Shin splints, runners' knee, tendonitis - Rosemary Rhodes has seen it all. After eight years in Dubai the physiotherapist's reputation within the running fraternity is so well established that she can no longer accept new patients during the busy running season. With no real hills - which apparently promote the correct running technique - Dubai's flat surfaces encourage inexperienced runners to adopt a "wiggle", rocking from side-to-side as they run long distances and get tired.
This, Rhodes says, often causes injuries: "One of the big problems in Dubai is that we only run on hard road surfaces and there are not many hills. If you run like Haile Gebrselassie you run efficiently, so the whole body motion is going forward. He has very strong forward and backwards motion. But if you run like me there is a fair amount of wiggling." Rotating and using the sides of the body wastes energy and promotes strong sides, which need to be stretched. The front and back of the body, meanwhile, tend to be too weak and so need to be strengthened.
Good runners, Rhodes says, are flexible, strong and have good core stability. She recommends activities such as yoga, Pilates and body balance classes for stretching and strengthening work as well as some cross-training, particularly for Dubai runners whose lifestyles are often more sedentary. "We sit at the office, in cars, in restaurants at night, then we go and do high-level activities like running and gym work," Rhodes explains.
"We don't do much walking in between so our body gets stiffer than if we were in a place where we have to do more walking in everyday life." While most people involved in exercise know the importance of stretching after a workout, very often areas which need specific targeting to prevent repetitive injury are not known or understood. "Everyone should stretch, but people don't have or make the time, so there are a few core things, very specific stretches, that are applicable bto hard road surfaces," Rhodes says.
Three key muscles to stretch are the calves, hip flexors and the outside of the hip - the piriformis muscles, followed closely by the quads and hamstrings, at the front and back of the thigh. Rhodes says that most running injuries can be avoided by wearing the correct footwear, stretching properly and following the right training programme. "Injured runners could be doing too much mileage without enough strength work or, for example at Safa Park, there is a camber so people tend to get problems with runner's knee because the side of the iliotibial band gets too tight if they keep running in the same direction," she says. Rhodes recommends all runners to incorporate some short, faster runs or sprints into their routine. This builds up the lactate threshold and thus tolerance for longer bursts of high-intensity running. Equally important, she adds, it encourages a better running stride, allowing the hips to move.
"If someone is injured I often send them back to faster, shorter runs because their form of running would be better if they were to run faster for shorter distances," Rhodes says. Simply stopping and resting for a week when you feel pain will not solve most running injuries, which need stretching, massage and possibly physiotherapy to correct, she says. "If someone has run down Jebel Hafeet and has some pain from shin splints, for example, if they ice it and cut back on their mileage they will probably be OK. But if someone has a recurrent problem that comes back every time they increase mileage, then they need to get treatment."
Stretching has become an area for debate among runners with many questioning if it is necessary and, if it is, when they should do it. Rhodes believes it is paramount to keep the body healthy and injury-free. "People tend to seize up, particularly running longer distances in marathon training. The purpose of stretching is to keep flexibility, particularly in the hips, to improve the running style," she says.
"It is very hard to quantify when the best time to stretch is, because every runner finds something that works for them. All I will say is that people do need to stretch and find a time that works for them - in the morning before they run, after the run or at a different point during the day. "Running causes muscular imbalances so stretch to make yourself more flexible, balanced and to lengthen the muscles so they can work more effectively."