How to Prevent Injury When Marathon Training: A Response from Simon Lamb

After my post a few weeks ago on how to prevent injury when training for a marathon, I received a few tweets from Simon Lamb disagreeing with what Greg Ryan was saying. I know a lot of people that see Simon for sport’s massages and trust his opinion, so I thought I’d give him to opportunity to explain his anger towards Greg’s advice and give out some of his own. Simon is a qualified Sports Massage therapist, but as far as I am aware, not a physiotherapist.

‘Running is the most basic of human functions and what the human body
was designed to do. Just as birds fly and fish swim, we as humans run
and walk. What makes me so mad is when healthcare practitioners ignore
this and suggest that running is something only strong, talented and,
in this case, people who can afford access to a physiotherapist should
attempt to do and are successful or capable at without injury. This is
perfectly illustrated by the following statement:

“We were told that running doesn’t make you strong, running makes you
better at running.” – this is an utter nonsense thing to say, what
does it actually even mean? Of course running makes you stronger,
there are millions of humans on this planet who have become stronger
and healthier through running who have never done a single strength
session in their lives.

“In order to run to keep fit, you must be fit to run.” – Again utter
nonsense, empty meaningless words. Praying on people’s feelings of
weakness, vulnerability and inability is a vile aspect of running
culture that is becoming more and more prevalent. I see this more and more every time I hear a physiotherapist speak about running or open a running magazine, the total myth that you can only run if you are strong and capable. It is nothing short of body fascism.

“If you have a weakness and you go running, running will not
strengthen or fix this weakness, rather it will adapt and compensate.”
– Yet more empty, dangerous and insulting talk of runners being weak
and incapable. The idea that there is a perfect running form or an
ideal human form to run with is insulting. The human body is
constantly adapting and compensating to deal with certain situations
it finds itself in. Look at Priscah Jeptoo-her running form
illustrates many bio-mechanical differences from other elite athletes of
her class yet she has found through adaptation and compensation of these
differences a running strength that finds the path of least resistance
and has lead to her being one of the greatest distance runners ever. Does her differences mean she is constantly injured as the statement suggests, no, is the answer.

If I sat you down and made you learn to play the piano for six months
(an activity similar to running in that you need awareness, strength,
practice and determination to achieve) and I gave you two different
ways in which to learn, which one would you choose? Option one:
sitting at the piano and learning to play and strengthen your hands
whilst you learned at the piano keyboard or, option two: sitting at a
table with some hand strengthening apparatus and exercises and
strengthening you hands first for four weeks before you sat at the
piano for the last two. Which one do you think would make you a more
capable, happy and successful piano player after those 6 weeks. I
notice Greg suggested that to strengthen your muscles his advice is
to perform single leg squats, lunges, hopping and other gym based
strengthening exercises. The same advice that suggests that running
alone can’t strength your muscles. What on earth is running if it is
not a set of continuous single leg squats, lunges and hops.

I see some of the strongest, fittest runners through my clinic, whose
bodies are balanced to perfection, they spend hours strengthening
every muscle in the gym, but they are still injured. Why? Because,
having strong muscles means nothing if you don’t know how to use them
within running. Strength does equate to ability. The problem is that
many of these runners don’t practice their running form. They miss
that running in itself repeats all of the things you are told to do
inside the sterile atmosphere of a gym and think that they will step out of a gym strong, capable and injury free. Runners can have the strongest
most balanced muscles imaginable but unless they put that balance
through the motion it was designed to take, it can still be
unbalanced.

In running we have this disgusting culture of self abuse where we are
supposed to ignore what our body is telling us and push through the
pain. That a session is not worthy of attention unless we have
“smashed” ourselves or “killed” it and left ourselves incapable of
functioning. The phrase “Go Hard or Go home” is a disgusting
illustration of the self abuse ingrained in running culture that preys
on the less talented in suggesting that unless a runner exhausts
themselves to the point of collapse then a runner is not a real
runner.

Can I ask you this, how many sessions do you run a week where all you
focus on is your running form? No Garmin, no training plan, no reps,
nothing but how your feet are landing on the ground and how your body
is moving through space. Not many I am guessing but excuse me if I am
wrong.

Look at any other sport, right to the top level. You will see athletes
practicing hour after hour of form based movements relevant to their
sport. However in running many runners ignore this form practice and
head to a gym to recreate a false sense of strength though an activity
you are perfectly capable of achieving through running, if you focus on
practice and form. I am constantly hearing the following statement
from runners “I am just a novice runner, I don’t know anything about
my body, I just go out and run”. This attitude is constantly propagated
by healthcare professions, trainers and coaches who make runners feel
stupid about their bodies,making them feel that they are filled with weakness and causing them to doubt about their capabilities. They are told to ignore the pain and unless a session is painful it has no benefit. They are told to push their bodies to the limit to progress. They are told that they will never be able to run unless they utterly transform themselves from weak imbalanced amateurs to strong, fit, elites. It is this sort of attitude which I see flowing throughout Greg’s words that I object to the most.

