Conversation with an NHS podiatrist

I had this conversation with NHS podiatrist Robyna King, answering your most asked foot questions! This blog post is in support of the We are the NHS campaign. If you enjoy it, please do share on Instagram! If you have any further questions, please visit NHS Live Well.

Robyna King graduated from the University of Plymouth in 2012 with a first class honours degree in Podiatry and currently works in the Solent NHS Trust. Since qualifying as a Podiatrist, Robyna has experience of working in a variety of NHS Podiatry roles, with both clinical and management responsibilities. She particularly enjoys the opportunity to make a real difference for people; either providing direct patient care, supporting staff or service development. Robyna is looking forward to supporting staff through a Podiatry Apprenticeship Degree later this year and is excited by the personal development this will also provide.

  1. Any advice for preventing blisters? What should you do once you have them?

Blisters for runners are very common as well as for many people when they start wearing a new pair of shoes for example.

There can be some ways to prevent blisters when running and exercising such as:

  • Wearing 2 pairs of socks or there are some double layer socks you can purchase. These can help reduce the friction on areas of the foot prone to blistering for example under the ball of the foot, heels, and toes by putting the stresses on the sock rather than the skin.
  • Using Surgical Spirit, applying to vulnerable skin with a cotton pad 2-3 times a week, which helps strengthen skin. This can also be used between the toes to prevent them become sore and too soggy when they get hot and sweaty in your trainers. Follow the guidance on the bottle and do not use on broken skin.
  • Ensuring your trainer and shoes fit you correctly. We advise footwear with a fastening such as laces to ensure they are tied and tightened to support the foot and prevent the foot from moving in the shoe causing friction of the tendons and joints from having to overwork to keep your shoe in place. Having the footwear wide enough at the toes and ball of the foot is very important so that they don’t get too much pressure in the wrong places. If you are struggling with getting footwear to fit it can be worth finding shoe or sport shops that help fit shoes.

When treating blisters, you should try to avoid bursting or popping them, instead allow the blister fluid to be reabsorbed into the skin and heal naturally.

If, however, they have already burst and the skin is open, it is very important to clean the area carefully and apply a sterile plaster or dressing while the area heals. This will not only prevent further friction on the skin but also reduce the risk of an infection by keeping it clean and dry.  If you have a large intact (not burst) or open blister, then it is worth having a rest from running or exercising where you are weightbearing (on your feet) to give the skin chance to heal.

If the skin or blister area becomes red, hot, swollen, has increased discharge or smell then it may be a sign you have an infection. If you notice these signs or the blister is taking a long time to heal, it is important you contact your GP surgery for guidance and likely will need some antibiotics. 

2. If you have a collapsed or weak arches, how do you strengthen them?

It is important to know that many people naturally have lower arches or flat feet. Most people inherit this from their family and are born with this foot shape, some with no pain and do not need treatment such as insoles. 

However, if they become painful or your feet have started to become flatter over a period of time then it is worth contacting a podiatrist for an assessment to see what individual treatment you may need and what may be causing the pain. 

If you have painful arches it is best to avoid any strenuous exercises such as running as is high impact on your feet and joint and could make it worse or more painful.

Some people find intrinsic foot muscle strengthening can help to strengthen the muscles in the feet to support the arches. There are many strengthening exercises available including videos online including ‘the big toe stretch’. If you decide to try these start them gradually and only do a small amount at a time. Its best to try get do them regularly and get the into your routine but remember if you start getting any increased pain or side effects stop. 

3. Many runners lose toenails in training or races – is this harmful? How can you stop it?

It is very common for runners to lose toenails, which to the person can cause some worry and pain. Losing the toenail itself does not always cause any harm, however if the skin on the nail bed is broken which would need a sterile dressing or plaster applied and follow similar advice to above when discussing looking after blisters that burst (Q1).

Over time if you damage a nail through regular trauma, where the nail is repeatedly knocked or the nail falls off, it can damage the nail cells (where the nail grows from) meaning the nail will grow back thicker or a different shape. This can make the individual feel the nail is unsightly or can be painful. If the nail is thicker you can help by filing over the surface of the nail to carefully thin the nail slightly as they can be difficult to cut.

If this does not manage it, I would advise they contact a podiatrist for advice on treatment whether that be how to prevent the trauma to the nail, cutting/filing the nail in a way to manage it or have the nail removed permanently to prevent it growing back.

Ways to prevent it include ensuring your running trainers fit correctly, avoiding running downhill or on rough terrain as this often puts increased pressure on the nails and cutting your toenail carefully straight across so they are not too long and pressing on ends of the trainer.

4. Should we all be moving towards zero-drop/barefoot shoes? What are the benefits, if any?

For some people this can be the right option but for many it is not. There is little research to say moving toward zero/low drop or barefoot shoes can help with performance or for any other practical reasons. Therefore, unless you have been advised to for other reasons and you are used to running in this way then I would not advise to just start this without getting further individual guidance.

5. How can runners deal with bunions? Are they always problematic?

Similar to low arches and flat feet, one reason we can get bunions is because we inherit them as part of our foot shape. They are not always problematic even if they are quite prominent or not aesthetically pleasing. 

Depending on the cause of the bunion it can change how a podiatrist would advise you manage them. Pain from a bunion could be from the joints or tendons being inflamed, or it could just be that because skin on top of the bunion gets rubbed and sore and could cause blisters.

Some find bunion supports or protectors to help with the bunion and skin getting sore.

Others may find insoles/orthotics can help to reduce pressure and workload on the bunion area and encourage the rest of the foot to do more. The main thing to help to reduce pain or you getting a problem is to follow guidance on footwear, including wider fitting shoes with a fastening and a stretchy material upper of the shoes that sits around the bunion to avoid pressure.

If you would like further advice on individual management of your bunions or joints in the feet then contact a podiatrist for an assessment to see what other options may be available including insoles and surgery options.

6. How did you get into podiatry?

I always wanted to do something in the health field to help make people better. I was lucky enough to do some work experience when I was 16 in a private Podiatry clinic and an NHS physiotherapy department.

I loved both but my choice was Podiatry as I felt it was a bit unusual and that there were so many opportunities for different roles in the future in the  NHS. I completed my A levels at sixth form including Biology and Psychology and then applied to university to complete a Podiatry BSc(Hons) Degree. It is a 3-year course and included both theory and practical skills which I really enjoyed, as I went on placements to different NHS Podiatry Services to learn on the job experience with NHS Podiatrists. When I qualified as a Podiatrist, I then applied using the NHS Jobs website to find roles in my local area and a couple of years later ended up in the Solent NHS Trust which is where I am now. I have loved being able to develop my skills and continue to learn things every day, which most importantly helps patients and support them with their foot conditions making a real difference for them!

As a podiatrist I have great opportunities to use all different skills including wound care, nail surgery and MSK (musculoskeletal) care. We can work in patient’s homes, hospital and health centres, meeting a variety of people along the way. 

So, I would say if you are interested in health care and do not mind looking at feet all day this is the job for you! If anyone is interested in podiatry as a career or any health profession look on https://www.healthcareers.nhs.uk/ which shows all the amazing careers out there and what to do to have a health career including going to university or even apprenticeship courses which are available for some professions.

