Help with Running and Posture from a Member of the London Marathon Clinic

March 12, 2013 - Mike Dilke

Interview with Member of The London Marathon Injury Clinic

I am slightly paunchy, 46 years old have been persuaded by the BackCare charity to run the London Marathon. I am very excited about this but in the last few years I have done little exercise so I thought I should ask one of the clinics appointed to be a member of the London Marathon Injury Clinic some advice.

Stephen Makinde is the Director of Perfect Balance Clinic (Physiotherapy, Osteopathy and Sports Injury Clinic) in Hertfordshire and London. He has great experience in injury prevention and treatment specific to endurance running and he was good enough to answer some of my questions.

Q.            I suffer from the occasional back twinge. Could the jarring from long distance running aggravate this and what can I do to try and prevent it?

A.            Long distance running may be aggravating on the back, as it is an activity that involves repetitive impact and stress to the joints. It is critical that importance is placed on not only the abdominal muscles and back muscles but most importantly the balance of the leg muscles and pelvic stabilising muscles.


Q.            Does running ever ease back pain?       

 A.            If you are experiencing back pain, it’s important that the cause is understood. There are many health benefits to exercise, but the correct exercise. Once the cause is understood then an appropriate programme can be adhered to.  Running should help some back pain in the later stages and is actually an important part of rehabilitation of back injuries as it is a natural movement for the spine and pelvis to go through.


Q.            Do people with a good posture tend to be better runners and get fewer injuries?

A.            Having good posture will aid correct and efficient running technique and will in turn prevent injuries.   However, I have seen some people with awful postures and technique that just never seem to get injured.  I am always amazed at the resilience of the human body.  It’s a difficult question to answer really but running efficiently has an underlying biomechanical basis so we can only try and stick to this and hope I guess.

Q.            Can I do any particular warm up to help prevent injury when training?

A.            A good warm up and cool down is very important in preventing injuries. A warm up aims to increase heart rate, breathing rate and blood flow to the muscles, allowing you to work more efficiently and prepare the body for vigorous activity. Warm ups should vary depending on what type of training you will be completing. For example, for an everyday run, start by walking around the block, then progress slowly to your pace. Make sure you build your warm up slowly, and be aware that warm up may take longer if tired or sore.  Prevention of injury when training I think comes from the correct physical, emotional, biomechanical and psychological preparation, these are all important factors and must not be forgotten.

Q.            Do you have any particular advice about warming down after a run?

A.            Devise a thorough warm down routine on all muscle groups and learn how to use a foam roller! Quite uncomfortable and painful at times to use, but foam rollers are very beneficial to help 'stretch' your muscles and reduce tension and knots.  Make sure you maintain your hydration levels post exercise.

Q.            Do injuries and hence your advice tend to change when runners are over 40 years old?

A.            Yes. We all should start to realise that as we become older we often find ourselves becoming less flexible and more stiff post exercise. A lot of my runners say if they could turn back time, they would have definitely stretched more often in their younger days when running. So, in short yes, I would advise taking more time stretching, using foam rollers, attending Yoga, Bikram classes. Runners like to run! Most runners find stretching time consuming and it is, sometimes dull at times too. However, if you speak to any regular runner what their routine was like 10 years ago compared to today, I can guarantee they would answer with... "I stretch more and pay more attention to my recovery in between my runs"

Q.            Is there any advice you can give that will prevent or at least lessen the stiffening of muscles after training runs.

A.            Up until a few years ago, most sporting health professionals would advise regular runners or people training for marathons to have an ice bath or cold bath post long runs. However, new scientific evidence is now suggesting otherwise. An recent article in Athletics Weekly explains further. ( My advice??? Go for a long run, 10 miles for example, warm down,  then get home and have a cold/ice bath for 10 minutes. The following week, repeat exactly the same running course and distance, warm down then go home and have a normal bath or shower, no cold/ice baths. See what difference, if any, you feel?  I think each person is individual and what research says this week will change next week, try a few ways of recovering and see what works well for you.

Q.            Do you have any special advice for race day to help ensure an injury free event and to try and stop too much pain the next day?

1. Make sure you have a well structured active/dynamic warm up and you are organised with the start time so you don't warm up too early then stand in the cold shivering! Equally make sure you leave yourself enough time! Warm up wearing old clothes on top of your race day clothes, so when you are about to start the race, you can remove your old clothes and leave them on the side of the road. Most established marathon races will have a Charity that your unwanted clothes are donated to.

2. Plan the race day, i.e. in your marathon training, pick one of your long runs and pretend that is the actual race day. Carb load the night before, organise how you are going to get to the 'race', eat the same breakfast you are going to eat for the real day, wear the same clothes, take on board the same nutrition (energy gels, sports beans) you plan to have on the day. If you are running a large, well organised race for example, find out which sporting nutrition company is sponsoring the event and giving out complimentary energy gels or energy drinks. DO NOT eat/drink foods on the race day that you haven't trained with, who knows what your stomach will do!

3. Try and keep active post marathon. At most larger marathon events, you will not go and have a shower/bath whether hot or cold, as it will be in a city. Most runners will meet their loved ones after the race and go for food, sit and relax. But try not to sit down for too long, get up regularly and stretch the legs, otherwise you are at more risk of the storage of waste products in your muscles and will seize up. Wear fresh, dry clothes once you have finished your marathon to regain normal body temperature, also known as 'Homeostasis.' If you are running for a well estabilished charity, they will often have Sports Massage Therapists providing post marathon sports massage. This is a great opportunity, for you the help reduce the waste products accumulated in your muscles, gives you some mental and physical 'downtime' whilst you are relaxing on the massage couch too, time to rehydrate and eat. Take advantage, you deserve it!

4. Most importantly.....listen to your body! If your right calf is 'crying' out to you because it is feeling so tight at mile 18, then stop, walk, stretch, take some electrolytes on board and relax. Wouldn't you rather complete your marathon happy and as injury free as possible, or are you determined to maintain your 8 minute miling, increasing the risk of a muscle tear in your calf and having to limp over the finish line to greet your family at the end of the marathon?

 5. Finally..... go and enjoy it! Feel blessed that you are able to train and compete in a marathon


Perfect Balance Clinic operate from 6 locations across London and Hertfordshire. Their flagship running clinic is in St Pauls where they work alongside top running specialists to help improve your running.

Telephone 0800 0724012