Accelerate Physiotherapy

27/10/2026

When is pushing through worth it?

My one rule going into Equinox was not to break myself. I had other races planned and didn't want a 24-hour event to leave me with an injury that stopped me running for weeks or months afterwards.

For most of the race, I actually did a pretty good job of sticking to that. I listened to my body, changed my gait, walked the hills and adapted whenever something started hurting.

Then I got to the final 50km.

By that point I was leading the women's race, and suddenly the rule I'd set myself before the race became much harder to stick to. I knew second place was still moving behind me and that if I stopped for too long, I could potentially lose the win.

But looking back, it wasn't only about winning. There was definitely some pride involved too.

I'd spent the night putting in consistent lap times and I was proud of that. I'd worked my way, unknowingly, up the leaderboard after not even being on the first page in the first six hours. After doing that for so long, I didn't want to suddenly slow down dramatically and feel as though I'd blown up at the end.

Whether anyone else would actually have thought that probably didn't matter apparently, I cared enough for all of them. 😂

Pride can be useful in sport. It can make you dig in when things get difficult and discover you're capable of more than you thought. But it can also make it harder to make the sensible decision when your body is telling you to back off.

Somewhere in those final 50km, holding onto the win and not wanting to feel like I'd blown up became more important than my original rule of "don't break yourself."

So, I kept going.

And there was a consequence. Immediately afterwards my Achilles was extremely swollen I couldn't get a shoe on for a week (hence the crocs in clinic!), I could barely manage stairs, getting in and out of a chair was an event in itself and I was, quite frankly, more than a little broken.

It's made me think a lot about a question runners ask us in clinic all the time:

"Can I still do my race?"

Often there isn't a simple yes or no answer.

You might be carrying a niggle and still be physically capable of getting around. But that's not quite the same question as whether doing it is worth the risk.

🏁 How important is this particular race to you?

📅 What's coming up afterwards?

⚠️ What happens if the niggle gets significantly worse?

⏳ Are you prepared to sacrifice a few weeks or months of running for today's finish line?

🎯 Is this the event you've spent months training for, or could you defer it and protect a bigger goal further down the line?

Sometimes the decision might be to start, knowing you may need to change the plan or stop if things deteriorate. Other times the sensible decision might be not to start at all.

There's also a big difference between managing some discomfort while continuing to move well and pushing on while your gait is changing significantly and other areas are starting to take the load.

That's why I don't think "never push through pain" or "just tough it out" are particularly useful rules on their own. Context matters.

At Equinox, I eventually chose the result in front of me. The win and as many laps as I could manage and, if I'm being completely truthful, probably my pride as well, became worth taking more risk than I'd intended when I started.

Would I make exactly the same decision if I had an important race in the following weeks? Probably not.

And that's the point.

The same symptom in the same runner might lead to a completely different decision depending on what that runner is trying to achieve and what they're prepared to risk.

Know your body, understand the potential consequences and think about the bigger picture rather than just the finish line directly in front of you.

Sometimes you decide the goal in front of you is worth the risk. Sometimes the bigger goal means it isn't.

The important thing is understanding the decision you're making and the potential consequences of making it.

🎥 Safe to say, the “don’t break yourself” plan hadn't gone entirely to plan… 😂

24/10/2026

Who else has a secret race-day rival? 😂

You know the one. The person you are absolutely NOT racing… but you're also definitely not letting them finish ahead of you.

It might be someone you've spent the whole parkrun leapfrogging, someone in your age category, the person who always seems to finish just ahead of you at your local 10K, or simply a completely unsuspecting stranger you've decided is now your competition. 😂

Mine just happened to appear about 18 hours into Equinox.

For the first 17 hours of the race, I genuinely didn't care what position I was in. I was concentrating on my own laps, my own targets and seeing how far I could get.

By the final lap I was still leading the women's race, my Achilles and knee were making normal running increasingly difficult, and I had absolutely no idea where second place was.