7. Should runners be doing anything specific to look after their feet? Creams? Massage?

You will see a lot of this has already been answered in some of the other questions for example how to prevent blisters, prevent painful arches and bunions. 

Here are my top tips to look after your feet if you are a runner:

  • Wear good fitting trainers that are wide enough, have a fastening and good cushioning sole for shock absorption. 
  • Air out your trainers and footwear after wearing them and rotate the use of your shoes (so you are not always wearing the same pair) to ensure they have chance to breath and dry, which prevents bacteria and fungal spores growing.
  • Don’t save your new trainers to wear for a race or long training session. It can be best to wear them in gradually over a few shorter sessions preventing blisters and allowing your foot to get use to that style/shape of footwear.
  • Wear good quality socks to protect your skin and prevent friction.
  • Wash your feet and change your socks daily and after exercising, this can prevent fungal infections on the skin or nails and will keep the skin condition healthy and clean. 
  • If you think you have a fungal infection also known as ‘athletes foot’ speak to your pharmacist about treatments available over the counter. If not improving, then consider discussing with a podiatrist or your GP.
  • Dry feet well all over and between toes after washing them. This again prevents fungal infections and the spaces between your toes from getting too soggy and sore. Using surgical spirit as advised in question 1 can help too.
  • Using a urea base foot cream can help hydrate the skin on the feet, preventing hard skin and calluses. It is best to use daily all over your feet but not between toes after you have washed them. 

8. Plantar Fasciitis. What is it and how can it be helped? Are there any injuries assumed to be PF that are actually something else?

Plantar Fasciitis (PF) is a painful condition where there is inflammation of the plantar fascia, which is a structure that supports the foot from the heel to the toes. It can affect both feet or just one foot and the pain is normally felt around the heel and can sometimes be felt into the arch or into the calf. It is a very common condition and can affect both those that do and do not exercise regularly.

Check out the NHS website for further guidance but here are some simple ways that can help if you believe you have or have been diagnosed with PF.

  • As tight calf muscles can exacerbate and potentially cause PF therefore stretching your calf muscles (the gastrocnemius and soleus muscles into your Achilles tendon) may help. You can find safe, gentle stretches for these muscles and the Achilles Tendon online. It is important to start any exercises or stretches slowly and gradually build up. If you start getting more pain or any side effects, then it is important to stop. 
  • Footwear being changed to more supportive shoe as advised in previous answers
  • Choose more non weightbearing exercises such as swimming and cycling, whilst the foot is inflamed and painful
  • Ice to reduce any inflammation that may be present. 20minutes daily recommended either in form of frozen peas or similar wrapped in damp cloth or foot rolling over a chilled bottle or can. This can really help discomfort especially after a day on your feet.

Often with these treatments and over a couple of weeks it can resolve and reduce in pain. But if these treatments do not help it may be that you do not have PF and could instead have another issue or need more individual advice or care. It is important to contact your GP for further advice or contact a local podiatrist. The podiatrist would be able to do an assessment to look at the lower limb and foot structures, review your gait (the way you walk) and much more to help to diagnose PF, another condition and give more treatment options including insoles/orthotics and specific exercises.

9. What’s the most common issue you deal with as an NHS podiatrist?

At the moment in my local NHS Podiatry clinics, we are prioritising the most poorly feet in the service during the COVID-19 pandemic, therefore, the main conditions we manage are foot ulcerations using our wound care skills and knowledge. This is often for patients with medical conditions that cause reduction in circulation to the foot and/or loss of sensation due to nerve damage. Our main goal the podiatry treatments we provide is to aid with wound healing and reduce, where possible, infection and amputations from occurring. 

The second condition we see a lot of are ingrowing and painful toenails conditions. We complete a lot of nail surgery clinics where we carry out a minor surgery under local anaesthetic to remove a painful toenail. Those are only two areas of specialisms we deal with in podiatry and we do so much more with supporting the management of foot and lower limb conditions including pain management and mobility support.

10. What’s your favourite foot fact?!

My favourite foot fact is your feet can continue to ‘grow’ even into older age. Meaning there is always an excuse to go shoe shopping and buy new shoes! The reason behind this change in size despite normally finishing their growth stage by age of 20, is that feet can either swell or your tendons and ligaments loosen in the feet causing the feet to spread, making the foot wider and longer. This can happen with age, certain medical conditions or even pregnancy! 

Many thanks to Robyna for answering these questions!

Robyna is supporting NHS England’s ‘We Are The NHS’ campaign. To find out more about a career in the NHS, please search NHS Careers’ or visit We Are The NHS to find available roles and training support on offer.

The best experts to follow on Instagram

Running

The Running Channel is full of information and content for runners!

The Running Channel

While potentially more exciting to subscribe to on YouTube, The Running Channel shares great running advice, myth busters and relatable running content, all backed in good science.

Emma Kirkyo

Emma Kirk Odunbi is a strength and conditioning coach who specialises in running shoes, having previously worked in a trainer store. She shares running motivation, kit advice and lots of info about feet and shoes!

Rush By Nature

Holly Rush is a running coach and GB athlete. She knows what she’s talking about when it comes to running and produces plans to suit all abilities. She is also the co-host of Marathon Talk podcast which is great!

Carla Molinaro

Ultra-athlete Carla Molinaro has recently completed a 100km road race, and is the LEJOG world record holder, an incredible feat. As an endurance athlete, she knows a thing or two about nutrition, and preaches balance in all things.

Renee McGregor

Sports dietician Renee McGregor specialises in REDs, overtraining and eating disorders, especially in athletes. Follow for no-nonsense advice about fuelling properly when running. She also takes part in many ultramarathons so really knows what she’s talking about.

Run 4 PRs

This is an online run coach and strength training guide, but also shares loads of interesting information about various elements of running. They also interview some great athletes to hear their stories.

Physio

The Irish physio has loads of great videos for runners and others!

The Irish Physio

Physiotherapist Aiden O Flaherty specialises in running injuries and performance, and promotes exercise for both the mind and body – something I also feel strongly about. Follow for useful vids and sensible advice if you’re a runner.

Manni O

Manni is a Nike running coach and physiotherapist and shares some great drills nd physio sessions on his page. As with everyone else on this list, he preaches balance – not performance at the expense of health, or health at the expense of happiness.

Lucy Tri Physio

Lucy Sacarello is a hello ultra-runner who enjoys the trails as much as me. As a physio she also shares information and videos about keeping healthy and mobile while running.

Adam Meakins

Physio and S&C coach Adam Meakins provides simple, evidence-based advice on almost everything to do with living as a human being, especially various pains and aches. Very no-nonsense.

Nutrition

If you fancy recipes, evidence based nutrition info and a great podcast look no further than The Food Medic

The Food Medic

Dr Hazel Wallace is an NHS doctor and nutritionist. She shares SO much great and balanced information on her page, I honestly think everyone should be made to follow her. She also has a great podcast that’s worth a listen.

Doctor’s Kitchen

Dr Rupy Aujla suffered from burnout in his early hears of being a doctor, and since has shared information about how to live a healthy and balances lifestyle. He has loads of great recipes and balanced advice on his page, as well as a great podcast!

Rhitrition

Dr Rhiannon Lambert is a dietitian aiming to help people build healthy relationships with food. While not vegan, she promotes a plant-heavy diet and balance above all else. Follow for tasty recipes!

