lot of stress on your, on your body, do you? I mean, how do you?

Speaker 2: 28:40

well, we're sort of trained in a way to look after your hands and your posture. So, although it might not feel like it, when someone's laying on the bed we might be in an extreme squat position or lunge position, because that's our way of kind of working on a body to a get our sort of technique across properly but, also to look after ourselves.

Speaker 2: 29:00

So a lot of people say your hands must feel really sore and you sort of think, no, they don't at all, because you're actually looking after your body whilst you're massaging, so okay and so you have, you know, and your particular technique also protects you, but as well as you're giving benefit to the client yeah, and it's sort of having a better position. That's the right height for yourself, so that you're in those sort of certain positions to be able to sort of provide the pressure and correct motion.

Speaker 2: 29:25

So it seems like we probably should look exhausted by the end of the day, but we can keep going. I know you look fine, we can keep going.

Speaker 3: 29:32

Molly said that.

Speaker 1: 29:39

Great Right. I think you've been brilliant. Both of you have been brilliant today. Thank you very much for your time, do you've got social media too? I mean, I know you've got a website.

Speaker 3: 29:48

Oh yeah, we have a website, yeah, which is sendempsphysiotherapycouk. And then our Instagram is sendmargaretsphysio Right, so yeah, we can easily find you Can be found on there.

Speaker 2: 30:01

absolutely yeah okay.

Speaker 1: 30:02

Well, thank you very much, and it's always good, you know, not to be doing it sort of in a 2d, virtually, as it were, on zoom or whatever, but it's good to see you guys in person and uh please, please do, please, do come along. You know, if anyone's out there, you know he was listening.

Speaker 3: 30:20

Yeah, excellent thank you very much. Thank you for having us.