Suddenly, 10km felt like an incredibly long way if I reached the point where I couldn't run and could barely walk. And realistically, I probably couldn't crawl that far either. 😂

I couldn't see second place behind me, but my increasingly rational brain had apparently decided she was about to pull out a sub-60-minute 10K and chase me down. So I kept trying to walk as quickly as I could and run whenever my body would tolerate it.

Eventually I saw her...I don't think I've ever been so relieved to see another person walking slowly and clearly feeling it just as much as I was! 😂

I finally realised I had enough of a gap that I could stop attempting to run and just get myself to the finish. But apparently I still wasn't prepared to walk across the finish line.

Whenever I had run during the race, I'd tried to make it feel like running rather than shuffling back to what I knew from the track and road: up on my toes, light, springy and with some purpose. Physically my Achilles actually tolerated that better than fast walking, but mentally it made me feel fresher too.

So when I reached the camping field for the final kilometre, I ran. And I was very, very relieved to stop. 😂

So come on, runners who else has had a completely one-sided rivalry with someone who probably had absolutely no idea they were racing you? 😂

19/10/2026

The conditions are part of the race.

A few weeks on from Equinox, I've been thinking about how different my result could have looked if we'd had different weather.
190km is 190km, but the number alone doesn't tell you the whole story.

Apart from the wind, we were incredibly lucky with the conditions. Had we had the torrential rain and epic thunderstorms Equinox has experienced in previous years, I'm pretty sure my race would have looked very different.

A wet course would have changed the footing, how I approached the hills and potentially how much I could run. Wet feet certainly wouldn't have helped my already questionable blister management, and spending hour after hour in wet clothing brings its own problems too.

But this isn't just an ultra-running thing.

We're heading into the time of year when parkruns, 10Ks, half marathons and cross-country races can mean rain, mud, wind, cold temperatures and slippery ground. The pace you can comfortably hold on a dry surface in good conditions may not be the pace that makes sense on a wet, windy or muddy day.

The same applies when you're comparing performances. A 10K in perfect conditions isn't necessarily comparable with a 10K into a headwind, just as a dry cross-country course can be a completely different challenge once it's turned into a mud bath.

It can be frustrating when you've trained for a particular time and race day doesn't give you the conditions you wanted. But sometimes adapting your pace, expectations or race strategy isn't having a bad race it's responding sensibly to the race you've actually got.

I definitely benefited from the conditions we had at Equinox. On another weekend, 190km might have looked very different.

So, as we head into winter racing, have your goals, but be prepared to adapt them. Race the course and conditions you've actually got, not the ones you were hoping for.

📸 Antony at Equinox last year, helpfully demonstrating exactly why I was so grateful for this year's weather. 😂

15/10/2026

The bits of running we don't usually talk about.

As if running for 24 hours wasn't going to be enough of a challenge, my period decided Equinox weekend would be the perfect time to arrive. 😂

Not necessarily something we talk about much in running, but perhaps we should.

Hormonal changes around menstruation, and also through perimenopause and menopause, can affect women very differently. Some experience lots of symptoms, while others barely notice a difference.

It can be incredibly frustrating when you've trained for an event for weeks or months, only for race day to fall at a time when your body just doesn't feel quite the same.

You might be more fatigued, bloated, have abdominal or back pain, notice changes in your bladder or bowel habits or simply feel that everything takes a little more effort than usual.

For me, I can sometimes get some of my familiar sciatica-type symptoms. I noticed this mildly during the first couple of laps but, because I recognised it and knew how it normally behaves for me, I wasn't particularly worried by it.

I also noticed changes in bladder urgency which, when you're trying to keep moving for 24 hours, isn't particularly convenient! 😂

It gave me a whole new appreciation for the importance of having a functional pelvic floor when you're on your feet and moving for that length of time.

And pelvic floor function isn't just a women's issue - men have one too! It's also not simply about having a "strong" pelvic floor. It needs endurance and coordination, but it also needs to be able to relax when required.