Dr Joshua Wolrich

Dr Joshua Wolrich is one of my favourite ‘myth-busting’ accounts on Instagram. He promotes HAES (health at every size) and works to reduce weight stigma.

The Gut Health Doctor

Dr Megan Rossi is a gut-health expert, sharing science-based information on diet, immunity and various recipes too. She has a great book that I’d recommend!

Food and Psych

Kimberly Wilson explores the links between diet and brain health. There’s lots of interesting evolutionary science, history and psychology woven into her posts, which cover a variety of topics.

Charlotte F Nutrition

Charlotte Fisher shares a lot of the same sentiments as I have when it comes to nutrition and performance. Nutrition needs to be healthy for the mind as well as the body. These posts are great for anyone who doesn’t have a perfect relationship with food.

Faye Nutrition

Faye is a sports nutritionist looking at the scientific evidence behind various popular diets, sport-related topics such as overtraining and myth busting a lot of the bro-science you see on the internet.

Fitness

If you’re looking for workout videos and a lot of easy to understand science, follow Natacha

Natacha Oceane

It’s rare that someone gets so famous for sharing science, but Natacha is the perfect example of someone who is well known for literally all the right reasons. As a biophysicist and athlete, she shares science-based information in lay terms on her Instagram and YouTube, as well as great workout videos and challenges.

Sohee Fit

For more evidence-based information on fitness, health, nutrition and the industry as a whole, give Sohee a follow. She delves into the primary literature (so you don’t have to) and supports a balanced approach to nutrition and lifestyle.

LittleLyss Fitness

Alyssa Olenick is great for promoting a variety of types of fitness both for health and enjoyment. While she’s currently trining for an ultramarathon, she promotes healthy lifting for the health benefits. She is also very open about where her areas of expertise start and end – kudos for that.

Alice Liveing

Women’s Aid ambassador and Women’s Health columnist Alice Liveing is a qualified Personal Trainer with over a decade of experience in the industry. She hosts live workouts daily and promotes the use of training to support everyday life, not the other way around. Everything is about balance!

Shona Vertue

Ex-gymnast Shona Vertue is a qualfied personal trainer and psychology student. She shares home workouts, strength training sessions and mobility work – useful for runners!

Tiffins

Sometimes nothing but a rich, decadent slab of chocolate will do. Although I’m partial to almost any tiffin, I prefer those with really dark chocolate. Here is the recipe I made the other day.

Tiffin topped with almond butter – deliciously decadent

Ingredients

  • 300g dark chocolate (I used a mix of 77% and 95% – I would recommend 75% minimum)
  • 100g margarine (I use Flora)
  • 50g syrup (I use maple if I’m feeling fancy, agave works too – use whatever you have)
  • 100g nuts (I used almonds but choose whatever you prefer – pistachios are lovely too)
  • 120g biscuit of choice
  • 40g raisins or other dried fruit (chopped if large)
  • Extra 80g dark chocolate for the topping

Method

  • Break up the chocolate into a saucepan, add the margarine and melt on a low heat (take care not to burn)
  • Add the syrup towards the end and combine. Turn off the heat.
  • Break up the biscuits into the mix, add the raisins and nuts and stir to incorporate
  • Line a baking tin with cling film, baking parchment or foil and add the mixture on top, flattening so it’s evenly distributed
  • Slowly melt the remaining chocolate in the saucepan until smooth.
  • Pour on top of the tiffin mix to create a thin layer over it.
  • Place in the fridge for 2h to set.
  • Remove from the tin and enjoy!

Conversation with an NHS physio

I had this conversation with Emily Davies Physiotherapist, answering your most asked physio questions! This blog post is in support of the We are the NHS campaign. If you enjoy it, please do share on Instagram!

1. How do you know whether a pain/a niggle is something you can run through or something to rest and check?  

Symptoms such as swelling, pain when weight bearing, redness, the joint area giving way, numbness, pins and needles, reduced strength/ movement due to pain can all be worth a professional opinion.

Ask yourself how long have you had this pain for. It’s not uncommon to get pins and needles after exercise as well as redness/ swelling if you’ve been working hard but this can often resolve on its own. If this is something that’s happening persistently it’s definitely worth getting it looked at. 

If symptoms aren’t persistent and you’ve only had this pain/ niggle recently when running, rest is your best friend! Listen to your body if it’s in pain. Our body needs rest to strengthen and adapt. Rest, ice and elevation can often help these niggles! If after this you are still getting pain, ignoring it will only end up doing more harm and the recovery is likely to be worse. 

2. What’s your best advice for those that sit at a desk all day?   

Planning your day in advance is a massive help in ensuring you achieve what you set out to. If you are sitting at a desk all day, getting up every hour is so important; whether that is just going to the kitchen to make yourself another cup of tea! (Check out this blog post on how I keep active when working a desk job).  

If your job means you aren’t active during the day, make up for this in the evening, it doesn’t have to be something intense! It could be going for a walk outdoors- this will be great for your mental health too, releasing those endorphins and improving your mood! Try and set yourself a goal, that way you are more likely to stick with it e.g. how many steps do you want to achieve each day? 

If it means you are sitting at a desk all day, you need to look after your posture and your musculoskeletal system. Make sure you are sat at a chair you find comfortable with back support, feet flat on the floor, screen at eye level, try and avoid crossing your legs! Working at home during the pandemic is not easy but it’s important you have the correct equipment to ensure you aren’t straining your posture/ body. Speak with your workplace if it is concerning you. 

3. How is it best to return to running after a long period of time off?  

Build it back up slowly, if you dive straight into the level you were previously at, your muscles and joints will be at risk of injury.  Stretching your calves, quads and hip flexors after your runs will help to reduce risk of injury. 

Make yourself a goal! What would you like to achieve with your running? But it is really important you make this goal realistic to yourself and over a realistic time frame! How far do you want to be able to run and by when? 

Make sure you take some days off to start with to give your body time to recover. Even just going for a gentle walk, cycle or swimming (when we can access swimming pools again!) can also help build our endurance/ strength. Swimming is brilliant as it is a non-weight bearing form of exercise which provides our joints with a bit of a rest!  

Footwear is also so important! Make sure you’ve got some correctly fitting trainers with good shock absorption qualities for running and are supportive for you! There are more top tips on running form in one of the answers below!

4. Words of wisdom for someone starting physio at university?  

One thing I wish I’d have had a better understanding of before I started my degree in Physiotherapy was the range of areas involved in this profession. Having a good understanding of this will put you in a great position at your lectures on all the different areas e.g respiratory, musculoskeletal and neurology 

Don’t be afraid to use your course mates for studying! The best way I found to learn anatomy/ practical treatments was with my course mates. Remember you aren’t the only one learning this whole new topic, your course mates will be in the same position as you so learning together will widen your depth of knowledge! 

Printing off lecture power points and annotating them as you go is another tip I recommend! With permission of you lecturer, recording lectures was hugely helpful for me. This way, for anything I didn’t understand or was struggling to learn I would listen to the lecture over again to confirm my understanding. 

And finally, your placements! This is where you get to transfer all that you’ve learnt into real life situations. Really make the most out of your placements, get as much experience in different professions that work alongside physios so you are aware of the bigger picture of your multidisciplinary team! And ask as many questions as you can!

