Observations over the long run

Another year another successful Air New Zealand Queenstown Marathon. Over 11,000 runners turned up to see some of Queenstown’s nicest trails under flawless blue skies – and tick off a pretty big challenge. Congratulations to all.

As I write this a few days later, the DOMs will be wearing off and we’ll be starting to sort out the “just a bit sore” runners from those who’ve properly injured themselves and will be arriving in physio waiting rooms around the country. This is the point where the running community and the physiotherapy community usually intersect – after the fact.

This year I had a slightly different experience. One that made me wonder whether that intersection point might be causing some problems.

I spent this year’s marathon on the side-lines a few kilometres down the road from the half-marathon or a bit after half-way for the 42.2km runners. I was there in ‘civilian’ mode, but you can never turn off your physio brain and so I couldn’t help quietly analysing – in a not especially scientific way – the different gaits of the runners and they strode past.

It’s all a bit non-scientific, but here’s the three big flaws I kept spotting:

The arm-chair runner – If you think someone looks a little like there sitting in an arm chair when there running it’s probably because they are flexing at the hip. There was a tonne of weak hip extensors travelling past me. If your hip isn’t getting part neural then they’re be a lack of glut max activation going on, and some very tight hip flexors post-race.

Zombie shoulders – The neck and shoulder tensors. I could almost guarantee which muscle would hurt post-race. Rhomboids, upper trap and levator scapulae. Not because of the load of having the shoulders gently depressed with each foot fall for 22-km but from the constant muscle contraction.

Over rotator – The problem here was the number of runners swinging their upper torsos not just their arms. Swinging your arms a little can lead to great things. Focusing on swinging them faster increases your leg cadence – a plus for most runners. Arm swinging can also support your forward inertia.

Swinging your torso, however, means that instead of energy pushing your forward it just rotates you meaning another other bit of you (usually your pelvis) has to counteract it.

Monday morning experts
So, what should we do when these runners turn up in our treatment rooms in the days after a big race? What might make our physiotherapy regimes better?

Okay-ish: Treadmill assessment – perhaps if they used the same movement strategy on the treadmill as they had on the course. Potentially not.

Better: Trail assessment – this is potentially more useful. Getting them to move on terrain similar to the race, taking anterior, posterior and lateral views.

Good: Trail assessment after 5km – even more useful. Asking my clients to do a bit of distance before I assessment them would show me how they actually move when they get into the swing of a longer-distance event rather than when there at the very beginning.

Great: At race footage – the new social media age is a Physiotherapists best friend. Whereas not so long ago we relied solely on the client’s memories of the incident. Today however we have smartphone, GoPro and even drone footage of incidents as they really happened. If you’re not considering these sources of information in your diagnosis then you’re missing a trick!