Being a strong capable runner is a wonderful thing and can bring
about some amazing experiences and help lessen the chances of injury.
Strength training in itself is not wrong, and can lead to some incredible benefits. It isn’t the key to injury prevention though, why do profession elite athletes all of whom continuously strength train
still find themselves injured. We will always have times of injury as
runners, just as we will always have times of illness as humans.
Trying to protect ourselves from illness and injury is a noble
endeavor. But, what is wrong within the running culture is the consistent berating of runners as weak and incapable. It is wrong to constantly fixate on people’s differences within their bodies and highlight them as faults. It is wrong to pray on those differences and suggest that you will not be able to achieve their ambitions without adhering to a myth that running is only for the strong and fit. It is wrong to suggest that there is only one way of being strong, and it is
unforgivable to suggest that running is bad for you unless your body
is in a indestructible state of strength first.

There is a terribly worrying and upsetting trend in running culture
and literature to target and illustrate every weakness a person has;
you are not running fast enough, your body is filled with
imbalance and weakness, nothing is working as it should and you are
wearing all the wrong things, eating the wrong things and training in
the wrong way to become a runner. What this trend is forgetting is that every human is already a runner,everybody has the strength and ability to run.

I refuse as a therapist to pray on peoples weaknesses. I have patients
in my clinic in tears everyday who have come from other therapists who
assess them and pull their entire bodies apart pointing out weakness.
They are left terrified. Terrified that they will never run again and that running is a dangerous and specialist sport that only the fittest and the strongest can do. Small soft tissue tears that they have presented with and that should have taken a couple of weeks to heal has been blown in to such a complicated mess and state of paranoia within their minds that some have them have not run for month even years because the only help they have received is an egotistical therapist pointing out all of the weakness within their bodies and blame them for injury and inability to run.

It is this constant feedback loop of negativity, oppression and
paranoia ingrained in the mind of runners, and the constant use of this
negative image of the runner’s body that I believe is at the heart of
injury. So many runners are terrified of their body. They have been
taught that they are filled with weakness and inability. This fear
leads to masses of tension within the body that translates to the body
not moving correctly though space when running.

If I was to give you advice as a runner it is to ignore all this
noise. Injuries will happen but how we respond to them doesn’t have to
be the same negative feedback loop about our capabilities as human’s
and as runners. If you find yourself injured be very basic, you cannot
outsmart the human body it needs rest and a stress free environment to
heal. Look at how animals behave when they are injured. They lay down
quietly, hardly moving until their body has fixed itself. As humans we
have forgotten that we are still part of the animal kingdom. Our body
heals itself if we work with it instead of constantly pushing against
it.

There isn’t any stretching exercise that will help you overcome an injury, that isn’t how the body works. If you are having problems with say your knee- heat it with a hot water bottle as often as you can to allow blood to do its work. Leave it on for 20-30 minutes at a time take the bottle off and massage the area and surrounding area. Repeat this for an hour. Also however your muscles are moving it is worth learning to run with a good form. New Balance have created a wonderful set of videos explaining how to do it and this is the link.

http://www.goodformrunning.com/learn-good-form-videos You don’t need
special shoes or equipment or gym equipment it can all be done through
running and will help balance out your muscles.’

Thank you to Simon Lamb for taking the time to respond to my post and Greg’s advice. I love having a different perspective on things, and allowing you, the readers and runners to make up your own mind as to which ‘camp’ you’re in when it comes to strength training and running. Everyone trains differently, runs differently and thinks differently. I’d love to hear about your experiences with physios and sports massage therapists? What are your thoughts on Simon and Greg’s advice?  
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11 Comments

  1. February 25, 2014 / 2:16 pm

    An interesting response! However, I think that the main issue with both of the two posts is summed up in your conclusion – everyone is different. For some runners, no specific “strength” sessions will ever be needed and they will be fine. However, for others, including myself, strength work has really helped. I was getting knee pain, went to a physio (not because I felt pressurised, or any other negative reason but because I wanted to try and stop the pain!) and was told that there wasn’t anything wrong with my knee itself but that the muscles around the knee were quite weak and some strength work would help. In my case, it has helped (touch wood!). The physio didn’t put any pressure on me and in fact said that I probably wouldn’t need to come back. For other people, that strength work might not have made any difference or might have been unnecessary, but it’s about finding out what works for you and your body. I find Simon’s response a little bit aggressive and I think it is important to be open to different approaches.

    I look forward to the rest of the debate unfolding!