 5. What’s the most common issue you see as a physio and the easiest way to avoid it?  

Achilles tendinitis is a common injury we see a lot of, especially during lockdown where more people are taking up running due to gyms being shut.  Most Achilles injuries can be treated at home with support of a qualified physiotherapist. It is important to get issues like this checked as overuse of our tendon can lead to a rupture, resulting in surgery in worst cases.   

To avoid injury in the first place, increase your activity level slowly whilst stretching and strengthening the area. A good tip is being aware that we have two calf muscles (gastrocnemius and soleus) so we must stretch them both! 

Again, having good fitting trainers with enough padding to help with shock absorption will help prevent this injury. 

6. What makes a good physio?  

A good physio knows the importance of building trust with you, as it is likely you will see your physio over a period of sessions, so it is important to make sure you have a mutual regard and respect during the sessions. I’d check for continuity reasons that you will have the same physio for all your treatments rather than have to build up a rapport with a new physio on each session! 

7. Should you stretch? If so, how often? Any specific stretches you’d recommend? 

Stretching is SO good for your body! Stretching can improve range of movement, decrease stress levels, reduce pain/stiffness, reduce risk of injury and improve blood flow and circulation.  

Stretching once in a blue moon will not make a difference to your flexibility, consistency is key!

I would start off with a manageable amount of stretches each day e.g. 5 and as long as the stretch is not painful, I’d recommend holding for between 30-60 seconds. Try to implement stretches into your daily routine, even better after you have been exercising so your muscles are warmed up.  

Be aware that as the muscle we are stretching becomes more flexible, it is at risk of becoming weaker so completing strengthening exercises of the same area is recommended.   

The main stretches I would recommend to anyone starting off would be targeting our main muscle groups! This would include the hamstrings, hip flexors and glutes. I also think that stretching out our muscles in the shoulders/chest (trapezius and pectorals) is important in improving posture, especially now people are working from home more.  

8. Any general advice on running form?   

Be aware of your posture, it is so easy when you are running to forget about posture but try to be aware of your shoulders, keep your back straight and make sure you aren’t leaning forwards. Having a stooped posture when running can lead to back, shoulder and neck issues in the future.  

Find a stride that works for you; land gently to help prevent any injuries. Elbows tucked in by your side and good arm swing will help maintain a rhythm and propel you forward also.   

Again, completing frequent stretches and strengthening exercises for our big muscle groups e.g. abdominals and glutes will help stabilize your running technique. 

9. How is it best to support recovery e.g. on a rest day, after training etc? Top tips?  

Stretching after training will support our recovery by eliminating lactic acid build up and improving our blood flow. Try and incorporate stretches after every work out to support your recovery. A gentle walk on a rest day will also help reduce joint stiffness by circulating the blood flow. Correct nutrition will also support our recovery e.g.  Consuming an adequate amount of protein will help recover muscle fibres that may have been damaged through exercise as well as helping to replenish any depleted energy stores. Recovery days are important as these are days which allow our muscles to repair and therefore strengthen and improve performance. Everyone is different in regard to how many rest days a week they should have but I would recommend to rest the muscle group the day after you exerted it. Definitely make sure you are sleeping enough also, our body needs sleep to recover, try to get a good 7-9 hours. 

I would also recommend foam rollers, ice/ heat packs and even a sports massage to also aid recovery for more intense training schedules.  

10. How should I treat/prevent runner’s knee? 

If you start to experience pain around the knee (patella area more specifically) when you are running, bending your knee, kneeling, walking down hill/ downstairs, you may have runners knee. It’s a very general term for knee pain that may not have stemmed from running.

It is a problem that can often resolve itself.

To treat it I would recommend resting the knee from strenuous activities for around 2 weeks e.g. running, squatting, lunging. Not everyone will get swelling with this pain, but a cold ice pack on the area for 20 minutes or so every 4-5 hours can ease not just swelling but the pain also. Elevating your knee when you can will also help with swelling. 

To treat / prevent this condition, correct footwear can help improve position of your feet and therefore pressure around the knee. I’d also recommended stretching and strengthening the area around the knee. For stretching, I would target the quadriceps, calf, hip flexors and hamstrings. For strengthening I would recommend calf raises, wall slides, clams, step ups and glute bridges. As always, if this pain persists, get it looked at by a professional. 

Many thanks to Emily for answering these questions!

Emily is supporting NHS England’s ‘We Are The NHS’ campaign. To find out more about a career in the NHS, please search NHS Careers’ or visit We Are The NHS to find available roles and training support on offer.

Why does running make you feel so good?

Ok, ok, not ALL the time, but the runner’s high is a real thing, and with over 858,000 people downloading the NHS couch to 5k app in lockdown 1, there must be something going for it! There are many elements that make running positive for your mental health, and it is increasingly being seen not only as great for the body, but for the mind too. So what is it about running that makes it so good for your brain and mood? Let’s look at the science.

The runner’s high is a real thing!
  1. brain imaging study on endurance athletes and healthy controls at rest showed an increase in coordinated activity in some brain regions involved in executive functions (decision making) and working memory. They also found a reduction in ‘default mode’ activity – what our brain does when distracted, i.e. nothing very useful. This part of the brain is also linked to clinical depression, showing one pathway by which consistently running may reduce depressive tendencies and improve brain health. Interestingly, these are similar results to those seen in meditation – while running you’re turned into your surroundings, and what your muscles and breath are doing, not worrying about work, family or other stressors. So, running could be seen as a form of ‘active/moving meditation’.
  2. Another study in mice showed that exercise breaks down a stress-inducing molecule Kyneurenine. The molecule itself builds up when you’re stressed, and can enter the brain, causing stress-induced depression and anxiety in some people. During exercise, there is a build up of an enzyme able to break down this molecule in the muscles, meaning it’s unable to enter the brain, protecting it against stress-induced depression. 
  3. Beta-endorphins are released in running, improving mood post-run. The hormone is generally used by the body to reduce stress, and, as an endogenous opioid, is also linked to reducing pain. This happens not just over the course of one run, but also over the space of several months, meaning that the effects can last long after you’ve ended a run. This is potentially the source of the elusive ‘runner’s high’, which usually starts to kick in after 30 minutes of running. It’s also one of the reasons that runs can feel very hard at the beginning but get easier throughout – pain relief and a reduction in anxiety are both side-effects of our body’s reaction to exercise. 
  4. While endorphins have long been credited for the runner’s high, it is likely that endocannabinoids play an even larger role. These are small enough to cross the blood-brain barrier (unlike endorphins), and act on the same receptors and systems that THC (the active ingredient of cannabis) does. This triggers feelings of euphoria, a sense of calm and reduced anxiety. There’s still a lot of research in this area and the mechanisms in humans still aren’t quite ironed out, but it looks promising!
  5. Running (and exercise in general) also acts as a buffer to life’s stressors. In the same way that stressing out the body through exercise can lead to physical adaptations to cope, it can also lead to mental adaptations associated with resilience, which are then transferrable to other areas of life. Regular runners tend to be better able to cope with stress, thanks to the effects of
  6. In rats, high intensity aerobic exercise such as running has been shown to literally create new brain cells. Up to a limit, running stimulates an increase in grey matter in the brain (beyond that limit, grey matter temporarily decreases, e.g. in extreme multi-stage endurance events – not surprising if you’re running 4,487km like those in the study!).
  7. There are other endogenous benefits of running that may benefit the brain through indirect means, such as improved insulin response, improved immune function, improved circulation (including to the brain), increased energy levels, better sleep and improved focus (including the ability to multitask better!). 
  8. Tangential mental health benefits of running include having a feeling of community (the running community is like I’ve never experienced before), having quantifiable goals and the sense of accomplishment that comes with that, which is transferrable to other areas of your life. Running has been shown to improve your self-esteem – placing the focus on what your body can accomplish and how it feels rather than what it looks like is one of the best to move away from being sucked into diet culture and the constant drive to lose weight. 

