Injury Prevention

Few things are as frustrating to a runner as injuries. No one wants to be sidelined halfway through their training for the big race.

Here’s the tricky part for runners: How do you tell the difference between normal pain that comes from training and an actual, legitimate injury?

Most running injuries are progressive in nature, essentially an accumulation of stress on a certain body part that hits a critical point. Compare this to injuries in a team sport; it’s pretty obvious when you sprain an ankle or pull your hamstring.

So think of the typical aches and pains that come with running as falling somewhere along a spectrum. One end of the spectrum represents the mild soreness you feel following a long run or hard workout. The other end of the spectrum is characterized by stress fractures and debilitating pain with walking.

All day, every day, we are somewhere on that spectrum.

As a Physical Therapist, part of my job is helping people figure out where they land on that spectrum. Essentially, the question we have to answer is, can I keep running? If you have a stress fracture, no you may not keep running. If you have crankiness that ebbs and flows, but can be influenced by stretches, strengthening, foam rolling, etc, then yes, you can continue running. However, there are some rules that we have to be aware of for the next few weeks in order to avoid a stress fracture or something debilitating.

Essentially, injury prevention comes down to a few key principles:

1. Don’t make drastic changes. If you’ve been running 10-15 miles per week, don’t jump up to 30-40 miles per week. If you’ve run twice per week, don’t try to run seven days per week without building up to it. If you’ve been running in normal shoes your whole career, don’t try to become a barefoot runner all at once.
2. Keep your muscles balanced. This might be opening a huge can of worms but stick with me for a few moments. Every time you take a step, it requires the careful coordination of dozens of muscles. Your nervous system is constantly monitoring how it’s going. If one muscle misbehaves (due to tightness and/or weakness), other muscles are going to be affected. If we’re not careful, this can turn into a habit and our muscles will be out of sorts right from the first step. We need to be proactive about this and take the time to prepare our bodies for running. Sometimes it’s as simple as doing 2-3 key stretches as part of a warm-up routine. Sometimes it requires a few exercises to fire up your abs or glutes.
3. Run with good form. We’ll skip the full dissertation for now, but let’s cover the basics. Don’t overstride, which means landing with your foot way out in front of you body. Find your ideal cadence. There are experts touting 180 steps per minute, but I think that it depends on the individual and will vary. Still, if it’s too low, it can be more stressful for your muscles and joints. Maintain good upper body alignment. Any flailing of our arms or swagger in our shoulders can indicate core or hip weakness.
4. Take care of your body. Take a rest day when you’re getting over being sick. Give your muscles some TLC with the foam roller or massage. Go for a bike ride or cross train instead of an easy run. Do some yoga to keeping it all together.

Obviously, there’s no way to guarantee you’ll never be injured. However, following these principles is a good insurance policy against it!

All this is good and philosophical, but takes a little work and intention on your part to actually implement. I’m a big fan of figuring out your own warm-up routine for each run. If you can dial this in, you will make big strides with #2 above. Essentially, it boils down to stretching areas that need it, firing up muscles that tend to get lazy, and working on your form and movement patterns with drills. It can be done in 5-10 minutes and doesn’t need to be arduous.

But don’t think of it as a warm-up. Think of it as tuning a musical instrument or calibrating a tool: a musician wouldn’t play a note without tuning up and a woodworker wouldn’t attempt a cut with dull blades.

Runners’ bodies are the same way. Every time you lace up and head out the door, it’s worth the time to make sure you’re doing all you can to stay healthy!

Run Fast, Friends!