Every year, ACC sees a spike in running injuries in spring as people get ready for marathon season.

Between now and the end of the year, there are 16 marathons around Aotearoa, including the biggest marathon the Auckland Marathon on October 29.

We caught up with David Cooper – a former elite-level runner and Principal Physiotherapist at Kinetics Rehab – to talk about preventing injuries and making it to the finish line.

What is your background as a runner and as a physio?

I started competing as a runner in high-school as a middle-distance runner on the track. After starting university this transitioned into road running with a focus on 10km racing.  I worked my way up to around the top 15 in the country over a 10km distance and did the odd half marathon as well. Fun fact though that I've never quite had the guts to do a full marathon!

I have been a physio for 15 years and have worked in several settings and a number of sports. I had the privilege of working alongside a lot of New Zealand's top runners and athletes.  I have travelled with a number of New Zealand teams, including to the World Cross Country Championships; so running really is close to my heart.

What do you enjoy about running and supporting people in this space?

Running is very much a love-hate thing. People either love it, or they absolutely hate it. However, for me running was always a mental outlet. It was a chance to try and work through problems and challenges and clear my head. 

I'm a little bit unconventional, and typically never run with music or other distractions. It’s time for just me and my thoughts and I've always valued that.

With running being such a big part of my life, it has been awesome to help people throughout my career as a physio.  Whether it is to help improve performance or guiding someone back from injury, I really enjoy seeing people get back to doing what they love.

What advice would you offer runners as they get ready for the Auckland Marathon?

The biggest thing is patience. Five to six weeks out, we start seeing runners coming in with injuries because they have left things a little too late and have rushed the training. 

The health research is very clear that a rapid increase in training load causes problems.  A sudden decision to do a marathon or half marathon leads to an enthusiastic transition from couch life to pounding the pavement. 

That's usually where people end up in our consult rooms because of injury. So, the biggest advice, with five to six weeks out, be patient and don't do suddenly jump into big training weeks without building up to them gradually.  The rough guide is 15-20 percent increase in distance or run duration per week. 

What would you say to people who are worried about getting their preparation right?

A common myth is that you have to complete the event distance before race day.  Personally I don’t buy into that.  On the day, the adrenaline, the crowd and the excitement will help to get you through.  If you don't have quite enough time to get those final stage longer runs in, don't get too worried or stressed.

For the half marathon, you can get away with an 18km run, and you'll get through in the last 3-4km. With a marathon you can get away with 35-38km and once again you'll get through the tail end of it.

A lot of people might be following a training program on the internet, and then life and family in terms of work gets in the way and so you have a few off weeks and you're stressed out a little bit because you haven't had that number that you thought you had to. Don't worry. You can still get there on the day.

The data shows that 90 percent of injuries are soft tissue injuries – what do you see in your physio clinic?

That is pretty accurate.  We see a lot of Achilles tendon problems, knee-cap (patella) related pain, IT Band issues and hip tendon problems.  More serious injuries occur if the bone is affected resulting in stress injuries or stress fractures.  The most common denominator is a rapid increase in load.  I will frequently review Strava or Garmin data with a runner in the clinic to help understand the cause of their injury.  If you want to avoid visiting a physio then start slow, stay steady and increase training volumes in a gradual way. 

What sort of stuff can people do between now and race day to stay injury-free?

I’m certainly a broken record but as mentioned before – consistent gradual training progressions are the best way to avoid injury. 

Aside from this muscular strength is also crucial.  A ‘good’ running style requires strength of your lower calf, quadriceps (thigh), gluteal and core muscles. 

A common myth is that stretching reduces the risk of injury – which is simply not true.  Stretching may be great for comfort, a foam roller might feel good (afterwards!)…but these activities do not directly reduce the risk of injury.  I would suggest that doing two to three good core, glute and quadriceps strength exercises is much better bang for buck for reducing your risk of any injury. 

If people sustain a running injury in the build-up, when should they go and see a physio?

A few features are worth paying attention to because let’s be honest – at times running really hurts! However not everything that hurts is harming you, so here’s what to look out for.  If you are experiencing pain in one particular area (and not on the other side), if it lingers for more than one to two days, or if it remains painful at rest or at night then it’s worth getting it checked out. 

Every year before the Auckland Marathon, we get people rocking up to our clinics, with maybe for four or five days before the marathon or half marathon with a problem they've sat on for three weeks. They want us to get our magic toolbox out and sort them out prior to race day and though we try, it’s always better when we have more time to address an injury.  Sometimes when the niggle or complaint turns out to be nothing serious then the reassurance with a few tips can also go a long way!

What is the feeling on race day when you achieve your goal?

I've raced at a pretty decent level for over two decades and I can honestly count on one hand, the number of races that have gone perfectly. So that's probably the first thing to keep in mind.  I’m a firm believer that you should have that audacious goal; but I have taken the approach that every race there might be a “great result, acceptable result or a lesson”. 

Chasing that great result is an addiction.  Personally the most memorable was a personal best in a half marathon.  My race plan worked to perfection with the second half faster than the first half by more than a minute (the elusive negative split), with the fastest kilometre being the very last of the race.  The feeling crossing that finish line is incredible, knowing that all the hard work has paid off to achieve your goal.

Former elite-level runner and Principal Physiotherapist at Kinetics Rehab.

Running injuries by the numbers

• In 2022 ACC accepted 11,726 running related injury claims. These injuries came at a cost of $9.8 million to help people recover.
• There is a noticeable jump in running injuries in spring – ACC accepted 985 running injuries in August and these increase throughout spring – September (1,077), October (1,082), November (1,259)
• The leading regions for running related injuries in 2022 were Auckland (4,242), Canterbury (1,544) and Wellington (1,247)
• People aged from 25 – 49 made up 52 percent of all running related injuries in 2022.
• Soft tissue injuries made up 90 percent of all running related injuries in 2022 and the most affected areas were people’s knees and ankles.