Evolutionarily, this all makes sense. As hunter gatherers, we would have had to chase prey for any miles, and having adaptations to a) make that feel good and b) reduce pain on long runs would have meant we were able to run further. And enjoying the chase/run would have meant more food for everyone, so better survival.

It’s important to note that many of these studied were either done on animals, or in small numbers of volunteers. However, anecdotally the benefits of running for the brain are multi-fold and substantial, and it’s great to see this backed by multiple studies. Hopefully we’ll start to see more of this in the coming years as the link between physical and mental health becomes increasingly clear. 

While these benefits mainly pertain to running, it’s also possible to get many of the same benefits through other forms of aerobic and anaerobic exercise. The benefits may be to differing degrees, but the important thing is that you find a form of movement that is enjoyable and sustainable for you – there’s no point in overdoing it on a sport that you hate. Moving your body in whatever way feels best is a good place to start! And if you’re just starting your running journey, keep it up! It is always hard at first (and at second, and at third), but the benefits are SO worth it. If you enjoy this topic, check out the book Endure by Alex Hutchinson. It’s fascinating and delves into the science further without being hard to read. 

If you regularly read and enjoy my articles, please consider making a small contribution to the running of my blog. If you’re looking for a little challenge to focus on for your training, why not join in our 5k time trial challenge at the end of March?

What does ‘sustainable’ even mean?

It’s rare that a term becomes such a key part of common lexicon in such a short space of time as sustainability. The term itself is derived from the Latin ‘sustinere‘, meaning ‘to maintain’, ‘to hold’ or ‘to support’. The word can now be found used widely in policy, commerce and economics, usually in a way that pertains strictly to environmental sustainability

It’s become widely used in the last 30 years in spite of (or perhaps because of) its multitude of potential definitions. For example, this catch-all term can be found explaining why you should buy a new dress, why a city council should build new properties or why a brand’s coffee is better than other coffees. But what does it actually mean?

Around 30 years ago, the World Commission on Environment and Development published Our Common Future, charting a path for development that “meets the needs of the present without compromising the ability of future generations to meet their own needs.” This is essentially our current definition of environmental sustainability. However, the term has since come under fire for lacking any unified, definitive or quantifiable meaning – basically, it means nothing.

There is no doubt that the fashion industry requires movement in a direction that manages its demands on the environment without compromising what’s available for future generations. No one would argue that the fashion industry, responsible for 10% of global emissions, doesn’t require more investment in ‘sustainability’, but without any quantifiable definition of the term, what does this look like?

Various other terms within many industries are verified using third-party certifications and accreditations, meaning that a brand or business has to prove it is doing something to be able to use the term. The Soil Association, for example, is a UK-based charity that regularly reviews manufacturing processes throughout the supply chain to ensure a business is producing organic products. You cannot use the term ‘organic’ without being certified. The Global Organic Textile Exchange (GOTS), does the same for textiles, showing the buyer that the products throughout the supply chain have been verified by an external body as organic.

One issue with sustainability within the fashion industry is that almost all accreditations are voluntary. Rather than having regulatory standards, similar to those within the food industry and mandatory energy labels on EU white goods, accreditations are seen as ‘optional extras’, often used as a marketing tool rather than a baseline standard.

Because of this erosion of state power, brands and organisations within the fashion industry looking to become more ‘sustainable’ are left in a state of ‘choice paralysis’; there are a multitude of private-sector accreditations which all claim to provide certification of ‘sustainability’ in marginally different ways. And of course, because they’re private sector, all claim to be slightly better than their variants, yet none are government regulated. This isn’t to say they don’t all provide some benefit – many do in considerable ways – it’s just that the whole industry is open to confusion and lack of regulation, to the point that the consumer has a very hard time understanding what they’re buying into. 

Various voluntary initiatives available to the textiles industry – but by no means all of them

So what can we do?

With WOVN’s 2020 consumer report showing an 84% increase in the use of terms such as sustainable, ethical, Fair Trade and eco-friendly and an increased desire to shop from brands seen as ‘sustainable’, it’s important now, more than ever, to understand what this term really means. As brands cotton on to this fact, there’s an increasingly opaque arms-race to appear more sustainable, where being truly environmentally conscious is almost secondary to appearing as such.

There have been calls to incorporate ‘Carbon Labelling‘ on clothing, but of course being sustainable isn’t about simply releasing as little carbon as possible (in the same way that the health of a food item isn’t about being as low calorie as possible), but also things like wastewater reduction, ceasing the use of harmful chemicals, improving labour standards, using renewable materials, reducing waste textiles and so much more. While innovative, labelling like this would only solve a proportion of the problem, and potentially just become another method of greenwashing.

Accreditations will play an important role in the fashion industry’s road towards becoming more in balance with the environment, but there are serious changes that need to happen, including regulation of the regulators. Consolidating numerous similar accreditations into larger, stronger and more rigorous ones would be a powerful first step. 

Secondly, as a globalised industry, fashion requires international regulation. The majority of the textile industry has outsourced its negative environmental and social impacts to the Global South, affecting the people and habitats that can least afford to protect themselves, all the while making masses of money for the corporations residing in the Global North. This inequality simultaneously exacerbates the issues and hides them from view of the consumer. This means that it’s hard to know how what you’re buying is impacting the people who made the clothes, for better or worse. Because of this, we need international regulations throughout the supply chain, protecting both the environment in the world’s most biodiverse areas and those most affected by the industry’s indiscretions. 

In the meantime, companies must be more transparent about their supply chains, allowing the consumer to make their own decisions about what is ‘sustainable’ and what is not. After all, no brand is going to be perfect in all regards, certainly not while industry accreditations are such a minefield. It should be possible for the consumer to decide what matters most to them, and be able to accurately measure up brands to this standard. It is important that this doesn’t automatically disadvantage those choosing to become more transparent; while transparency may highlight areas requiring improvement, brands that choose to avoid transparency for fear of what it may show up should be penalised beyond those showing up less favourable elements within their supply chain. This is important because transparency is the first step towards accountability. Brands that doesn’t show the former will never have the latter.

Consumers, while requesting greater transparency and action from the worst offenders, should also realise that no amount of sustainable production will counteract buying clothes we don’t need. Buying less overall, buying secondhand, fixing what we already have and finding new homes for clothes we no longer wear will always be better than shopping, even from ‘sustainable’ brands. 

