Running Like a Girl (21 page)

It seems that this myth comes from the absurd idea that we each have a finite number of heartbeats in our lives, and by increasing your heart rate through running, you will use them up faster. There is so much research to show that life expectancy is extended by exercise that the notion is entirely absurd. Honestly, it is pure madness. Try to smile pityingly at the people who think it, as they probably also believe in witches.

Then there are actual injuries. Yes, sometimes running does hurt—and not just in the “oh my, that was a stiff wind this morning, my ears are stinging” sense. Here are the five most
common injuries among runners, how to identify them, and how best to cope with them.

1) Iliotibial band (ITB) syndrome

By a significant margin, this is the most common source of pain for regular runners, particularly long-distance runners.

The iliotibial band is a fascia that runs down the length of the outer thigh from hip to knee. The repetitive action of running can put a large amount of stress on it, causing it to tighten and shorten after runs that are longer than half an hour or so. This in turn can cause fiery pain in both the outer side of the knee and up in the hip. It starts off as mild discomfort and ends up causing agony, leaving you in despair of ever running again and tackling staircases tearfully in reverse. It is a genuine torment for many runners, as it's impossible to tell whether it has gone until you have been running a while. It tends to make its reappearance when you're tired, possibly being rained on, a few miles from home, and feeling rather low. Like a bastard ex-boyfriend who sends you a flirty text every time you think you might be moving on.

While ITB pain is common, it is not insurmountable, and there is a lot that can be done to alleviate or prevent it. An excellent solution in the short term: Buy a foam roller (a large foam rolling pin–type object that looks not dissimilar to a buoyancy aid or a prop from
Gladiators
) and lie on your side massaging the fascia while you watch TV. While initially painful, this activity does a great job of relieving tension in the ITB and can be a huge help with the pain. However, it does not solve the problem of what is causing the pain.

In the long term, it is important to work out why the iliotibial band is shortening. There can be many reasons. The most common is because the gluteus medius muscle on the outer buttock is not strong enough or working hard enough. This muscle is the one you can see—the outer muscle lying on top of the others, or as I call it, “the Kardashian muscle.” It is this one that turns the leg outward. In many of us, the leg may be inclined to turn inward, collapsing the arch and making the foot flatter, which is called “pronating.” This lack of proper foot control as the foot hits the ground (which many fancy running shoes claim to eradicate entirely) lets the knees roll inward, creating tension on the ITB. This is generally a result of an underdeveloped gluteus medius and can be helped enormously by activating and strengthening the muscle.

You can investigate further, asking why your gluteus medius isn't strong enough. The answer will relate to the fact that instead of spending our days clambering over fields picking berries and chasing animals for dinner, we watch telly and wang around on the Internet. Bits of our bodies are unused like never before, so when we challenge them, our muscles are, quite reasonably, a little startled—at least at the outset.

While there are a lot of exercises online, as well as hundreds of “helpful” YouTube videos (which I suspect are more often watched by curious fourteen-year-old boys with a developing taste for physiotherapists in Lycra), it is always worth finding a professional who can look at exactly which muscles need to be reactivated and how. I am of the opinion that investing in a decent physical therapist and spending an hour working out specifics with them is a far better use of time and effort than trying on numerous pairs of running
shoes and bleating to your loved ones about how your new hobby hurts. Doing a few (admittedly boring) exercises can generally do a much better job of solving the problem than spending hundreds of dollars on the right corrective running shoe or orthotic insert. Save your money for getting someone attractive to talk to you reassuringly while rubbing your thighs, and then buy a running top you feel a bit sexier in. Everyone's happier this way.

2) Plantar fasciitis

Plantar fasciitis sounds like a baddie from a science-fiction novel, but is in fact a sore foot. It is pain in the heel and sole of the foot that creates a realistic sensation of either running barefoot on hot coals or wearing through your heel altogether.