It was another reminder of how useful it is to know what's normal for your own body.

We talk a lot about training plans, pacing, shoes, fuelling and recovery, but periods, bladder and bowel changes, pelvic health, perimenopause and menopause can all be part of the picture too.

There isn't one experience that applies to everyone. Some women find hormonal changes have a significant effect on their running; others don't notice much at all.

You can't necessarily choose what your body decides to do on race day. But understanding your own patterns can make it a little easier to adapt when it doesn't quite cooperate with the training plan.

Maybe not the most glamorous part of running to talk about but definitely one that's worth talking about.

12/10/2026

📝🏃‍♀️ Plan your training. Then review it.

It’s great to have a plan and an idea of where you want to be. 🎯

But your training plan was written when you were motivated, well-rested and imagining the perfect few months ahead.

Real life doesn’t work like that. 😂

Review it week by week — or even run by run.

🦵 Niggle? Adjust.
😴 Tired? Adapt.
🤒 Ill? Rest.
👨‍👩‍👧‍👦 Life gets in the way? Rework it.

Train for how you and your tissues are actually feeling, not what you pencilled into a calendar weeks ago.

A plan should be a guide, not a contract. ❤️

11/10/2026

09/10/2026

The pain kept moving.

One of the things that surprised me most about running for 24 hours was how often the thing that hurt the most changed.

At various points I had blisters, clothing rubbing, knee pain, hip and IT band pain, p***c bone discomfort, some mild sciatica, hamstring soreness and, of course, my existing Achilles issue. Quite the collection by the end. 😂

What I found fascinating was how something could feel like the biggest problem in the world for a few minutes or a lap, only to become almost irrelevant when something else started shouting louder.

Something that had been consuming my attention could suddenly feel much less significant, not necessarily because it had completely gone away, but because my brain now had something else it considered more important to deal with.

It was a good reminder that pain needs context.

A new pain after you've already run well over 100km doesn't automatically tell you exactly what is happening in the tissue. But the same principle applies whether you're running an ultra, a marathon, a 10K or your local parkrun.

Pain isn't always as simple as "something hurts, therefore something is damaged." Equally, that doesn't mean you should blindly ignore it and keep going.

You still need to consider how severe it is, whether it's worsening, whether it's changing the way you're moving and what happens when you alter what you're doing.

One thing I definitely got wrong was my feet. 🦶

I knew they were becoming a problem, but I didn't want to lose time at the checkpoint sorting them out, so I kept telling myself I'd deal with them later. In hindsight, spending a few minutes dealing with them earlier might have saved me considerably more time, and pain, later on.

Sometimes losing a few minutes dealing with a small problem is a much better option than spending hours dealing with the bigger problem it becomes.

And that's relevant over shorter distances too. Maybe it's a hot spot developing on your foot, a shoe that doesn't feel quite right, a calf that's becoming increasingly tight or a niggle that's starting to change the way you're running.

It doesn't necessarily mean your race is over, but noticing what's happening and deciding whether you need to do something about it can be much more useful than simply trying to ignore it.

The way I was moving at 5km certainly wasn't the same as the way I was moving at 150km, and the thing demanding my attention changed repeatedly throughout the race.

The challenge was working out what I could tolerate, what I could adapt, what might settle again and what actually needed me to do something about it.

And you definitely don't need to run 190km to experience that.

It has given me a new appreciation for that conversation when runners come into clinic saying, "It started here, but now it hurts here as well."

Because pain doesn't always stay neatly in one place and understanding what has changed along the way can be just as important as knowing where it hurts now.

And the photo? A little throwback to another occasion when I perhaps could have paid attention to my feet a little earlier… 😂

06/10/2026

🏃‍♀️🏁 Training for a spring marathon? Don’t rush the mileage.

I’ve seen a number of runners over the last couple of weeks starting to plan their spring marathon training and trying to get their mileage really high before Christmas.