    Katie

    • February 25, 2014 / 2:43 pm

      Hi Katie, thanks so much for your comment. I’m like you, for me strength training as well as cross training really help. I really like the physios that I’m working with at the moment, which is not to say that I haven’t seen a few duds in the past! I hope your knee pain has gone!

  2. February 25, 2014 / 5:18 pm

    I, for one, agree with Simon. I think there’s countless people that are all too quick to send us scuttling off to a gym to ‘strengthen’ muscles, when actually focusing on running form would help- you can have the strongest muscles in the world but if you slam your feet down and overstride, you’ll have shin splints before you can say ‘physio’- I think strength work can have its place, but not over and above spending time running, and focusing on form- his analogy about the piano sums it up perfectly, to me!

    • February 25, 2014 / 5:21 pm

      I totally agree that I need to spend some time thinking about running form, infact my 25-30min run this week will be spent purely focusing on that! Thanks for the comment Sarah!

  3. February 25, 2014 / 5:21 pm

    Hello. I’m a physiotherapist and also a follower of Simon who I think is great. I have been a physiotherapist for over ten years and I have experience in sports treating the elite and the amateur. I don’t always agree with Simon and he doesn’t always agree with me but as long as we’re getting people back running I don’t think it matters a huge amount.
    The issue I have with group sessions like Greg’s is that you can only approach things from a general perspective. I think if you did actually have an injury you would have to see a practitioner rather than attend a seminar.
    The other thing I would like to address is the idea of strength training. I am not a strength and conditioning coach, it is I feel beyond my scope of practice but what I prescribe are therapeutic exercises which have a completely different goal to usual strength in a gym exercises. When people are in pain their muscles are inhibited which leads to atrophy of muscles supporting a joint such as the hip or those in the low back. These muscles don’t always spontaneously strengthen up because of the inhibition and I feel it is my job to get these muscles working functionally again so that the joint is protected and works properly, preventing future injury. I also believe that if it ain’t broke then don’t fix it. As individuals we are so full of our own asymmetries but our bodies have learnt to adapt as Simon says. When I rehab runners I often find it’s not always about weakness but about how the muscles are ‘firing’ and acting on a joint or area. So my job is to re-educate those muscles and get them a bit more switched on and get them performing the role that they were designed to do, as it were so that they do their job again. I always introduce functional running movements into my rehab and I am pretty proud to say that I have got almost all my runners back to plodding the street, keeping fit or competition, whatever their end goal is.
    Sorry for the long winded comment but I am a runner so I follow the same twitter groups that many other runners do yet I am also a physio. I guess what I’m trying to say is that we aren’t all duds yet we don’t have magic powers either. Sometimes just physio isn’t the answer. I think to assume that I as a physio can mend everyone would be naive and arrogant. Most running injuries aren’t serious but very occasionally people do require intervention from elsewhere, that’s not nonsense, that is fact. Going to stop now because I’m getting cross and I do get a bit fed up with people knocking my profession! Nobody seems to refer to doctors as duds!

    • February 25, 2014 / 5:28 pm

      thank you so much for your comment, and I apologise for the ‘dud’ comment. In fact I have seen a lot of dud doctors too but that’s another point. I really appreciate where you’re coming from in terms of group sessions, and agree that people need to be treated in a case by case way. Thanks again for your informative comment!

  4. February 25, 2014 / 9:45 pm

    Thanks for following up on this with another blog post Charlie. I know that Simon’s voice and approach can be somewhat aggressive sometimes but I think it’s needed. There are too many people out there in the running world (stores, races, medical professions, running schools, trainers, blog & twitter people, etc) telling us what to do and how. It’s about time someone said, ‘Stop and listen to your own body and work with your own body to improve.’ The more responsibility we put back on runners themselves the better.

    • February 26, 2014 / 5:17 pm

      Thanks Laura, I think for me I always look to the ‘expert’ to have an answer. Whereas actually, when it comes to my body, the expert should be me!

  5. February 26, 2014 / 2:39 pm

    I actually agree with Simon (yes, he was a bit aggressive). I was fine running and then I went to the gym and did yoga, because I felt that I had to strength train or loosen my body to help me run. Now, I’m with a back injury again. And running was never the issue. This isn’t the first time either. So, maybe there is something to what he says. I’m now just doing slow runs and swimming and walking. And I’m okay with this. But yes, there is no one size fits all for the runners and I do get tired of hearing it that way. I also get tired of the 50 million different types of information out there, which becomes overwhelming.

    • February 26, 2014 / 5:18 pm

      Completely overwhelming. What works for one person might not work for another! Thanks so much for your comment and I’m so sorry to hear about your back injury. Get better soon!

  6. February 26, 2014 / 5:18 pm

    Completely overwhelming. What works for one person might not work for another! Thanks so much for your comment and I’m so sorry to hear about your back injury. Get better soon!

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