As with ITB pain, plantar fasciitis is most common when runners are at the peak of their training and taking on longer and harder runs. This is also when they can least cope with a painful and confusing injury. And as with ITB pain, it is caused by tightness in the body's fascia, in this instance, the foot area. The fascia is a tissue that each of us has covering the entire body. While I sat, gagging and squealing over my cappuccino like a first-time passenger on a roller coaster, Anna explained to me that the best way to imagine the fascia is to compare it to the film which you see when you pull the skin off a raw chicken: that opaque, slimy, cling-film-like connective tissue between the meat and the skin. For years I thought that my ITB was red and sinewy, like a piece of muscle, but apparently, I was living a lie.

The creepiest thing of all is that the fascia is one continuous tissue enveloping every single muscle and organ in your
body. It wraps around your stomach, intestines, spinal cord, and brain. There is no beginning to it and no end, although it is thicker in some places, such as along the length of the thighs (the ITB) and under the arch of the foot. I find this simultaneously fascinating and repulsive, as if each of us has a never-ending sci-fi beast within.

Medical science has only recently learned that the fascia has some bearing on communication within the body. We already know that the blood and the neural system play vital roles in transporting both messages and substances around the body; it seems the fascia can also communicate. What this means is that if you have tension in one part of your body, it will often create tension somewhere else. Hence the idea of “referred pain” and the popularity of reflexology.

Overstretching can cause inflammation of the fascia, and this is what is behind plantar fasciitis. Typically, it will occur in someone who pronates, as she will tend to repeatedly overstretch the fascia when the foot rolls over.

People mistakenly believe that yet more stretching will ease the pain. This will not help and may exacerbate the problem, particularly in the early stages. In the short term, get a bottle of water and pop it in the freezer, then use the frozen bottle to roll up and down the length of the foot like a rolling pin. That and rest will ease both the inflammation and pain. The injury responds well to rest, but in the long term, it is worth looking at your running style and the condition of the supporting muscles to the area.

3) Achilles tendonopathy

This condition once was referred to—and sometimes still is, in older reference books and the darker recesses of
the Internet—as Achilles tendonitis, because it was believed that the condition was a result of inflammation. (The suffix “-itis” denotes inflammation.)

It was recently discovered that it is actually a physiological change in the tendon fibers at the back of the ankle, caused by repetitive overload on the area. When the Achilles tendon is overloaded (the diplomatic medical term for “overtrained” or “overused”), the body recognizes that it is under increased stress and starts to change its fiber composition. Over time a tendon that once had the springy qualities of a fresh stick of celery takes on the fibrous rigidity of a root of ginger: not so malleable and significantly stiffer. This causes the stiffness and pain that many runners are familiar with.

If you were to look at the tendons under a microscope, you'd be able to see that there are actually more cells, or a bigger “cellular matrix.” This is caused by more blood vessels feeding in to it to try and make the tendon tough enough to cope with the overload. This becomes counterproductive, since to carry on running, you want a nice boingy tendon.

No matter how diplomatic the term “overload” is, Achilles tendonopathy is an injury caused by overwork. If the biomechanics of your body or the way you run are such that you put a lot of stress on that area, the most effective thing you can do is to rest. Think of it as an excuse to catch up on some box sets with your feet up. Running through the injury won't help, even if getting the blood flowing through the area makes it feel better in the short term.

4) Piriformis syndrome

The piriformis is a relatively tiny muscle that sits between the other gluteal muscles in the buttocks. One of
the problems with the muscle is that it sits right over the sciatic nerve, so when someone is diagnosed with sciatica or back pain, she is sometimes suffering from an overactive piriformis muscle. This feels as if someone has jabbed a red-hot knitting needle into your bum from the side, as if planning to barbecue both your buttocks as a human kebab. It is also a hard location to describe when it is causing you pain. You're often reduced to pointing at your bum and gasping, “So . . . sore! In . . . there!”