If you’re an experienced runner, injury-free, and you know that approach works well for you… great. Crack on! 👍

But if you’re new to marathon training, relatively new to running, or already carrying a niggle, suddenly pushing big volumes can be a quick way to overload tissues or turn a niggle into an injury. 🦵

Right now, think BASE.

🐢 Slow, steady runs
⏱️ Shorter runs
💪 Build strength
🧱 Build resilience
🏃‍♀️ Get used to being consistently on your feet

The big training comes in the new year.

You don't need to cram it all in before Christmas. 🎄

02/10/2026

You can't make load disappear. 🏃‍♀️

This was very obvious over 24 hours at Equinox, but it's something that applies to runners over much shorter distances too.

We all change the way we move. You might alter your stride going up or down a hill, change your running style as you fatigue, or start moving differently because your knee, Achilles, hip or foot is beginning to hurt.

Sometimes those changes are useful. But one of the important things to remember is that you can't make load disappear you can only redistribute it.

One thing I was very aware of from quite early on at Equinox was trying to spread the load around rather than running exactly the same way for 24 hours.

At different points I'd deliberately change my foot strike. Sometimes I'd heel strike more, with the aim of reducing the demand on my calf complex, and at other times I'd move towards more of a forefoot strike when I wanted to change the load around my knees. I was essentially rotating through slightly different ways of moving in the hope that no one area had to take exactly the same load for the whole race.

As the race went on, those changes became less about prevention and more about responding to whatever was complaining at the time. 😂

When the outside of my hips and IT bands started getting sore, I'd remind myself to run a little wider. When my hamstrings started complaining, particularly when fast walking, I'd shorten my stride to make sure I wasn't over-striding.

The Achilles was probably the best example. Eventually I reached a point where fast walking was actually harder to tolerate than running. I could still run relatively quickly if I stayed more up on my toes, so I adapted again and started doing more running and less fast walking.

But every change had a knock-on effect.

Trying to take some pressure away from the painful inside of my Achilles meant I started loading the outside of my foot more, which didn't do my blisters any favours. More running then started irritating my knees. By the final lap, it was actually my knee rather than my Achilles that had become the main reason I couldn't sustain my normal running.

It was basically 24 hours of load management in real time. 🫣

But you don't need to be running for 24 hours for this to happen.

A runner with a sore knee might shorten their stride. Someone with an Achilles niggle might start putting more weight through the other leg. Your running style might change towards the end of a hard 10K or half marathon simply because you're tired. And anyone who's run cross-country knows you don't move the same way through mud and hills as you do on a flat road! 😂

None of those changes are automatically good or bad. They simply change which tissues are doing the work.

Changing how you move can alter which areas are doing more or less, and sometimes that's incredibly useful. But the load doesn't magically disappear you're redistributing it, and whatever takes more of it needs to be able to cope. ⚖️

That's why, when we assess runners in clinic, we're interested in much more than just where it hurts.

What have you changed because it hurts? What are you now loading differently? And does your body currently have the capacity to tolerate that?

Whether you're 4km into a parkrun, 18 miles into a marathon or 150km into something slightly ridiculous, the principle is the same.

You can't make load disappear. You can only decide where it goes.

I just chose a slightly excessive 190km experiment to demonstrate the point. 😂

30/09/2026

🤔 Who decided 5K — or 30 minutes — was the starting point for returning to running?

Because it isn't. 🏃‍♀️

If you're new to running, or returning after an injury, 5K or 30 minutes of running can be a LOT of load.

And jumping straight into it because that's what a generic programme tells you to do can sometimes be enough to cause an overload injury or flare up an existing niggle. 🦵

You don't have to run 5K.

You don't have to run for 30 minutes.

You can start with whatever amount of running your body can currently tolerate even if that's much less.

Shorter runs still count. ❤️

Build gradually. Let your body adapt. Then build from there. 📈