Prevention Is The Best Medicine
Training for a Marathon
Continuous and long distance events can take a toll on your body and can ultimately interrupt training periods.
The best way to get out in front of this is through preventative injury screening with a physiotherapist or prophylactic soft tissue massage for those high load areas with a Myotherapist or Remedial Massage Therapist.
What is a “Screening”? - Musculoskeletal screening of athletes is an assessment designed to detect internal abnormalities that may increase the risk of injury for an individual. (Harvey, 1998)
This is something that we deal with regularly and something that our Richmond Rehab sponsored athlete Scott knows all about.
Scott has a history of track and long distance running as well as completing the Melbourne Ironman, with his current target the Melbourne Marathon in October.
His injury history includes stress fractures of the lower leg, so preventative assessment and management was high on his list of considerations heading into the final 3 months of training.
Through this series we will outline the structure of Scott’s sessions and outcomes on his training plan through until October, including his assessment and treatment modalities provided.
Session 1: Initial Assessment
Physiotherapy: Injury screen and Endurance testing
After Scott had provided me with all the necessary information on his running distances, symptoms and running plan for the upcoming period it was onto objective testing to apply any specific treatment modalities to address issues that Scott himself may not be aware is going on while running.
Primary symptoms included bilateral lower calf and bilateral lateral hip tightness, both of which are common sites for long distance runners.
From this we started with the following.
Figure 1. Muscle Length Testing
Thomas Test: Designed to examine flexibility of the anterior hip (Illiopsoas), Lateral Hip (Tensor Fascia Latte / Illiotbial Band) and the anterior thigh (Quadriceps Group)
Lumbar Spine Active Range of Motion: How far can the patient move and how do they move through the muscles and joints of the lower back.
Muscle Length Testing of the Lower Leg: Both the flexibility of the Gastrocnemius, Soleus and Achilles Tendon through the knee to wall test. Fig 1.
Calf Raise Endurance Test: A metronome based test to examine how many single leg calf raises you can complete prior to failure. Fig 2.
Figure 2. Calf Endurance Test
Figure 3. 3 Hop Test
3 Hop Test: Power test of the lower leg where the patient hops forward 3 times and holds the landing on the last hop. The distance is measured and compared to the opposing leg. Fig 3.
This concluded the testing portion of Scott’s initial assessment, which will mould the basis of his ongoing treatment.
Treatment provided on the initial assessment was soft tissue massage through the Soleus/Gastrocnemius as well as the TFL/Glute Medius/ITB. For the endurance portion of Scott’s strength and conditioning, single leg calf raises were prescribed to improve his endurance.