James Vickers 


Injuries happen for a reason. What I mean by this, is that there are reasons why a muscle, tendon, ligament or bone fails. This can be an obvious impact or with run related injuries a more subtle mechanism related to the biomechanics.


As a physiotherapist who specialises in lower limb injuries, for me the most powerful outcome of an assessment is to determine why the injury has occurred. Of course identifying what structure has been injured is important but when you combine this with 'the why', the efficiency of the rehabilitation is significantly enhanced.
When considering run related lower limb injuries I consider two main factors.
1) The capacity against the ground reaction force of running
2) The torsional load during each run stride
When considering 1, the ground reaction force, running is high load. The research suggests that the forces are around 3 times body weight. There are two main muscles that work against this ground reaction force. These are the quadriceps and the calf. If the ability of either of these are lacking then the risk of injury surely increases.
When considering 2, the torsional load, this can be either a lack of rotation range or an inability to control the rotation. There are two main areas were this rotation should occur; the foot-ankle and at the hip. Therefore if you identify either a restriction or the inability to control then you have relevant areas to target.
This method doesn't disregard the affected area, in fact the affected area stays center stage, however purely focusing on the injured site is likely to result in slow rehabilitation.


Considering the biomechanics and relating them to the injury, in my view is essential for all run related lower limb injuries. It will add depth. Help you prevent a re-occurrence, guide you on the best running shoes and likely increase your performance. This depth is not possible without considering the biomechanics. This type of assessment is available at Four Sides London.
At Four Sides London we work closely with Runners Need, Clapham Junction. Their excellent understanding of the running trainers on the market. Having the correct footwear is an essential part and compliments the level of detail achieved from our physiotherapy assessment.