I would offer her the following training advice and support:I would tell her: I think that taking on such a big challenge is a noble idea, and I am extremely happy for you on this decision. I will be following and supporting you throughout your journey. However, just imagine when you climb the Everest there are a few camps you need to stop on your way to the peak. Running the marathon is the Everest of physical activity. Therefore I suggest that you set a few milestones on the way to the peak.

 Ultimately, once you achieve the ultimate goal, I’m am sure you are going to feel accomplished and be a healthier and happier person. But you must remember to respect the challenge. We live in a time where a guiding hand in this process is available and you could use this. You may consider doing it just right, without causing any possible damage to your body as this is a long journey, with several milestones on the path. While it’s not my specific expertise, I believe that once you consult an expert trainer, you will be advised how to reach those milestones, namely 5k run preparation program, 10k preparation program and half marathon before you are fully ready to do a full marathon preparation program.My first stop would be a visit to the GP, to make sure he feels you are physically fit to embark this journey.

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Once you have done that, I would advice going to a sports doctor. He will run some basic heart EKG, lung and effort test and will analyse your running style etc. It is important to correct mistakes at early stage, since running incorrectly may cause damage to your body.My next stop would be visiting a professional running equipment shop. In the shop they will help you to choose the most suitable shoe for you and will equip you with pulse measuring watch, light reflecting gear to keep your safety while running outside etc.

Some shops are specialised to test your walking and stability (gait cycle) and provide you with custom made insole. I am able to recommend you a great shop for that. Then I would join a running group which you can look for online. These groups are excellent as most are being guided by expert trainers. Not only that, a group will provide mental support and the social aspect makes your journey more fulfilling and pleasant. When in the group, you will get professional help with nutrition, sleeping habits, training advice, correct running equipments and so on to make sure you do this right.As you go through this process, I will be delighted to guide you regarding stretches and give you soft tissue therapy, pre and post event and maintenance massage treatments as required. As you go along, you can share your journey, and raise money at each milestone.

I can’t wait to see your updates on social media. You will not only raise awareness to the charity, but also promote a healthy lifestyle.  Regarding her painful and stiff leg I need to investigate and get more information. When does she feel pain and stiffness? Does she feel it after the training? If her answer is yes, then she needs to rethink her training routine and program. If she claims that her pain is constant, then I would look closer at her posture, medical history, muscle imbalances, her body-structure and would carry out several tests in order to find out what is the source or sources of her constant pain.

It might be caused by postural imbalance, over-trained/overused muscles, muscle strains, muscle sprain. I need to look at what kind of pain does she feel? Where is her pain located? Is it in her whole leg or only in certain area(s) or spot(s)? Is it in her hamstring or in her calf? Is the pain radiating somewhere or does she feel it only locally? Depending on the answer it could give me a rough idea where to start her treatment. First scenario: DOMS effectLet’s say that she claims that her legs start to feel painful, stiff and sore only after a training session and it disappears within a few days. Let’s say she also claims that she has increased the distance and the intensity of her running not long ago. In this respect I would assume that her pain could be caused by DOMS (Delayed onset of muscle soreness) and could be a sign that her body tries to adapt to the new physical stress. In this case I would advice her firstly on how to take precautions to avoid or minimise the effects of DOMS. I would explain that regular and proper warm up would be essential before training.

I would advice her to ease into her current training routine and gradually increase the intensity of it. This way she would enable her muscle to recover more easily and reduce the effects of DOMS. Over time her muscles will adapt to the new workout. (bout effect) I would advice her on gentle pre workout stretches of the muscles and joints of her leg such as:”rotating stomach stretch” starting with lying face down and both hands close to the shoulder-line. Hips remain on the ground and face look forward. Then rise up by straightening the arms then slowly bend on arm and rotate the same shoulder towards the ground. “kneeling quad stretch” while kneeling on one foot and the other knee pushing the hip forward.

“standing leg up hamstring stretch” starting with standing on one leg and the other leg is raised on a chair and is kept straight. Then lean forward to your toes while keeping the back straight.”standing wide knees adductor stretch” feet wide apart, toes pointing diagonally outwards while bending the knee and as you lean forward, you push your knee with your hands outwards. “leaning heel back achilles stretch” starting with standing and leaning against a wall, place one foot behind the other while the toes are facing towards the wall (forward) and heel remain on the ground.

Then bend the back leg and lean towards the wall. Hold this position 30 seconds Stretches needs to be held 30 second and being repeated 5-6 times. I would offer her pre-event massage treatments before her training or competition to prepare her body for optimal performance. I would explain how pre-event massage could enhance her performance physically and psychologically pre-event or pre training and how tailored pre-workout stretches would warm up her muscles reducing the risk of injuries. I would advice her on the many benefits of pre-event massage treatment such as: it stretches and warms up muscles, reduces muscle tension, enhances circulation, and mental clarity, improves flexibility and reduces excessive pre-competition tension. I would explain that the techniques and methods are used involves gentle mobilisation of joints along gentle stretching of the muscles.

