Everything about sports injuries, sports medicine, prevention and rehabilitation. A setback is just a setup for later success – work through it!
Autorin: Cornelia Caviglia, Physiotherapeutin MSc, Sportphysiotherapeutin ESP, Medbase Zürich Löwenstrasse, Center for Medicine and Sport.
Osteopathy prepares the body, physiotherapy builds it up, and chiropractic helps when things get acutely stuck somewhere – these three manual therapies can be summed up in a nutshell. The most important differences briefly explained.
Autor: Dr. med. Patrik Noack
Specialist for General Internal Medicine SGIM and Sports Medicine SGSM
co-head of medicine
Medbase Center for Medicine and Sport in Abtwil
Running is a great sport – but it can also be unhealthy. Especially if you overdo it.
With every step, your feet absorb 2.5 times your body weight at the moment of impact. The amount of work the body can tolerate varies greatly from person to person. However, if the musculoskeletal system is gradually accustomed to the load, tendons, muscles, joints and bones can usually keep up well.
As long as the pain in the musculoskeletal system is only slight (two to three on a scale from zero to ten) and disappears quickly on its own, you can continue to train – but you should keep it in check. Because further excessive strain can lead to “over training injuries”. Therefore, recovery after training should be given the same priority as the training itself.
Over training injuries are usually due to overloading and rarely the result of accidents. These complaints can occur in untrained people after only a few training sessions, if the workload was higher than the musculoskeletal system tolerates.
However, over training injuries are more frequent in intense runners who do not listen to their own body enough and who are driven by ambition: But overachieving can cause physical problems.
Overloading is accompanied by various basic factors that also favor over training injuries. These include, for example, legs of varying lengths, malpositions such as knock-knees or bow legs, previous injuries, age-related signs of wear and tear and also unstable joints or ligaments.
The most common over training injuries are summarized in these tables:
If the first symptoms become apparent, patience is required. It is worth it, because if you get a overtaining injury there is a significantly longer recovery period.
The first thing to do is to reduce the amount of training for one to two weeks. Instead of running, sports that are less stressful for the musculoskeletal system are a good idea. Cycling, for example, is usually possible despite the discomfort of running.
Aquatraining is most gentle on muscles, joints, tendons and bones. If this works without pain, the next step would be training on a crosstrainer, followed by a stepper and treadmill before going outside again for a run.
You should only train properly when you feel well again and your confidence in your body has returned. Supporting bandages, well-fitted running shoes, insoles or other aids can be a good help. Kinesiotapes can also help, for example with muscle injuries or hardening.
If you want to prevent overtraining injuries, you should set yourself reasonable goals, plan and monitor your training well and ensure the necessary recovery.
Without special attention, runners usually lack the necessary core stability. If you don’t want an overtraining injury, you will therefore have to strengthen your core muscles, because they provide good stability. This is especially true for athletes who have had back problems in the past.
In 2002, an interesting study compared the back and abdominal muscles of runners with different levels of training. The result: there were no significant differences, regardless of whether someone regularly ran a lot or a few kilometres. Running training per se therefore has no effect on the core muscles.
Various tests show where the runner stands in terms of mobility and muscle length. Here, too, deficits must be remedied through targeted training.
For example, it has proven to be a good idea to alternate running training with cycling, swimming and cross-training on a regular basis. Training of leg axis stability and foot gymnastics round off the program. Muscular imbalances in the legs also promote complaints.
Autor: Franziska Zehnder, Head of Performance Diagnostics Sports and Movement Scientist MAS Nutrition and Health at Medbase Zürich Löwenstrasse, Sports Medical Center
An injury during the preparation or competition phase can severely disrupt the course of the season and lead to a significant reduction in physical performance. The longer the rest phase lasts, the more time must be invested in reconstruction. However, once the physical and psychological setback has been overcome, many positive aspects of the development can be gained.
Exercise and fitness are a major factor in good health. That’s why SWICA supports its customers who have COMPLETA PRAEVENTA or OPTIMA supplementary insurance by making contributions of up to 600 francs towards their silver or gold six- or twelve-month subscriptions to running.COACH.
running.COACH is a SWICA-recognised partner, offering runners a comprehensive training platform with interactive coaching and training plans. Whether you want to improve your running style or get fit for the next marathon, running.COACH can help you along the way.
