Too much too soon

Doing too much too soon is a common scenario we see here in advance physio.

A 5km runner comes in explaining they have had pain at the front of their knee for months on end. They’ve tried rest, which didn’t work cause when they returned to running 5km the pain came back.

They’ve tried deep heat and pain medication, which lessened the pain for a while but then they tried running 5km and it was still sore.

They’ve tried a few general stretches but that didn’t work either, infact that made the pain worse. So what did they do wrong and why did all of these things not work.

Too much too soon is a simple term used to describe the unbalanced nature of volume and load compared to what the body can handle after an injury. For example, a runner with knee pain who rested for 2 weeks and then tried to go out and run the exact same distance he was running before the injury, made the crucial mistake of thinking that his rested injured tissue was at the same strength prior to the injury. He’s done too much too soon.

A good example of how to return to sport after a knee injury is to gradually increase the load through the knee. A couch to 5km is a great method of gradually increasing the load on the knee after an injury over the course of 9 weeks because it uses walking and running to get you fit.

Obviously different people will require different loads and volumes and intensities of training as they return to sport. There are key bench marking steps that a good physiotherapist will use to help assist you to determine at what stage in the healing process you’re at.

Can you jump vertically once/ twice/ or even twenty times with pain less than 3 out of 10?

If no – then surely you shouldn’t return to running where you are basically jumping over and over again.

What about hopping?

Can you hop with no pain and without your knee falling towards the other knee when you land? If you’ve no pain but your knee falls in the way – then perhaps you’ve got a dynamic weakness into your gluteal muscles and this was the cause of your knee pain in the first place.

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increased pressure through the inside of your knee joint
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do this over and over again while running and the tissue becomes inflamed

A good physiotherapist will help you to identify the cause of your pain and then help you to gradually increase the amount you do on the injured area.So keep that in mind if you get an injury that very often people return to their activity doing too much too soon.

References
Goom, T. 2015. Balancing training load and tissue capacity. http://www.running-physio.com/capacity/