There are so many surrounding muscles, tendons, and nerves that it seems impossible to articulate what you're feeling. For the greatest immediate relief, find an old tennis ball (spiky built-for-purpose rubber balls are also available in sports shops) and sit on it, rolling your buttocks around until you hit the spot. In the long term, the injury is usually caused by some kind of problem within the pelvis. As with iliotibial band pain, relieving the condition long enough to get through an event and working out the cause are two very different things. It's up to you how far you want to take it.

5) Ankle sprain

There is little that can be done to avoid this one beyond looking where you're going. It's easily done and incredibly common, especially if you're not concentrating. An ankle sprain is the result of placing your foot incorrectly and turning it over as you wobble off a pavement or out of a car, or by misjudging a piece of craggy ground if running in the countryside. The sprain refers to rolling the foot inward so that the underside of the foot turns in and the structures on the outer part of the ankle are massively overstretched.

I am particularly proud of having done this from a sitting position by getting up to go to the bathroom without
realizing that my foot had gone numb. I took two steps on a waggling misplaced foot before the pain hit me, and I spent two weeks on crutches. Not strictly a running injury, but one that means I know this REALLY HURTS. Rest, ice, compression, and elevation (RICE) are your friends here. (these are what the RICE leaflets in doctors' waiting rooms refer to).

6) Stitch

Yes, I appreciate that I told you it was the top five injuries and a stitch isn't strictly an injury, but I am not sure there is any pain worse than a stitch. It paralyzes you with an evil pincer of pain and humiliation. Why does getting a stitch make you feel so idiotic? Surely you should have had some water or stretched properly, or done whatever it is that you're supposed to do to avoid getting one. Why does something so simple feel so utterly debilitating?

A small consolation is that no one really knows what you are meant to do to get over or avoid stitches; it turns out that there are all sorts of theories being expounded about what they are. The received wisdom is that it's a spasm of the diaphragm. The diaphragm is a muscle, so using it irregularly, or creating irregular breathing patterns by becoming out of breath at either the start or at a difficult part of a run, will make it contract out of sync and cause pain.

The best thing you can do is to try and breathe through it, to regulate your breathing by getting your rib cage to expand and contract. Beyond that, we're still waiting for the scientists' next big theory.

You have brains in your head. You have feet in your shoes. You can steer yourself in any direction you choose. You're on your own, and you know what you know. And you are the guy who'll decide where to go.

—Dr. Seuss

R
unning shoes are pretty much all you need to start running, and there are those who would argue that you don't need them at all. You can get away with “these things I used to wear in the gym five years ago” for a good few weeks. But if you're running with a view to a specific event or you've decided that you're going to go for it for a few months, a decent pair of shoes will save you a fair amount of pain. The problem is that you have to buy them. And buying your first pair of shoes can be more painful than the harshest marathon.

Entering a running shop alone for the first time can be overwhelming. Attempting to buy my first pair of running shoes was one of the most terrifying, humiliating, and dispiriting experiences of my life, and I've interviewed Naomi Campbell.

All you are trying to do is find something that will take a milligram of the pain away from those first runs, but it can feel like an assessment of the most committed and intrusive kind. It should not be as hard as it often feels—after all, it's just buying some rubber and canvas to cover your feet. Since that first proper purchase before my first London Marathon, I've done it many times and in many different environments.

Top Ten Tips for Buying Running Shoes Without Having to Exchange Them for Your Dignity

1) Don't leave the shop with a pair of shoes that you find aesthetically distressing.

Running shoes are never going to be exquisite finery, but their strange stripes, swooshes, and signs can be peculiarly pleasing. Before I ran, I always found tennis shoes to have the most charm and had to be talked out of buying them on more than one occasion by those more knowledgeable than me. These days I care what my running shoes look like, but I am prepared to compromise for something that won't actively do me harm. Nevertheless, I remain convinced that the single most important thing about running shoes is that you're not repulsed by putting them on. If you don't want to wear them, you probably won't, and if you're not wearing them, you're not going to run.