1. Check whether you have COMPLETA PRAEVENTA or OPTIMA supplementary insurance from SWICA.
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You will then be sent a confirmation email with a subscription confirmation attached. Send this to SWICA. You should receive your refund within a few days. If you have any questions, please send an email to: info@runningcoach.me.
Although runners are constantly on their feet, they tend to neglect their feet. Regular foot training brings speed and more stability on uneven terrain.
Running barefoot changes the running mechanics. This can be advantageous in case of knee problems. But it is important to allow yourself enough time for the adjustment.
Author: Dr. med. Roberto Llano, Specialist for General Internal Medicine FMH, Sports Medicine SGSM, Head of Medicine Medbase Bern Westside
In childhood barefoot walking was common practice in summer. Adults, on the other hand, hardly do it anymore. And the runners are divided: For some runners barefoot running is almost like a religion, for others it is totally frowned upon. Both sides have good arguments – but there is little scientific proof. What is certain, however, is that the biomechanics of barefoot running are significantly different from those that are used when wearing shoes. Various studies have shown this.
With shoes, the runner becomes a backfoot runner. This means that the runner places the foot on the heel and rolls over the entire foot. In barefoot running, on the other hand, the midfoot touches the ground first and then rolls a little over the forefoot. The front part of the foot is angled less upwards (dorsiflexion) and the knees are stretched less. This shortens the stride length.
When running barefoot, the foot skeleton absorbs more shocks, so that the transmission of force upwards is less than when the heel lands first. This reduces the load on joints such as the patellofemoral joint, where the kneecap glides along the thigh bone. For runners with kneecap problems, such as osteoarthritis, barefoot walking can therefore be an option. The same applies to back pain.
However, the two biggest advantages of barefoot running are that it trains the foot muscles and trains perception for the underground. Many people use their eyes to orient themselves when walking and running. The feeling for the situation in the room, on the other hand, often withers because it is trained too little. You notice how much, for example, when you try to walk on a line painted on the floor with your eyes closed. At the latest, however, when your eyesight deteriorates with age, a good sense of the ground is all the more important. Barefoot walking trains this perception for the position of the feet in space.
It also offers advantages in other respects, as various typical runner injuries occur less frequently for barefoot runners. These include, for example, inflammation of the sole of the foot fascia (plantar fasciitis), iliotibial syndrome with pain on the outside of the knee or hip and problems with the muscles on the back of the thigh (hamstrings).
To conclude from this that barefoot walking is generally better would be wrong. For example, it causes more problems with the Achilles tendon, the calf muscles and it also leads more frequently to injuries to the sole of the foot. However, barefoot walking per se is not more unhygienic than walking in shoes, as long as you wash your feet afterwards.
If you want to start running barefoot, you are well advised to proceed gently and slowly. Because every experienced runner has a well-established running pattern that cannot be changed overnight. As mentioned, both the foot mechanics and the foot muscles change when running barefoot – and that takes months. Over time, the soles of the feet also become more resistant and can endure an amazing amount. In the beginning, the feet quickly become hot when walking barefoot. You can feel every muscle. This is a good sign. And at the same time the signal to stop. Because it should not become more, in order not to overload the feet. If you expect too much of yourself, you risk a stress fracture of the metatarsal bone in extreme cases. A good idea is to cover only a short part of the usual distance barefoot at the beginning and gradually cover an ever longer part. Or to do the running drills barefoot, but then put on the training shoes again.
Whether barefoot running brings faster times in competition is an open question. There were some competitive athletes who competed barefoot. As a rule, however, you run the fastest with the technique you have learned.
A compromise between running barefoot or in shoes is minimal or “barefoot” shoes, of which there are now many models. As far as running mechanics are concerned, they stand between both types of running. However, the exercise profile is similar to that of normal training shoes. But the same applies to miniature shoes: Give your feet time to change!
Tips:
Stimulated blood formation, but decreasing muscular performance – training at altitude can be quite the balancing act. Find the most important tips below.