Further up the chain there should be incentives and clear direction for brands wanting to do better. This direction should be passed on to suppliers, with brands using their purchasing power to push suppliers to be better, and workers using unions to effect chain from the ground up. Large brands and conglomerates especially have huge amounts of power to effect change, and it’s time they were forced to do so. 

Over over 300,000 tonnes of clothing ends up in landfill in the UK each year – no matter how sustainable the brand, this can never be environmentally friendly.

TL;DR

  • There are many steps available to brands looking to become more sustainable, in whichever way they choose to interpret the term.
  • However, without quantifying what sustainability actually means, it’s going to be difficult for the fashion industry to ever reach the goal of being ‘more sustainable’ in any meaningful way.
  • Currently there is a mishmash of private-sector accreditations and certifications all with overlapping goals being regulated with varying degrees of success. Without unifying these standards and consolidating the accreditations that exist, it will be hard for consumers to be able to assess which brands are truly sustainable vs which are using accreditations as a facade.
  • As the fashion industry is a global one, it requires global regulatory bodies, which currently don’t exist. Currently it is beneficial for brands to outsource their labour and environmental harm to the Global South, which doesn’t have the resources to protect itself. International regulation could limit this harm.
  • In the meantime, brands should improve transparency of their supply chains to allow consumers to choose who they want to buy from. Brands should be congratulated for improving transparency, although not at the expense of action which is the obvious end goal (H&M is one of the most transparent brands but also one of fashion’s biggest polluters – transparency can’t come at the expense of action).
  • Consumers have the power to request greater transparency from brands, and also to stop buying from the biggest polluters. Shopping small businesses is a great place to start, but we should only buy what we really need. No amount of sustainability will make up for purchasing a wardrobe of clothes you never wear.
  • Large brands have huge amounts of purchasing power and are in a strong position to effect change. It’s about time they did so.

If you enjoyed this blog post and would like to read more, there is a great report on palm oil, fishing and textiles, all of which suffer the same lack of unified regulation – you can read it here. If you regularly read and enjoy my articles, please consider making a small contribution to the running of my blog.

March 5k time trial challenge

Hi everyone! Over the next eight weeks, I will be training for my first ever official 5k time trial. Other 5k efforts have all been as part of park runs (which I’ve dearly missed over lockdown), and after a year of steadily getting slower and slower (thanks to focussing on running further), I thought it about time to pick up the pace and get in a 5k PB. And I want you to join me!!

How can I join?

Whatever your ability, experience or goal, I’d love if you could join in both training for and racing this 5k. All you need to do is sign up to Strava (an app that records your runs) and join our virtual run club, March 5k timetrial.

Once you’ve joined, all your runs on Strava will upload automatically, you’ll be able to keep up with the other runners taking part. On 27th – 31st March, you’ll have the opportunity to race the 5k virtually alongside all the other runners.

What route should I race?

As a virtual event, there’ll be no official route you need to do the time trial on, although I would recommend you find a flat, relatively empty route for your effort. If that doesn’t exist (Dorset I’m looking at you), a hilly route will do just fine and be all the more impressive – good luck!

Is there a training programme?

If you’re looking for a training programme and not sure where to start, these are two that are great – one for those looking to get sub-20, and one for those looking to simply speed up their general running times.

Home training & faster 5k plan: https://www.rushbynature.com/shop/home-training-amp-a-faster-5-10k

Sub 20 5k plan: https://www.rushbynature.com/shop/strength-amp-a-sub-20-minute-parkrun

Is there a way of joining in if I don’t have Strava?

You’re more than welcome to join if you don’t have Strava, but there won’t be an official ‘page’ for your participation. However, I will be recording my training on my Instagram and YouTube, so you can follow and subscribe to keep up with everything! If you tag me in your training runs on Instagram I’ll be sharing them on my stories so we can all keep each other motivated. 🙂

Happy training!

10 Veganuary myth-busters

January 1st has marked the start of Veganuary since 2014, when the non-profit of the same name started encouraging people to try a plant-based diet each January. During the 2020 campaign, more than 400,000 people signed up to the Veganuary pledge, while more than 600 brands, restaurants, and supermarkets promoted the campaign, and over 1200 new vegan products and menus launching in the UK alone.

In 2019, a scientific report released by over 100 scientists shared that plant-based diets can help fight climate change, showing that the West’s high consumption of meat and dairy is directly fuelling global warming. Diets high in meat and dairy are on average significantly more warming than diets without red meat, diets with no meat at all, and vegan diets. Food production is responsible for a quarter of all greenhouse gas emissions, contributing to global warming, with meat and other animal products being responsible for more than half of food-related greenhouse gas emissions, despite providing only a fifth of the calories we eat and drink. So for someone looking to reduce their carbon footprint, choosing a more plant-based diet is a great place to start.

When looking across the board, almost all plant-based foods have lower GHG emissions than almost all animal products

Health-wise, vegan diets are richer in many nutrients due to the increased plant matter, and those who choose a plant-based diet (vegetarian or vegan) are less likely to suffer from heart disease. There are lots of other health benefits of veganism too, but also plenty of things to consider, so read on if you’re thinking of going vegan, whether for one month, one year or the rest of your life!

1. Don’t forget supplements

If you’re planning on only being vegan for a month, and already eat a diet heavy in plant-based foods, the chances are you’d be really unlucky to become deficient in anything (unless you already were to start with). However, if you’re looking to become more plant-based over the long-term, it’s important to understand what supplements you need, such as B12, which is recommended for all vegans. Check out this blog post for all the recommended supplements.

2. Consider not doing veganuary….

… But instead moving to a more plant based diet over the course of a few months. It’s not as ‘exciting’ or ‘glamorous’ as a difficult challenge, but it’s my belief that slow change is usually more sustainable and beneficial than immediate change. Unless you ate a diet heavy in plant-matter prior to switching, you may suffer gut issues (thanks to the high-fibre content of most vegan diets), and slowly cutting out various animal products gives you time to reintroduce new foods and meals to your repertoire, reducing the shock to both your body and your culinary skills!

3. It’s not about cutting things out

Many people I know who have struggle with a plant-based diet are those who have seen veganism as a way to cut out half their diet (myself included, when I first tried it aged 15). Cue sluggishness, grumpiness and constant hunger. It’s true that veganism likely isn’t for everyone, but you can avoid the above ailments by introducing, rather than just cutting out, foods. Meat serves as the protein source in many meals, so this must be replaced by a number of other substitutes, such as pulses and/or meat substitutes. There are lots out there, so experiment! Find what works for you, and most of all, make sure you’re eating enough – plants are high in fibre and low in calories, so you’ll likely need to eat more volume to get enough calories from your diet. Don’t let yourself go hungry.

4. Vegan does not necessarily mean healthy

It’s perfectly possible to eat a vegan diet and gain weight. It’s also perfectly possible to eat a vegan diet and end up considerably less healthy than before, because veganism does not equate to health. Nowadays especially, it’s so easy to get confectionary and desserts that are vegan – and despite the fact that they’re vegan, a cake is still a cake. As with any diet, becoming plant-based requires thought, planning and attention to nutrient density of foods. By all means eat the cake, just don’t fool yourself into believing it’s healthy just because it’s vegan.

