How to Prevent Running Injuries

Hispanic Female jogger, having a cramp in her calf.
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Has your running program been sidelined by an injury? It is not uncommon for elite runners and novices to experience setbacks during training. These injuries may be mild and only require a slight modification to training or they may be severe and require you to avoid running completely. Either way, these hurdles can be frustrating.

While you might not be able to prevent running injuries completely, there are certain steps you can take to minimize their frequency and impact.

Common Reasons for Running Injuries

Most common running injuries are due to overuse, overtraining, improper shoes, or a biomechanical flaw in body structure and motion. The good news is that many running injuries can be prevented.

Overtraining

Many running injuries are a result of overtraining. Adding too much intensity, too many miles, too soon. It's important to go easy when adding mileage or intensity to your training.

Tips for Prevention: As a general rule, you shouldn't increase your weekly mileage by more than 10 percent each week. You can still push your limits, but you'll have to take a gradual and patient approach. By building up slowly, you can save yourself pain and frustration, and still reach your goals. Let common sense and a smart training schedule determine how much you should be running.

Improper Footwear

Be sure that your shoes aren't worn out and that you have the right model for your feet and for your specific running style. The wrong shoe can create changes to your gait, leading to injury or they may aggravate existing problems, causing pain in your feet, legs, knees or hips. Wearing old shoes that have lost their cushioning may also lead to injury.

Tips for Prevention: Go to a specialty running shop where you can be properly fitted for running shoes, and replace them every 350-500 miles. If you have a biomechanical problem with your feet, you may also look into getting fitted for heel lifts or orthotics.

Hard Running Surface

Once you have the right shoes, you want to make sure you're using them on the best running surface. Ideally, you want the ground to absorb shock, rather than passing it along to your legs.

Tips for Prevention: Avoid concrete as much as possible as it is about 10 times as hard as asphalt and is a terrible surface for running. Try to find grass or dirt trails to run on, especially for your higher mileage runs.

Also, consistency is important. A sudden change to a new running surface can cause injuries. For example, if you usually run on wooded trails and you start running on neighborhood sidewalks, you might notice some aches and pains. You'll also want to avoid tight turns, such as those on very short running tracks. If possible look for straight running paths or those that include slow curves.

Tight, Inflexible Muscles

Many runners don't consider a stretching program to be an integral part of their training, but they should. Especially when you are putting in mega miles for marathon training or intense speed work to improve your pace, your muscles can get very tight. Your gait may change to accommodate soreness or tight joints and injury may occur as a result.

Tips for Prevention: A regular stretching program can go a long way toward injury prevention. Be diligent about stretching after your runs. Just 5–10 minutes after each workout can make a big difference.

In addition, regular massage or use of a foam roller or other massage tool can help eliminate post-run tightness that is common among runners.

Muscular Imbalances

Injuries sometimes pop up when you pay too much attention to your running muscles and forget about important supporting muscles.

For example, some runners have very tight hip flexors because their quadriceps muscles (on the front of the thigh) are overtrained from running. By strengthening the hamstrings (on the back of the thigh), you can create balance in the lower body, reducing the possibility of injury.

Tips for Prevention: You don't need to lift serious weight to make a difference. Try to do 15 minutes of body weight exercises two to three times a week. Try to focus on the gluteal muscles, the abductors and adductors, and the core muscles to create balance and stability in your body. This small investment can make a huge difference in injury prevention.

Heel Striking

Heel striking is when your feet land in front of your hips during each step. This means that your heel hits the ground first. Heel striking is fairly common among new runners and can lead to injuries such as shin splints and joint pain.

Heel striking is a less efficient way to run because braking occurs with each step. In addition, a recent study found that runners who first strike the ground with their forefeet experience fewer knee injuries than their heel-striking counterparts.

Tips for Prevention: Ideally, you want to land mid-foot. Focus on landing mid-sole, with your foot directly underneath your body with every step. A short, low arm swing is the key to keeping your stride short and close to the ground. Try to keep your steps light and quick, as if you're stepping on hot coals. As you keep practicing landing mid-sole, it'll become easier and more natural.

Improper Foot Orientation

Runners who run with their feet pointed out or are more likely to experience ankle or knee issues. You want to try to avoid any twisting or sideways motion when running and keep your feet and legs moving directly forward.

Tips for Prevention: Try to run in a straight line, so that your foot placements are parallel to each other. This will reduce the rotation or twisting of your ankles and knees. For those runners whose feet naturally point in or out, running with your feet pointing straight can feel unnatural at first. Keep trying it for short stretches of your runs and it will eventually start to feel more comfortable.

Poor Posture

Good upper body form means staying upright and keeping your shoulders back and relaxed. If your shoulders hunch over, not only will you have more difficulty breathing (because your chest is compressed), but your lower back may start to ache during your run or after you've finished.

Tips for Prevention: Having a strong core makes it easier to maintain good posture while running, so make sure you're working some core exercises into your training. While you're running, do a posture check every mile or so. Raise your shoulders to your ears and then drop them down to their relaxed position.

Head Tilt

Your head may feel heavy, especially towards the end of a long run. But if you don't hold it properly, you may develop problems. If it tilts too far back, your head places a strain on your neck muscles. Holding your head too far forward can lead to neck and back pain. It can also compress your chest and make it harder to breathe.

