Physio Speak: Six tips to help the runner in you

Driven to pursue a career where she can forge a bond with fellow humans, Aishwarya Nigam is currently a student in the Sinhagad Institute for Physiotherapy but has already rubbed shoulders with the likes of Ali Irani, the celebrity physio who helped the Indian cricket team long before trainers and physiotherapists from overseas were pressed into service.

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“It’s more relatable to our everyday lives,” she says about her profession. “It’s about being very close to people.” Armed with passion, she has volunteered at the Pune and Mumbai Marathons as a professional physio addressing the physical pains of the participants. She explains complications that affect runners in the Mumbai Marathon where she provided her services. And she goes on to offer tips to prevent such complications.


If runners are not adequately hydrated or have not had the right nutritional balance, the electrolyte balance in their blood tends to go on the lower side. That causes cramping. A banana comes up as an ideal remedy here as it is high in Potassium and fixes the balance. Having small fixes of electrolytes before and after a marathon will also keep things in check.


Then there is tightness. People do not do their stretching properly – warm-ups and cool-downs are necessary. If you do not do that, you could end up with long-term muscle damage. Keep stretching. Strengthening is important too, particularly for the knee muscles.


Some runners experience clicking in the knee, others experience shin splints. They feel the pain while running and it lingers even after the event but this can be avoided. If you hear that clicking sound – accompanied by a bit of pain – during your preparations, stop overdoing it or just stop and rest for two or three days. If your knee clicks and you keep running, the friction in the joints increases.

Shin splints are very common too. The pain emerges in the lower leg - ankle to the knee on the anterior (frontal) side. To avoid this, the ankles and knees – both anterior and posterior regions – need to be stretched well.

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Runner’s heel is very common, particularly for those who are not well prepared. They don’t understand that when they run they put their heel forward, commonly done by all of us. But those who run the 21km or the 42km, they’ll get afflicted with runner’s heel.

Many people only run the major marathons, so there’s a good six of seven months to prepare. So, in the beginning, they can slowly start running ensuring they land on their toes or the front-half of the foot. Running on heels gets most of the body weight transferred on it, leading to runner’s heel. Body weight is smoothly transferred to the ground if the landing is done by the toes. Keeping the Tendo Achilles properly stretched is vital too.


One should also pace one’s running, know how much and how fast to go and slow down when required. In between a walk or a slow jog helps and, where possible, pause to take rest because the more you exert yourself, the more likely is the possibility of injury. Decrease the intensity and speed when needed and understand how body weight bears down on the feet, knees or legs.

If untrained, you should not overdo it just to get a good time. Do the marathon, complete it but make sure it’s within your limit. The moment any part of the body, particularly the legs, starts aching, it’s advisable to take rest. You shouldn’t just bear it and carry on, that’s one big no-no.

So stop when needed, rest, go to a therapist, strengthen it and then get back to running.


One of the first injuries some runners may get is bleeding nipples. It’s a very embarrassing thing but it’s quite common, especially when the athlete isn’t prepared. It usually happens with male participants. Sometimes the clothing rubs against the nipples and because of that friction is created. In the heat of the marathon, they do not realise this is happening. People notice it very late actually and many don’t mention it due to the embarrassment.

Many runners now know that this happens but rookie runners have no idea about it. Not very common as most take care of it now. In the 2016 Mumbai Marathon, I came across one such case. Some use Vaseline to avoid it, some use small bandages or adhesive plasters, which can be easily removed later. Smooth clothing helps too.

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