Ask a Physio:- I'm keen to start trail running, what should I be careful with?

Author:- Marcus Pain, Principal Physios and keen runner.

Trail Runner Magazine Aug/Sept 2017

Trail running is like the Rally sport of Motor Racing or the mountain biking of cycling, it is a fantastic alternative to running through the concrete jungles that many of us live in. But just like rallying and mountain biking, the risks are very different to the road alternatives. Try visualising a Formula 1 car doing the jumps like a rally car, or riding a Tri Bike down a dirty big mountain (offroad), I’m pretty sure neither would end well. With trail running there are many key differences that we must consider and prepare ourselves for, and from my clinical and practical experience, being informed is the critical first stage of injury prevention in this great sport.

All types of running, in fact almost all types of sport, have injury risks. Injuries in road running, like many endurance sports, are largely attributed to repetitive overuse injuries. Trail running has many similarities to road running, but there are many differences between road and trail running and some of these are much more obvious than others.

So, what should you be careful with? We could go in many directions with this question, such as getting lost, knowing the terrain that you are going to, the wildlife, especially the slithery type, and the first aid that goes along with these... but for this article I will stick to the physiotherapy side aspect, ie the injuries, we will cover the likely causes and will give you some general tips on what you can do to minimise the risks as you start.

The information provided here is important for all newcomers to trail running, whether already an experienced road runner, or a novice runner. In my clinical experience, it is often the roadies that suffer many injuries when they hit the trails, probably because it is not their cardiovascular fitness holding them back, but it is that their body is not prepared for the new conditions. One example is a friend who o is a 90minute half marathoner, he joined me for a trail session in the hills surrounding Melbourne for ‘something different’, we covered about 20kms at a cruisy pace over 2.5 hrs, and he was generally sore for days and it set off his Plantar Fasciitis.

The varied nature of trail running reduces the occurrence of the repetitive overuse running injuries, and in many cases I recommend injured runners incorporate off-road running as part of their return to running rehab because the loads on the body differ with each and every step, and this variety of load means that many different structures are sharing the strain rather than the same each step, there is less repetition. But there are things to be careful of, some more obvious than others. These I will simplistically classified under two categories, the acute injury and the load related injury.

Firstly the obvious, the acute injury...

Falls, Twists and Sprains

The uneven terrain on the trails means an increased risk of twists and sprains, any misplaced step can result in ‘going over’ on your ankle, or slips and falls resulting in bruises and impact injuries. As a newcomer to trail running an immediate difference you will notice is the need to watch the path ahead each and every step. Learning where to step, what surface is stable, what will move underfoot, how heavy is safe to land, and even simply how big your foot all takes time and practice, and they are things that rarely need to be considered when road running. Part of preventing these injuries comes down to proprioception, a key factor of balance, this is your own body’s sense of joint movement and position in space, more simply, do you know where your joint is? And, how quickly are you aware of any change in position? Proprioception, foot-eye coordination, strength, balance and stability are all very important to staying on your feet. If you have ever seen a top trail runner descending a steep, technical terrain, they are amazing, they have incredibly fast feet, every foot placement is perfect, they have great stability and it looks easy. This skill takes time, practice and experience. Be patient, it will come.

Now the load related injuries:-

When we think of trail running, we immediately think of the hills and the challenges attributed to them, the newbie will typically moan and groan at the thought of climbing the steep inclines, however, the climbing is not what will cause the groans the next day!

The bit you think is easy… is the hard bit on your body, the downhill.

Many running injuries are cause by load, and ‘flying down a hill’ is were load is at its greatest. The degree of decline is a huge factor here. The angle where a relaxed run down hill is now an effort, where you feel that relaxing isn’t possible as doing so will result in just going faster and faster until you lose control, this is where your body starts to whimper, the impact is high, and so are the loads. Your knees, quads (thighs), hips, they all feel the impact. This ‘putting on the brakes’ is where you are eccentrically loading your muscles, where they are working hard as they lengthen. This impact and eccentric loading causes that familiar day-after hobbling and cursing of every minor decline or flight of stairs that you never previously noticed. When your body is not conditioned to this impact and eccentric loading, it hurts, so gentle exposure and graduated loading over a period of time is the solution.

Another factor when it comes to downhill technique is that newcomers don’t immediately have the foot-eye coordination to have fast feet downhill, their risk of tripping is very high, so the tendency is to take long lunging steps, this allows more time to look and plan your next step, the bad news with this approach is that this magnifies the load even further, and the risk of twists and sprains. Once coordination improves, running downhill should be about fast, light feet, minimising impact and jarring, this reduces the load on your legs, causing less injuries and the bonus is that it will result in greater endurance.

So what can you do?

Three things, and ideally all three, especially number 3!

1. spend a bit of time planning where you are going, initially don’t try and climb Mt Everest if you usually run on the flat, use online platforms such as www.movescount.com to find a route that is gently undulating rather than all steep ups and downs, find areas that are not too rocky or covered in tree roots.

2. take it slow to start with, don’t push yourself, monitor your loads and don’t be a hero. Week by week gently progress as your body gets conditioned to your newfound love of this sport. Keep the distance well within your comfort and enjoy the day. Listen to your body and seek help from a Physio if any niggles develop.

3. This takes more work, but in my view, is a critical component, it will get you to achieve more, quicker, and aims to bulletproof you from injury, it involves specific exercises that strengthen your weaknesses, improve your balance and proprioception, your foot- eye coordination. The exercise program should involve exercises that target all the leg muscles, from your calves to gluts, as well as your core region and must include balance, proprioception and agility exercises, concentric and eccentric exercises. Speak to a Physio or trainer who knows the sport and can write a program that targets your specific weaknesses while being specific to trail running, ideally someone with experience in the trails themselves.

Also:- Footwear:

It is preferable to have specific trail shoes too, they have much greater grip, more lateral support to tolerate the side to side movement of trail running. Road shoes are primarily designed to go forwards. In my opinion, and I am sure I am not alone on this, one of the most fun parts of trail running a narrow single trail that winds side to side, and without appropriate shoes there will be greater risk of slipping sideways or rolling an ankle. So, save your road shoes for the road, spend a few dollars and get kitted out for he trails, and besides who doesn’t like a new pair of shoes… covered in mud?

Recommendations for trail newbies:-

1. don’t be a hero, your fitness may not be your limiting factor, it may be your ability to stay on your feet.

2. Initially choose gentle non-technical trails

3. Minimise distraction so you can focus on the trail ahead, this may mean no ipod, or not as much chatting on some parts of the run, enjoy the sounds of nature.

4. Bulletproof yourself

5. Have appropriate footwear

• First published in Aus TrailRunner Magazine Aug/Sept 2017

• Marcus has completed many trail run in Victoria, interstate and overseas- his greatest personal trail running achievements include the UTA100 (Blue Mountains- under 13hrs), Bogong To Hotham 56km, Tarawera 85km Ultra- NZ.