5. Soy won’t give you moobs/breast cancer

Another concern about turning vegan is that 50% of your diet will be soy, and soy gives you breast cancer. Except it won’t, and it doesn’t. Soy is a common ingredient in a lot of meat substitutes, plant-based milk and foods such as tofu and tempeh. However, it’s not as prevalent in most vegan diets as you might think, and has no link to breast cancer or ‘feminising’ effects on men. There is a lot to be said for varying your diet and mixing up your sources of protein, but in terms of health, soy is a complete protein, low in fat, relatively cheap and pretty damn good for you. Unless you’re allergic, you don’t need to avoid it.

The other concern about soy is that it leads to deforestation. While this is true of some soy products (deforestation linked to soy products is responsible for 29% of Brazil’s GHG emissions), it is worth remembering that around 75% of global soy production is actually fed to livestock – in far greater quantities than we consume it. If you want to reduce your contribution to soy deforestation, ironically going vegan could be a pretty effective way to do so. And, of course, vary up your protein sources so you’re not eating it for every meal.

6. Being vegan does not make you the perfect environmentalist

On average, the emissions released by a vegan diet are considerably less than those from an omnivorous diet or vegetarian diet. This is because almost all animal products result in greater emissions than almost all plant-based products, no matter where they’re from. However, some products, namely coffee, chocolate and beer, have differing impacts relating to how they’re farmed (e.g. is the cocoa and coffee grown on deforested land?). In addition, foods such as almonds and avocados are particularly water intensive, contributing to drought in the areas they are grown. However, neither avocados nor almonds are a direct substitute for meat, and vegans and meat-eaters alike are both likely to eat all of the above products – so this isn’t just a vegan issue.

Even environmentally questionable products such as almond milk fare better environmentally when compared to cows milk, so if being eco-friendly is high on your agenda, you’re still better off moving to a more plant-based diet, whilst keeping in mind that not all vegan products are necessarily good for the environment. Bear in mind that eating local and seasonal has numerous benefits and that while very beneficial, going vegan does not magically make you the perfect environmentalist.

On this note, your environmentalism should not end at changing your diet. Veganism has been co-opted as an extremely white movement, but plant-based diets have existed for centuries in other communities, long before making it to the white mainstream. Don’t let your vegan morals end at Joe and the Juice juices and quinoa – follow BIPOC creators and educators on Instagram and understand how the vegan movement currently benefits white people, often at the expense of its historical originators.

A graph showing the comparison between animal products and plant-based products, showing that how your food is grown can vastly alter its environmental impact

7. Consider why

Going plant-based is a great thing to do for so many reasons, but for some people, it can be exactly the wrong thing to do. For example, if you struggle with restrictive behaviours when it comes to eating, suddenly switching to a vegan diet can be triggering and lead to unhealthy behaviours. If you’re concerned, speak to a dietician before trying anything new. As mentioned above, eating a vegan diet shouldn’t be about restriction – it should be about expanding your diet to incorporate a whole range of delicious plant-based foods.

8. Look at other areas of your life

Scientists have said that going vegan is the single biggest thing an individual can do to reduce their environmental footprint. However, there are numerous other ways you can also benefit the environment, from consuming fewer goods overall (e.g. not buying new clothes every week), flying considerably less and moving to an ethical bank. Going plant-based was my ‘gateway drug’ to considering my other actions and their impact – and I’m still learning new things every day! Check out my vlog on some of the best ways to reduce your overall environmental impact.

9. You won’t get weak and weedy

One of the biggest concerns about veganism (at least among the fitness community) is that it doesn’t allow for ‘gains’ and fitness progress. This couldn’t be further from the truth – a vegan diet can certainly be sufficient and even beneficial for athletes – but it is something that you should consider when making the switch. When I turned plant-based I expected either massive gains at the gym or to lose all my strength and endurance over time. In reality, not much changed at all, and the diet provided enough of everything to take me through 2 boxing fights, a marathon, 2 ultra marathons and all my workouts in between. So long as you eat enough calories, ensure you eat a wide variety of foods and supplement what’s lacking, you may see fitness benefits, or at worst, just stay the same as you were before.

This guy was vegan!

10. Remember, everyone takes their time

Once you’ve made the huge step to becoming plant-based, it can be frustrating to watch others choose not to do the same. When you’ve educated yourself on the myriad benefits and made the effort to switch, it’s easy to get up on your high-horse and judge others who haven’t done the same. Getting angry at people, however, rarely leads to positive, long-lasting change – think back to the number of times someone suggested that you try vegetarianism or veganism. It’s likely you didn’t suddenly change your way of life and immediately turn vegan, so why would you expect the same from someone else? People have their own reasons for living the way they do, and trying to force someone into your way of thinking can have the reverse effect you want it to. By all means educate if someone enquires, but I find living my best life and leading by example is enough.

I feel great eating a plant-based diet. I love it for so many reasons, but that’s because I’ve planned it, researched extensively, listened to my body and learnt over the years. It’s undoubtedly the right thing for me. I’m still learning everyday and wouldn’t dream of considering the way I do things the ‘best way possible’; everyone is unique, everyone moves at their own pace and what works for you won’t necessarily work for someone else.

Good luck with your Veganuary or the start of your plant-based way of living! I’d love to hear if you found this useful and if you have any pieces of advice of your own! Comment below and don’t forget to share this on Instagram! If you enjoyed this article, please consider making a small contribution to the running of my blog.

Supplements for vegans

As we take the first tentative steps into January, many people will be making their first forays into veganism. And with all the many health benefits, environmental benefits and ethical considerations, it’s not surprising that more and more people are moving towards plant-based diets each year.

However, as with any diet, veganism is one that should be planned, in order to make it as balanced and varied as possible. One of my favourite things about eating plant-based is that it forces me to be more imaginative with my cooking. When I ate a pescatarian diet (no meat, just fish from the age of 5 to around 22 years old), I often cooked the same few meals over and over again. When I started eating plant-based, however, I had to reconsider the flavours, cuisines and types of food I wanted to eat. It was probably one of the better things I ever did for my cooking, but also for my health, as I had to start eating lots of different types of foods to remain healthy.

If you’re considering veganism just for a month and know what you’re doing, the chances are you won’t become deficient in anything. It’s also accepted that well-planned vegan diets are sufficient to get enough nutrients (and more!) into your system. However, if you would like to eat a more plant-based diet more of the time or are just starting out and unsure what you need, taking supplements is highly recommended, as well as aiming to introduce more foods into your diet. It’s not enough to just cut out meat and dairy, and continue eating all the parts of your previous diet, just without these elements with without adding anything new. Not only would it likely be bland and uninspiring, it’d also leave you at risk of deficiencies, and likely swearing you’ll never go vegan again. But alongside extra foods, there are some supplements that it’s recommended that vegans take. Read on for more!

Supplements you should consider as a vegan

Vitamin B12

Vitamin B12 is recommended for all vegetarian and vegans, and if you’re not sure whether you’re deficient you’re unlikely to cause yourself any harm by supplementing. Because of this, it is good to take whether you believe you are deficient or not, as much of the population is lacking B12. Some people suggest that you can get enough from unwashed vegetables, mushrooms, spirulina etc., but there is no scientific evidence for this belief.

Vitamin D

Vitamin D is recommended for everyone living in the UK or northern latitude countries due to reduced sunlight hours in winter. It assists with calcium absorption and is vital for healthy bones, so should be supplemented by anyone – vegan or otherwise – living in northern latitudes over winter.

