Tuesday, 17 September 2013

What are you thinking about when running?

A couple of weeks ago I had a gentleman who came to see me with recurring shin pain when he was running, this had been happening for about a year. This is a common complaint with runners and often attributed to poor biomechanics and increasing your running distance too quickly. This gentleman had had his recent pain for 3 months and had completely stopped running in the past two weeks, but he hadn’t increased his running too quickly and when I examined him he didn’t have any pain over his shins or the muscles surrounding them, which made me question whether biomechanics and overload were the cause of his pain.  So, I thought I’d dig a little deeper and asked him if there was any significant stress at the time the pain began, as this can produce over-activity in the nervous system and lead to pain.  He said that ‘yes’ he had been particularly busy with work and also had some family issues to deal with. Once the pain had begun he attributed it to a biomechanical overload of the shins and in his subsequent runs he focused on the shins to see if he would get pain. I asked him what he had been thinking about during his runs and he said he was analysing whether he could feel pain in the shins or not.  He worked out that the pain had begun about 18 minutes into his last run and so that when it got close to 18 minutes into his next run he began to focus even more on his shins and became anxious that the pain would come back and sure enough at around 18 minutes he began to feel pain. By consciously focusing on the shins it also makes the nervous system focus on his shins and become more protective of this area of his body and thereby increases pain as part of the protective mechanism.

This is a common thing that I have noticed particularly with runners. As it is a solo activity there are few distractions so it can be easy to focus on parts of the body where you may have had an injury in the past or perceive there to be an injury now. All this will do is make the nervous system focus on this part of the body. This will lead to over-activity of the receptors in that part of your body and will increase muscle activity in that area. Not only could this lead to pain, it could also make you a less efficient runner!

Next time you’re out running and you experience pain, have a think about what you were thinking about. Were you running stressed? Were you thinking about problems at work or family difficulties? If so it may have been this that caused the pain. Were you focusing on that calf that felt a little tight in your last run? Or are you thinking about that patella tendon or ITB that was sore a few years ago? If so you may be causing over-activity in the nervous system and potentially causing the pain by over analysing your body.

So what can you do to help prevent this? Well, mindfulness meditation is a great way of reducing stress and focusing the mind on your breathing and not on things that could cause you stress. It helps to induce relaxed breathing and relaxation in the nervous system and muscles. You can do this before running or whilst running. Visualisation is also another great technique. If you are imagining that your muscles are tight or that your ITB or patella is rubbing then it will lead to over-activity. Try to imagine that muscle being nice and relaxed, with a nice healthy blood flow to the muscle and the muscle will more than likely respond by relaxing and not tightening up. Or maybe try telling yourself that you are going out for a run just to enjoy it, not worrying about your time or doing well, just try enjoying it. Focus on your surroundings rather than your body. There was an interesting article in Runner’s World recently, where a runner did just this. He previously would worry about his race and would lose sleep, then he decided to just go out and enjoy his running and he actually beat his PB by two minutes:

Good luck and healthy running!

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