I would advice her that the best time to schedule a pre event massage will be 2 days to a few minutes before the actual event and it would last about 10-15 minutes in order to avoid overstimulation or too much relaxation. Also that pre event massage is applied generally through clothing and no massage oil or creams are needed.  I would definitely offer her post-event massage treatment to not just enhance her physical and psychological recovery following training and competition but also reduce the effect of DOMS. I would explain her the many benefits of post-event massage including: enhanced recovery and tissue repair, reduced fatigue, relieved muscle swelling and tension and removed build up of muscle aches and pains. I would explain that this type of massage will ease up on the pain and stiffness in her leg as it significantly enhance blood flow to the affected areas following DOMS after event or training. I would offer her post-event massage between 30 minutes up to a day or two after the actual event. She could decide when will be the most suitable time for her. I would explain exactly which techniques I would use during post-event massage: Stroking (Effleurage), Kneading (Petrissage), Broadening compression, joint mobilisation and assisted stretching.

I would advice her home stretching exercises and also a possibility to massage the affected area herself or can with a foam rolling to reduce the effects of DOMS. Second scenario: Shin splintsLets say she complains that she feels ache and sharp pain in her lower leg, precisely in her shin (around the inside of her tibia). She also claims that the pain gets worse during activity. She claims that she has increased her training routine recently and also would like to buy a proper running shoes as the current ones are worn off. Let’s say during assessment and examination I could see swelling in her shin area.

 In this case I would suspect that she has got shin splints and advice her the following: Please seek medical help as soon as possible for proper diagnosis and to rule out compartment syndrome or possible stress fracture. I would explain that shin-splint is a very common injury within runners and can be caused by poor foot mechanics, poor nutrition, poor training habits and or rapidly intensified training program which does not allow the body to adapt to the new physical load and effort. I would advice her to stop all running activity for now and wait until the pain and swelling go away. I would explain her that her condition is better treated now than later as it may develop into a more complex problem in her lower leg.

 In order to reduce pain and inflammation I would apply: R.I.C.E. method which is Rest, Ice, Compression and Elevation. Rest in order to avoid pain and further irritation and damage to the injured area.

Ice (wrapped or cold packs) in order to reduce swelling of the injured area, in every 20 to 30 minutes for 2-3 hours.Compression in order to support the injury and reduce swelling. Elevation of the injured body part above the heart level in order to allow the swelling to drain.Her doctor can prescribe her anti-inflammatory meds if needed. I would support her throughout her healing phases and rehabilitation program. I would recommend low-impact activity to high-impact activity in every alternating days, swimming or cycling, in order to maintain conditioning levels while recovering takes place.

I would advice her on appropriate flexibility, stretching and strengthening exercises to aid recovery once she is pain free. Stretching exercises of her calf and shin muscles and strengthening exercises of her lower leg muscles would help absorb the shock of impact activities. Strengthening the shin muscles may help prevent the condition to return.

Proper warm up and stretches before and after activities are crucial. Stretches needs to be held 30 second and repeat 5 times. Regular soft tissue massage is recommended to aid recovery and healing processes.  I would explain how important to identify the underlying causes of the shin splints in order to avoid recurrence. She might need to change her training routine, invest in a properly fitted running shoes.

She might consider to revise and modify her training regime before returning to running again. Support groups can advice her suited recovery program which helps to bring her back stronger than before injury. They can also help her to outline a long term training plan that will meet her goals without risking re-injury or further injuries in the future.As a long term support I would offer her regular maintenance treatments throughout her training for the races and the actual event. I would explain her that regular soft tissue therapy treatments will address chronic issues, muscular imbalances, bio-mechanical issues and any muscolosceletal injuries. I would explain the many other benefits of it such as released hypertonic muscles, improved ROM, flexibility and better performance. I would emphasize on the fact that regular maintenance treatment reduces work-out fatigue (delayed onset muscle soreness), aid recovery, and in the long term prevent injuries before they happen.

Regular treatment is a essential part of rehabilitation reduces recovery time between workouts, breaks down scar tissue and reduces pain. It also aid relaxation and improve athletes physical and psychological wellbeing. It also improves athlete conditioning and performance, makes them recover faster and with fewer or no injuries. I would explain her that maintenance massage treatment is ideal to have once a week or fortnightly lasting 60-90 minutes.

I would outline that the actual treatment plan will depend on her medical history, current situation, injuries, chosen sport etc. I would explain what techniques I use during treatment : Soft tissue massage, Soft Tissue Release (STR), Trigger Point Therapy, Muscle Energy Technique (MET – Post-isometric Relaxation and Reciprocal Inhibition), Neuromuscular Technique (NMT), Deep Friction, Deep Tissue Massage, Myofascial Release and stretches. If she has more question I would answer her thoroughly. I would offer her regular treatments and support as long as needed.