7 common running injury rehab mistakes

There are few things more frustrating to we runners than being sidelined with injury. That said, we don’t always help ourselves – we spoke to James Vickers, sports and exercise physiotherapist at the Centre for Health and Human Performance, to find out the biggest mistakes we make while rehabbing running injuries and what we can do to get back on the road.

1/ Telling yourself that it’s just a niggle

We get it. You’re in the midst of training for your goal race, you need to stay on track and you don’t have time for an injury. But running through niggles session after session isn’t going to lead you to glory at the finish line. It’s vital to know the difference between a true niggle and the beginnings of a full-blown injury. ‘If it wakes you up at night then something is definitely wrong,’ says Vickers. ‘If it’s really stiff first thing in the morning again that’s a sign it’s more than a little niggle that you would generally run off. If it’s getting worse and you’re noticing it more during your day-to-day - not necessarily while running but while you’re walking, going down stairs, after sitting for a while - then that’s going the wrong way.’

If you decide to take some time out, bear in mind that rest won’t always fix your injury woes. ‘If an injury is going to settle down quickly it will settle down within the first two weeks of not running,’ says Vickers. ‘If you had two weeks of relative rest, unloading it and progressively trying to get back to activity and the injury hasn’t come good then it’s unlikely that it’s suddenly going to get better without any sort of assistance.’

2/ Running through pain

On a similar note, continuing to run on an injury – even if it gets less painful as you go – isn’t going to help you in the long term. ‘There are certain injuries that kind of warm up as you run – common tendon issues like Achilles tendinopathy, patellar tendinopathy (runner’s knee) and high hamstring tendinopathy. These tend to follow a pattern that they’re worse to start with then kind of get better. That’s reassuring that things are actually okay, but then you’ll be set back afterwards,’ Vickers explains. ‘When you have tendon issues and have followed that pattern for months, you will probably make that tendinopathy harder to rehab.’

3/ Not finding out why you’re injured

There’s a big difference between knowing what an injury is and knowing why you’ve got it. Putting a name to your problem is helpful, but it won’t take you any further in solving it – so it’s time to see a physio rather than have an extended session with Dr Google. ‘The internet’s full of information – it’s a resource that’s there for people to use, but it’s not going to be able to assess you, look at your biomechanics and give you an insight as to why the injury has occurred,’ says Vickers. ‘To me, that is a more important question than what the injury is, because the answer gives you the power to get rid of it.’

4/ Heading straight for a sports massage

Sports massages are a powerful weapon to have in your running arsenal, but only when you’re 100% sure what you want them to achieve. If you’ve got a sore leg but haven’t got a diagnosis then you could be doing more harm than good. ‘If you’ve got an acute injury to the muscle, do you really want someone to go in there with deep tissue massage? Probably not,’ Vickers warns. ‘That’s definitely something to be aware of. You want to get an understanding of what that injury is, because the management of an acute muscular tear is different to the management of a long-standing tendon issue.’

5/ Skimping on physio exercises or stopping altogether

Physio exercises are the dental floss of the running world: dull, but necessary. If you want to iron out the muscle imbalances that have led to your injury, stick to your prescribed physio exercises – and keep them up even after your symptoms go away. Vickers has a handy rule of thumb to judge the progress you can make with physio moves post-injury. ‘If you’re doing something once a week, you’re just about maintaining what you’ve already got. If you’re doing it twice a week you can see some progress with that. Three times a week, you’re trying to push something to improve quicker.’

But remember, it’s not just the exercises you need to focus on. ‘You’ve got to think about what’s actually driving those weaknesses,’ explains Vickers. ‘Is it sitting all day and getting really tight through the front of your hips? Are your calves getting stretched out because you’re sitting with your feet under your chair?’ Seeing a good physiotherapist will let you figure out the answers to these and help you find a way to fix the weaknesses before they get worse.

6/ Putting too much focus on stretching and foam rolling

Stretching and foam rolling are important, yes. But they shouldn’t always be your first – and definitely not your only – port of call, according to Vickers. ‘Overall the thing people don’t really recognise during rehab is that running is quite a high load activity, and therefore strength is one of the most important things. There’s a tendency for people to be focusing on stretching or foam rolling and the strength aspect gets pushed aside.’

It’s easy to stick to the things we do well, which is an issue when it comes to injury rehab. ‘The people who love stretching and foam rolling are generally the people who perhaps don’t need it,’ Vickers has found. ‘They’re generally more mobile people and if you’re a bit more mobile then that’s actually a disadvantage when it comes to running. People like this really need to do some correctly guided strength work.’

If your muscles are tight, that’s a symptom of something else. Vickers says that while stretching and foam rolling can treat this tightness it’s important to find out why that tightness is there in the first place. ‘A muscle may be tight because it’s not strong enough for what it’s being asked to do. The foam rolling isn’t really getting to the root cause of the issue.’

7/ Forgetting major muscle groups

If you’re a regular runner, chances are you already know the importance of strong glutes to control your hip rotation and prevent injuries. But Vickers encourages runners to show a little more attention to two oft-neglected muscle groups: the calves and the adductors. ‘People’s calves generally aren’t as strong as they need to be,’ he says. ‘Nobody likes doing calf raises! Runners need good calves, especially the soleus, the deeper muscle of the calf complex, which often gets totally ignored by the running population and rehab programmes.’ You can improve your soleus strength with bent-leg calf raises.

Adductors, the muscle group on the inner side of your thighs, are essential for providing balance around the hip. ‘Adductors are massive. They work through many aspects of the gait cycle,’ says Vickers. ‘They’ve got the important role of helping stabilise the leg during the stance phase, power the leg through early stance phase and also initiating the swing phase.’ Work on recruiting your adductors by squeezing a Pilates ball or football between your legs, then build strength with sumo squats and high step ups.