Getting to the start line

Getting to the start line


The sea of runners starting off their race as all 100 000 of them charge down William Street, has become an iconic image. A race every Sydney sider wants to do at least once – the City2Surf.

The exuberant atmosphere makes the annual event addictive to participate in. From elite runners to weekend warriors competing for their personal best times, to families walking the arduous 14km, we all pass the dare devils doing the event in the guerilla outfit and the bands playing along the way. Who wouldn’t want to get involved? And boy, oh boy, is it frustrating when injuries hold you back from doing the race.

Runners are exposed to overuse injuries due to the repetition of the sport. Overuse injuries occur when the load placed on the body far exceeds what the body can handle. Imagine you have a pencil in your hands that you are trying to bend. As you apply a little bit of force, the pencil bends. But if you keep trying to bend it, eventually it will snap as the force through the pencil exceeds what the pencil can withstand. The same goes for your body. Your body can only reach a certain point before you get an overuse injury.

ImageCommon overuse injuries to runners can include stress fractures to the bone, shin splints, the dreaded ITB friction syndrome (see previous blog), wear and tear on the joints and cartilage (see previous blog) and knee cap tracking issues just to name a few.

The most common reason runners are exposed to overuse injuries is that runners just keep running, running, running, just keep running. What do sports like AFL, rugby union and netball have in common that running doesn’t?
These team sports have seasons. The players build up their fitness leading up to the season, play hard for the 14 week duration of the season, they then have at least 6 weeks completely off this sport. Sports exist in seasons to allow the body to rest and recover at the seasons’ end. This is the very reason why people participating in team sports are less likely to get overuse injuries.

Runners, on the otherhand, just keep running throughout the entire year.

It is not uncommon for us runners to get in the mindset of ‘I’ll just run a marathon every 2 months to keep up my marathon fitness’. We don’t factor in the idea of having running seasons. And this must be changed to prevent the notorious overuse injuries that runners so commonly experience.

Runners for your 3 hottest tips for preventing overuse injuries, here is what you need to do:

1. Plan your ‘macro’ cycle

This is your overall plan for the entire year. Develop running ‘seasons’ for yourself so you have periods in the year where you are doing other exercise. For example run through Winter to get yourself ready for the City2Surf or the Sydney Running Festival and train for some ocean swims in the Summer. This will allow you to load different parts of your body at varying times of the year, so no one structure or body part gets overloaded and therefore injured.


2. Plan you ‘micro’ cycle

This is your week to week plan. The average office worker should run no more than 3 times in the week, with each run being spread throughout the week and not on consecutive days. These 3 sessions should be varied within the week, with:
-one run being a shorter, faster run. This is where you can add in your sprints and hill sessions.
-another run at a medium length and moderate intensity
-and the third run should be a longer, slower paced run (how long will depend on what you are training for).


3. Stick to the 10% rule

Look at your training progressions and be disciplined with the 10% rule. You should only increase your training by a maximum of 10% each week. When you are just getting back into running, it can be tempting to start running everyday. Resist that temptation! Instead start with 2 shorter running sessions per week and slowly build up.


Adapt these hot tips to your running training schedule today to get yourself to the start of the race. Then immerse yourself in the electric vibe of the running festival.. just watch out for the guerilla outfit along the way!

Every runners nightmare – the dreaded ITB friction syndrome



With the major Sydney running festivals fast approaching, a very common overuse injury to try and avoid is the dreaded ITB friction syndrome. It’s like having the annoying feeling of trying to pay your credit card off – it takes a long time and it just keeps nagging at you.


What actually happens when this dreaded syndrome strikes?

The ITB is a long, thick tendon that runs along the outside of the thigh and knee. Its purpose is to give support to the knee. With repeated bending and straightening of the knee, the ITB and bursa rubs against the thigh bone (femur) on the side of the knee. This creates friction and irritation of the tendon and bursa. It’s just like having a blister, but under the skin.


Common causes

ITB friction syndrome is caused by a history of overuse and repeated mico-trauma. It can be a sign of fundamental training errors including:

  • A rapid increase in training
  • Excessive downhill running and running down stairs
  • Running on uneven surfaces

It is essential you look back through you training program with a fine tooth comb to assess changes to your training. You will then find that there is no coincidence that your training changes will have occurred at the same time your pain started. Therefore learn from your mistakes! And next time you want to increase your training, make the progressions smaller.