Author: PD Dr. med. Christoph Dehnert, Specialist in General Internal Medicine and Cardiology FMH, Sports Medicine DGSP, Medbase Sports Medical Center Zurich
What goal do I want to achieve? This question stands at the beginning of any altitude training. Because altitude training has various faces: Is it about preparing for a competition in the mountains, for example an alpine marathon? Or should altitude training provide training incentives to increase performance in the lowlands? Depending on the goal, different aspects are important.
If your goal is to achieve the optimum performance in an alpine race, you have to acclimatize as much as possible to the corresponding altitude. To do this, you should have trained at altitude before the race, according to the motto “Train high – live high”, i.e. “Train at altitude and live at altitude”. This type of altitude training is – in the truest sense of the word – a tightrope walk: the danger of overtraining is much greater than in the lowlands. In order not to get exhausted, you have to reduce the usual training intensity and train more slowly than usual. The catch: the muscular performance adapts quickly – and consequently decreases in height. One way out of this dilemma could be to spread the acclimatization over several short episodes of three or four days each. So, for a few days you have to train regularly at altitude, but in between you need to train in the lowlands repeatedly.
Because the air is “thinner” at altitude, the red blood cells take up less oxygen than usual. In order to improve the oxygen supply to the organs, the body first eliminates blood plasma and “thickens” the blood. In addition, the heart pumps faster and thus increases the volume of blood pumped per minute. However, there is no rule of thumb how much faster the pulse beats in the mountains. Therefore, the training levels from a performance diagnosis carried out in the lowlands cannot simply be transferred up in altitude. Also, the subjective assessment of the training intensity is often far off, especially when experience with training at altitude is missing. The best way to transfer this assessment to altitude is by looking at the respiration. As in the lowlands, during basic endurance training, one should be able to talk in short sentences while running. If you want to have a clearer picture of your performance, however, you cannot avoid performance diagnostics at altitude. Still, this is usually difficult to achieve.
While studies clearly prove that altitude training before a competition at altitude improves the performance there, the data situation is not too clear as far as altitude training for the purpose of increasing performance in the lowlands is concerned. The mechanisms of altitude training to improve performance in lowlands are not yet completely clear. Nonetheless, it is considered certain that the blood formation stimulated by the lack of oxygen at altitude has a performance-enhancing effect. However, this process only begins after two to three weeks of continuously staying over 2000 to 2500 meters. During this time, however, the muscular performance decreases due to the lower training intensities at altitude.
In competitive sports, therefore, two forms of altitude training have become established in recent years: firstly, the concept of “sleep high – train low”, i.e. sleeping at altitude to take advantage of the positive effects of oxygen deficiency on hematopoiesis, but training as usual in the lowlands so as not to have to reduce training intensities. And secondly, to shift the high-intensity training up to a considerable altitude in order to exert an additional stimulus. However, these two logical concepts do not always lead to an increase in performance. There are substantial individual differences here.
If at all, altitude training to improve performance in the lowlands is therefore only useful for top athletes who have exhausted their training in the lowlands to the maximum. But even with them it is controversial whether it really brings the hoped-for benefit. Amateur athletes have rarely optimized everything in terms of training. For the best possible result at the peak of the season (assuming the competition takes place in the lowlands), they probably benefit more from training optimization than from altitude training.
Those who nevertheless decide in favor of an altitude training camp should bear in mind that experience has shown that the maximum performance can only be expected about two weeks later. But here, too, everyone has to make their own experiences.
Tips
Translated by: Denise Kaufmann
This blog post is provided by the Swiss magazine FIT for LIFE. If you’re interested in reading informative articles about running and endurance sports on a regular basis, click here (Website and content in German)
What is seldom found in everyday life, is often available in abundance during the holidays: a grainy, fine sandy beach and the desire to run on it. Let us show you the best tips for injury-free running training on sand.
When the sun bathes the beach in a golden light at dawn and the waves slosh gently over the sand, endurance athletes feel the urge to run. For enthusiastic runners, beach runs are just as much a part of a perfect holiday by the sea as homemade gelato on the piazza in the evening. But what applies to ice cream also applies to running training on sand: high quantities are rarely digestible. It is therefore worth planning your training carefully and moderately to prevent injuries.