Tips for Prevention: You should keep your head right above your shoulders and hips. Simply being mindful of proper placement may help you make adjustments during your run. But if you think your running form could use some help, it may be worth consulting a physical therapist or running coach for advice. You may need some intervention with targeted exercises to correct some muscle weaknesses or imbalances.

The Most Common Running Injuries

There are a few running injuries that are extremely common among new athletes and even among seasoned elites. Current research reveals the most effective methods for treatment and prevention.

Plantar Fasciitis

Plantar fasciitis is one of the most common running injuries. The condition affects the fascia that runs along the bottom of the foot (called plantar fascia) from the heel bone to the place where your toes attach. This fascia is responsible for maintaining arch support in your foot and can become irritated, inflamed, or torn by repetitive stresses placed upon it.

According to research, common causes of the condition include excessive pronation, a flat foot, tight Achilles tendon, the type of training shoes worn, and errors in the training routine.

While you can't change the shape of your foot, you can get properly fitted for shoes that help accommodate your foot shape and any known pronation. Additionally, be sure to stretch the Achilles tendon after each run and increase mileage conservatively.

If plantar fasciitis occurs, there are different treatments available to manage the condition. These may include the use of ice, corticosteroid injections, nonsteroidal anti-inflammatory medications, stretching, physical therapy, night splints, custom orthotics, over-the-counter heel cups, taping and other medical treatments.

However, according to one extensive research review, most foot and ankle specialists prefer plantar fascia-specific stretching and supervised physical therapy over other treatments.

In the research review, the most effective stretches were identified as:

  • Calf and arch stretch using a towel. Sit with your leg extended in front of you and use a towel to stretch the ball of your foot towards your body. Pull back on your foot for 30 seconds, three times with 30 seconds of rest in between. Researchers suggest doing this exercise before bed and before rising in the morning.
  • Roll plantar fascia with can or ball. Place a soup can or ball beneath the arch of your foot and roll it around to massage the fascia. Roll for one minute, three times with 30 seconds of rest in between. Consider keeping at the bedside and performing before going to sleep and before taking the first steps in the morning.
  • Manual plantar fascia stretch with a cross-friction massage. Take two fingers and place them across the arch of your foot to massage the fascia, while taking the other hand and flexing the toes to stretch the underside of the foot. Stretch and massage for one minute three times with 30 seconds of rest in between.

Achilles Tendonitis

The injury commonly known as Achilles tendonitis may actually be Achilles tendinosis, according to researchers. Tendinitis is the inflammation of the tendon and results from micro-tears that happen when the tendon is overloaded with too much force or a force that is too sudden. Tendinosis is a degeneration of the tendon’s collagen in response to chronic overuse.

Scientists who study Achilles tendinosis and other tendon injuries note that they are the result of gradual wear and tear from overuse. Because of the repetitive stress that occurs in running, this is a common injury that happens when you increase mileage or speed.

As such, the best prevention is conservative training—increasing mileage at a rate of no more than 10 percent per week and incorporating speed work cautiously.

Unfortunately, research indicates that there is no gold standard of treatment for the condition. Surgical treatments are used in some situations. But non-invasive treatments are generally preferred.

Non-surgical treatments include activity modification, orthotics, heel lifts, massage, hot and cold compresses, strengthening exercises, ultrasound, and non-steroidal anti-inflammatory drugs (NSAID) or an oral corticosteroid.

One treatment that is often recommended is called eccentric strengthening. The exercises involve lifting both of heels in a controlled manner and then lowering one heel slowly (an eccentric contraction).

Iliotibial Band Syndrome

Iliotibial band syndrome (ITBS) is the most common cause of knee pain in runners. The condition often occurs in women but can affect men as well.

Researchers describe the condition as an overuse injury that results from repetitive friction of the iliotibial band (ITB) over the lateral femoral epicondyle (the outside of the knee).

Common causes of this injury include excessive running in the same direction on a track, greater-than-normal weekly mileage, downhill running, and weakness or inhibition of the lateral gluteal muscles (on the outside of the hip).

Prevention methods include running on even, unbanked surfaces, warming up before long or hard runs, making sure that you replace your shoes regularly, and keeping the knee joint covered and warm.

Research reviews investigating the most effective treatments for the syndrome suggest that a combination of rest (for 2–6 weeks), stretching, pain management, and modification of running habits work in most cases. Surgical treatment is only used in the most severe cases.

One treatment option that is commonly used by runners is to strengthen the hip and gluteal muscles that can cause muscle imbalances. Common exercises include the clamshell, lateral band walk, and the single leg squat.

You might also do IT band stretches to relieve discomfort.

A Word From Verywell

Running injuries can be frustrating and time consuming to deal with, but if you don't take them seriously, they can sideline your training for months or even years. When in doubt, consult a professional. Visit your healthcare provider or get an appointment to see a physical therapist who specializes in running injuries.

To prevent re-injury, ease back into training with deep water running, cycling, or using an elliptical trainer. Talk to your doctor or physical therapist about when it's safe to start running again. Overtraining is the number one cause of injuries, so try to remember that progress takes time.

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Article Sources

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