What do you feel if you have got it?

  • An ‘ache’ over the outside of the knee during and after runs
  • The pain may worsen to the point that you have to stop exercising and may limp after runs.
  • The side of your knee is particularly sore with walking/running downhill or going downstairs.


What you need to do about it

  • Rest: without appropriate rest the ITB will continue to be inflamed.
  • Training loads: need to be reduced. Reflect on your training program with your physio. Assess WHY this overuse injury started. Learn from your training errors, so in the future you make more informed progressions to training loads to ensure the ITB can adapt to the demands placed on it.
  • Reduce Inflammation: regular application of ice (20 minutes on, 1.5 hours off), will provide pain relief. Anti-inflammatories prescribed from your doctor may also assist.
  • Correct strength imbalances:
    • Get your quadriceps muscles stronger
    • Most importantly, improve the strength of your pelvic muscle stabilisers i.e. your buttock muscles, to reduce the load through the ITB. This is to help your knee track straight ahead when you run and not rotate in. This rotating in of the knee excessively loads up the ITB. See the pictures below – A is the correct alignment and B is the incorrect alignment. This can be improved – you just need to know the right exercises. That is what Physiotonic can help you with! Go to for more info.


  • Massage and stretching:

o   Stretching – you should be doing this regularly anyway, but if not.. get cracking! Stretch out your major muscle groups in the legs – gluts, calves, quads, hip flexors, hammies.

o   Massage and/or release trigger points down the affected leg. Get rolling on a foam roller daily.

  • Wear appropriate shoes for your foot type. Get advice from a sports podiatrist.
  • Other medical interventions:

 o   Injections: See your Sports Doctor for advice on a corticosteroid injection if the problem persists.

o   Surgery: to release the ITB may be necessary in the occasional case that fails to respond to the above measures. Further advice should be sought from an Orthopaedic surgeon who specializes in knee surgery. Physiotherapy rehabilitation is recommended post-surgery.


To help correct your muscle imbalances and prevent the dreaded ITB friction syndrome, enroll in a Physiotonic exercise class today. Visit to get in touch with us. 


The worn and torn knee. And a blurb on osteoarthritis.

Unknown   Have you tried increasing your running lately, only to be frustrated by the fact that you have vague knee pain and that your knees keep swelling up? It’s most likely signs of general wear and tear through the joint. We have 2 types of cartilage in the knee;

  • Articular cartilage, which lines the end of bones in a joint.
  • Meniscus – which is unique to the knee joint and is designed to help absorb shock as we move about and run.

We are born with cartilage that looks like a brand new dance floor: clean, smooth and shiny. As you get degenerative changes, the surface starts to look like a cobble stone road: messy, rough and tarnished.


Over time, your cartilage cops wear and tear, particularly if you have loved high impact sports and lots of running in your life. Osteoarthritis is simply these degenerative changes. Like you can’t make an old T-shirt look new, these changes in the knee cannot be reversed. And, much to your surprise, even though osteoarthritis is riddled in our population… we…. don’t…. yet… have…a…cure. There is so much in medicine we just don’t know, and this one on osteoarthritis is one of the biggest enigma’s in medicine that is still remaining.

Currently the only curative treatment is a total knee replacement, of which the lifespan is about 20 years in Australia. Whilst you can achieve relatively normal function, you can’t place them under large stresses such as running because the replacement will fail.

There are a number of non-surgical options that are currently being trialled (steroid injections, hyaluronic acid injections, stem cell therapy, etc). Unfortunately all have failed to show any benefit over placebo.

The current best advice for anyone in the early stages of osteoarthritis is to lose weight and restore good muscle strength to prevent the worsening of the disease.

You will be pleased to know that there have been some recent, large clinical trials looking at the effects of running with osteoarthritis. Running isn’t a complete no, no. In fact doing some running, in moderation, keeps your bones really healthy and strong!

Physiotonic joins the blogging world

Physiotonic are expert Sports Physios who run group exercise classes to help improve your buttock muscle strength, deep core stability and flexibility. By doing our exercises we will help you improve your posture. We specifically focus on helping runners to achieve their goals – and with our exercises, our runners will get a stronger, more stable running body to help you run faster! Visit for more information. 


Our blog will focus on running tips, information on injuries and injury prevention, and a myriad of health and fitness tips to help get you on your way. Sit back, relax and enjoy!