Long-chain Omega 3s

Long-chain omega 3s play a part in brain and eye health, so are pretty important to get right. Reduced levels have been linked with depression, breast cancer and various other conditions. Omegas are mostly found in fish oils, which explains why vegetarians and vegans have up to 50% lower concentrations of EPA and DHA (long chain fatty acids) than omnivores. Because of this, it’s recommended that vegetarians, and vegans especially, supplements with algae oil, high in essential fatty acids, to maintain healthy levels.

Iron

Iron supplementation, especially for women, may be advisable if you don’t eat red meat. Too little iron can lead to anaemia and symptoms such as fatigue and decreased immune function. Vegans can absolutely get enough iron from foods such as cruciferous vegetables, beans, pulses, dried fruits, nuts and seeds, as well as fortified foods such as plant-milks, but if you’re suffering from symptoms of anaemia, consider seeing a doctor to see if iron supplements would help. Don’t take iron supplements if you don’t feel you are deficient – having levels too high can be also harmful, so seek medical advice if you are unsure.

Iodine

Iodine could be beneficial for vegans, especially those who are pregnant. Since iodine is mostly found in seafood and dairy products (due to iodine used to clean farming equipment), vegans are at risk of becoming deficient. Reduced iodine levels can lead to hypothyroidism, so although it is possible to reach the RDA with vegan foods such as seaweed and iodine salt, if you don’t eat these regularly, it may help to take a supplement.

Thankfully, it’s easy to find supplements nowadays containing all the recommended vitamins and minerals required as a vegan so you’re not popping five plus pills each morning. Many non-vegans are also advised to supplement (e.g. for vitamin D) so provided you take supplements as recommended, you’re really not missing out on anything while eating a plant based diet! It can seem daunting having to take supplements, but in reality it’s quite simple – supplements such as Wellwomen Vegan and Boots A-Z contain almost all the required minerals in one capsule and would probably be beneficial for many people to top up their diet.

Of course, supplements should not replace a balanced and varied diet – many things are better absorbed when consumed in food form, not to mention better tasting – but getting any diet right is key to living a healthy, energetic and happy life, and the same goes for veganism, whether just for January or for the rest of your life.

I’d love to hear if you’re giving Veganuary a go, and whether you choose to supplement or not and why! Comment below and share this on Instagram if you found it helpful.

Dealing with injuries as an athlete

At university, I undertook a short course on sports psychology, hoping to garner some insight into what makes pro athletes tick, and how the rest of us can improve our own psychology to improve our sport. The topic that stuck with me most, however, was talking about the effects of injuries on athletes, and not just professional ones. Since sports have strong mental as well as physical benefits, the stress and anxiety caused by injury can sometimes be almost incapacitating. Figuring out how to keep fears and potentially serious mental health problems at bay is both vital and complex.

While I’m no expert, I have an unfortunate amount of personal experience dealing with recurring injuries, namely IT band syndrome, caused by doing ‘too much, too soon’ in most athletes, but initiated and exacerbated almost solely by road running for me. My first physio told me to ‘stop running’, in favour of all other sports, which did nothing to help the actual problem, since I was always going to run, I just needed to know how. And so commenced 6 years or recurring injury.

After a huge flare-up during training for and running Tokyo marathon in early 2019, I worked with my second physio, Zoe, from Physio Motion (London based) to figure out the cause of my particular injury (weak glutes, poor running form to compensate) and work on those issues. Since then, I’ve been able to run two ultramarathons and 50+km weeks on trail (big for me – previously 5km would hurt) with no pain until recently, on a very tiring 10km road run around Bristol.

So, in my current mindset, I thought it might be helpful to share my top tips for dealing with injuries, both mentally and physically.

Get a diagnosis

For many people reading this, your injuries will be recurring, so you’ll have a good idea of what the pain is, and what it means. However, for many others, you’ll have a ‘lateral knee pain’ or ‘calf niggle’ and won’t know what’s gone wrong. Getting a diagnosis is vital to taking the right steps to recovery. Taking time off until it doesn’t hurt and then going straight back to what you were doing before doesn’t treat the root cause of the problem, so you might have the same issue again. Get a diagnosis and a plan to recover.

Know what’s gone wrong

This might be personal to me, but when things go wrong, I need to know why. Understanding the details of why something went wrong, what happened in the lead up and what I can do next time to avoid the same thing happening helps me feel in control of the issue. It also helps prevent it happening again. If I think about it, the recent cause of my flare up was: 2 weeks off followed by 3 very stiff road runs in quick succession, followed by a lack of stretching on top of 9 months without a regular or sufficient physiotherapy strengthening routine. Know your triggers and work to fix them.

Accept reality

If you are injured, the chances are that you felt a niggle before it turned into a full-blown injury. If you had taken a step back at ‘niggle’, it may never have turned to ‘injury’. So now you’re injured, it’s time to accept that reality. It may not be the reality forever, but for now, pushing through the pain doesn’t make you hardcore, it makes you stupid (speaking from experience). It also means your injury will likely take longer to heal and you’ll spend more time away from what you love. Accepting your current state means that it’ll likely last for less time.

Treat recovery like training

If you’re anything like me, you get pretty exciting when a new training plan comes your way, but groan at the idea of a physiotherapy/rehab plan. However, technically, a rehab plan is the same as any other training plan – it’s taking small steps to improve from the position you’re currently in, to the position you want to be in. Switching your mindset from ‘rehab is a chore’ to ‘rehab is training’ can help keep motivated. The more you stick to your rehab plan, the sooner you’ll be back to the training you love.

Enjoy the time off

When you know you can’t run/do the sport you love, it seems like all you want to do is that thing, but in reality how many times did you think ‘I wish I didn’t have to go on this run’ when you still could? Time off is a chance to take stock, recover both physically and mentally, and improve other skills too, be it in the gym or at work. You’ll be amazed how much free time you have all of a sudden! Again, this is about mindset – you can choose to resent the free time, or you can choose to do something productive with it (rest is also productive).

Speak to others

While being pragmatic is always best when it comes to injuries, sometimes speaking to someone else who can share your frustrations can make you feel less alone. Sharing tips and irritations can be helpful, and having a downright bitch about your injury every now and again can feel good. It’s unfair that I’m injured. I read my body well, I rest well, I eat well, I don’t do huge mileage, and yet here I am once again. It’s immensely frustrating. Once you’re done, pick yourself back up and get on with your rehab plan.

Go back slowly

At the end of your 6 weeks or 6 months, you’ll likely be trepidatious but excited to get back to running/whatever sport you love. However, these are the tentative first steps after months of recovery and work. Don’t go out all guns blazing, however fresh you feel. Work with your physio to plan your return to training. A 2km run is as valid as your previous 20km runs. Don’t let ego or excitement get in the way of a slow and sensible return to training – your body will thank you in the long run (so to speak)! And if anything, you should be finishing your sessions feeling like you want to do more.

This piece has been helpful to write for myself at least, so I hope it also helps a lot of you! Save it, share it, bookmark it on your laptop. 65% – 80% of runners get injured each year, so it’s likely that you’ll need this advice at some point, whether that’s now or in the future. Good luck with your recovery!

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