Important note: Not all sand is the same. It plays a decisive role whether you walk on soft sand or close to the water on solid (and sloping) sand. The soft sandy soil absorbs the forces actively developed during running. For a similar propulsion as on asphalt, almost twice as much energy is needed. Anyone who almost exclusively runs on tar in damped shoes in everyday life will suddenly feel his foot and calf muscles considerably when running on ankle-deep sand. All the more so when doing it barefoot, as the running style naturally shifts to the forefoot or midfoot.
The other side of the coin: Frequent running in the sand quickly leads to overloading of the locomotor system if the foot and calf muscles are insufficiently trained. Heel spur, shin split or hamstring problems can be the result of an excessive training on sand.
Hard sand is harder than expected and therefore similar to running on asphalt in terms of its effect on the muscles. Whoever euphorically completes an hour-long barefoot run on hard sand at the beginning of the holiday will certainly be punished the next day with sore muscles in the calves. The most important rules of thumb for sand running are, in brief:
For those who do their running training on sand with shoes many possibilities for training design will open up:
If you walk through the sand with bare feet, you not only do something good for your muscles, you also treat your soles with a soothing massage. Barefoot is the most comfortable way to walk on soft sand.
It should be noted that, depending on the walking speed and the nature of the sand, the skin of the soles of the feet is stressed and coarse-grained sand can quickly cause chafing. It is therefore advisable to incorporate the following exercises into a “sand programme”:
Translated by: Denise Kaufmann
Performance tests are not only for professional athletes. Even beginners and athletes with little free time often get important insights from taking them.
Author: Raphael Huber, MSc, Movement and Sports Science, MAS in Nutrition & Health, Medbase Winterthur WIN4
Where do I stand in my training? How well is my general fitness? How do I train most efficiently despite little free time? And what is the best way to achieve my goal, for example, the half marathon? Those who ask themselves questions like the ones above are candidates for performance diagnostics since it provides the most accurate answers.
Performance diagnostics comprises two categories: Endurance and strength diagnostics. The core element is a lactate level test. Most athletes do it on a treadmill or bicycle ergometer, rarely on a rowing ergometer or while swimming. Every three or five minutes, the speed or resistance is increased – until the athlete can no longer do it or no longer wants to continue.
The continuous measurement of the heart rate during the performance test shows how trained the heart is. At the same time, the athlete should indicate at the end of each performance level how resilient they still feel.
The “Borg Scale”, named after the Swedish physiologist Gunnar Borg, serves as a measure for the perceived exertion. Six as the lowest value of the scale corresponds to a very light strain, the highest of twenty is the effort at which the athlete reaches their limit which can’t be maintained for long.
The performance test is most meaningful if the lactate concentration in the blood is analyzed as well. Lactate (lactic acid) is produced as soon as the oxygen supply through respiration is no longer sufficient for energy production in the muscle. As a result, muscle cells increasingly switch from aerobic to anaerobic energy production, which is reflected in a sharp increase in the lactate concentration. To determine this, it is best to extract one drop of blood per performance level from the earlobe. Such a performance diagnosis takes about 1.5 hours (including training advice) and costs around 250 Swiss francs.
The measured values – heart rate, subjective perception and lactate – can be used to determine when the runner is still training in the range of their basic endurance, when the aerobic (first lactate increase) and anaerobic threshold values are reached and when the athlete starts running in the interval range. This varies from person to person.
If, for example, the heart rate and lactate values are already high, but the perceived exertion is still in the middle range, this may indicate that the athlete tends to “bite their way through”. Those runners are mentally strong but often overtax their bodies.
Athletes who know their performance values, strengths and weaknesses can focus their training on what is important for their type of sport: Marathon runners, for example, need a good basic endurance, while 800-meter runners have to cope with high lactate values.
Good long-distance runners have low lactate values (about one millimole per liter of blood, mmol/l) in the test over several performance levels. This is partly due to the ability of their muscles to produce less lactate at a given level and partly due to the fact that their body can recycle the lactate more easily.
