Tim Noakes’ Ten Laws of Running Injuries
Jonathan King
At University I studied under Professor Tim Noakes, a keen distance runner and innovator in the field of Sports Medicine. In 1985 he first published a bible on running, named "The Lore of Running". The book has been revised and updated over the years. I summarise one of the chapters on running injuries.
1) Running injuries are not an act of God.
There are reasons why injuries occur. For example if one develops knee pain while training for a marathon, this can be caused by factors like increasing training too quickly, imperfect leg alignment, and inappropriate shoes.
2) Running injuries have 4 stages.
Grade 1: Pain after exercise
Grade 2: Discomfort during exercise
Grade 3: Pain limiting performance
Grade 4: Pain prevents exercise
3) A running injury indicates that the athlete reached a breakdown point.
Each one of us has our own tolerance when it comes to training. Breakdown occurs when we exceed our ability to adapt to training loads.
4) Virtually all true running injuries are curable.
Exceptions are when the athlete has severe biomechanical problems, and if there are degenerative problems like osteoarthritis of the knee.
5) Sophisticated tests are seldom necessary for diagnosis.
Most injuries are to soft tissues that do not show up well on most scans and X-Rays.
6) Treat the cause not the effect.
The symptom (pain) can recur unless the causative factors are found and treated.
7)_ Rest is seldom the best treatment.
Rest only helps acute injuries, and does nothing to solve the cause of the problem. Total rest leads to deconditioning and loss of fitness.
8) Never accept as final the advice of a non-runner.
Everyone considers himself /herself an expert on sport. A practitioner with first hand experience will be able to more easily treat an athlete who has an injury.
9) Avoid the knife.
There is a limited role of surgery in running injuries. Chronic Grade 3 & 4 injuries, compartment syndrome, meniscal (cartilage) tears of the knee, and chronic ITB friction syndrome may well respond to surgery. Most overuse injuries will settle with correct advice and non-operative treatment.
10) There is as yet no scientific evidence that running causes osteoarthritis in runners whose knees were normal when they started running.
Osteoarthritis is a degenerative condition where the joint surfaces wear out and break down until ultimately the bony surfaces are exposed.
Those with "ideal" biomechanics and a clear family history may well be able to enjoy very long running careers.