For good short-distance runners, on the other hand, lactate levels rise faster. However, their organism is able to continue to perform at its best despite high values of over ten mmol/l. In technical jargon, this is called “good stamina”.
Without knowledge of the individual thresholds one– in the truest sense of the word – runs the risk of training incorrectly. This is all the more serious when the time budget is tight. If you train for a marathon alongside work, family, and commitments, it is essential to manage your time very well. Here, the performance test can help to make the training efficient and goal-oriented. The running.COACH training plan is adjusted to your individual threshold for you to train in the right training areas.
The training plan also helps to coordinate nutrition. As long as the training is within the range of basic endurance, the body primarily uses fat reserves as a source of energy. At this stage, there is no need for an extra portion of pasta providing carbohydrates. In high-intensity training, on the other hand, the organism can hardly burn any more fat reserves. In this situation, a “low carb” diet makes it difficult to achieve the required performance.
Knowing where one’s own thresholds are thus makes sense for several reasons – not only for competitive athletes but also for amateurs and especially beginners. They in particular often make the mistake of expecting too much of themselves according to the motto “Only hard training is good training”. If this happens too often, the “basis” is neglected, and the risk of injury also increases.
The right training is one that is adapted to the individual organism. And this can best be determined by the performance test.
A rule of thumb can help to determine the performance areas:
As long as you pay attention to a few things, a bit of exercise is good for the body – even when your nose is running.
Active people not only have a fitter body than couch potatoes, they also have a stronger immune system. This results from sport improving the immune system. Exercise makes the body more resistant to germs.
At some point, however, sportsmen and sportswomen might still get it: a runny nose, a sore throat, a slight headache – should you really go running now? The answer is: Yes, but take it easy!
Good preparation is the be-all and end-all. It is thus advisable to dress appropriately. For example, a scarf around the mouth ensures that the cold and dry winter air is not inhaled directly.
If you have a cold, the warm-up before the run is best done in the living room. If you already feel that you are not feeling as well as you need for training, this is a good point to stop – and stay at home to get some rest.
The same applies outside, of course: If, for example, at kilometer three, you notice that you can’t perform as usual, the best way to finish the run is to walk back home.
Amateurs, in particular, tend to “ignore” their body feeling when it indicates an illness. However, this is not a favor to their organism.
Moderate movement supports the immune defense during a cold. A side effect of running is that the nasal mucous membrane is better supplied with blood and the respiratory tract is well “ventilated”. Both promote recovery.
However, too intensive training has the opposite effect: it weakens the body and makes it susceptible to injury and infection. In concrete terms, this means no high-intensity training during colds, no plyometric training, no interval training and of course no participation in a competition. No wrong ambition at the wrong time!
Fever is – in the truest sense of the word – a no-go. The reason: during sport, the body core temperature rises. Fever plus sport can increase body temperature to such an extent that vital proteins in the body are destroyed. Also, the body is not ready for training if it generally feels ill, experiences dizziness, a sore throat, breathing problems or if the cough increases during activity. If at least one of these symptoms persists, it is better to pause.
Optimal recovery depends on many factors. Sufficient fluid, enough sleep and a balanced diet are the keys to a rapid return to your training routine.
In general, it is important not to push the limits during training if you have a cold. Slight sweating during running is good in this situation, but full sweating would be too much for the body.
A good guideline is the pulse rate. If the resting pulse in the morning is higher than usual, it might indicate that the body is still occupied with the immune defense. In this case, it is better to skip a workout.
People who know their heart rate zones (training pulse) on the running track, can orient themselves towards it during training. If the heart beats faster or the stage feels more strenuous than usual, then the body needs more protection – and this immediately, not after completing the run.
In addition to running, casual strength training, gymnastics or stretching can also be useful. Swimming would also be suitable from the point of view of physical exertion but is not advisable during a cold. The disinfectant in the water can irritate the respiratory tract additionally and the germs in the warm indoor pool will do the rest.
Author: Raphael Huber, MSc. Movement and Sports Science, MAS in Nutrition & Health, Medbase Winterthur WIN4