Run to Win

At some point in your running career, you are going to get injured. It is inevitable. There are 3 reasons that you might sustain one of the 5 most common running injuries, and there are 5 simple steps that you can take to prevent you from getting injured in the first place.

Causes of Running Injuries

The vast majority of running related injuries are due to one of 3 things:

1. Poor biomechanics
2. Over training
3. Trauma

Poor biomechanics

Poor biomechanics are caused by adopting a running gait that does not agree with your body. You can do this by trying to improperly emulate somebody else’s running style, or by wearing the wrong kind of shoes for your running style.

Most people can wear most running shoes without hurting themselves too badly, but if you plan on running regularly you should first visit a specialty running store and seeking the help of an expert that can evaluate what kind of shoes you should be wearing.

Your running style is going to have a close relationship with the proportions of your limbs to the rest of your body, to your weight, and to how fit you are. Be aware that the shoes that you find that work for you now may not always be the best choice. Shoe styles change from year to year (much to the annoyance of most runners) and your gait may change as you get into better shape or gain or lose weight.

Poor biomechanics can also be exacerbated by inadequate flexibility or strength, even in muscles that do not seem to be related to running. While you can use different muscles to perform different actions, your body is really just one big, well-connected machine.

Over training

There are four ways to over train your body, and they are not mutually exclusive.

The first and most common way to over train can be caused by increasing your mileage too fast and running more than your body is ready to handle. A safe way to increase your mileage is to try not to go up more than 10-15% or so each week from the week before, and to cut back at least 5% every 3 or 4 weeks. This gives your muscles an opportunity to adapt to your new training load.

Over training can also be caused by running the same mileage, but increasing some other physical activity that can tire you out or make it easier to pull a muscle that will sideline you. For example, if you are walking around carrying heavy boxes on a factory floor all day, then you are not going to be getting the rest that you need to increase your miles and may want to take your advances a little slower.

The third way to over train your body is to increase the intensity of your work outs. If you have not run for 2 years and you jump straight into a quarter mile interval session, you are going to be stressing your muscles more than they can handle. The best way to prevent over training is to first build up a base level of fitness before increasing the intensity of your workouts, and to then increase the intensity or your overall mileage from week to week but not both in the same week.

And finally, the surface that you run on can lead to over training if you take too much of a pounding (or too little) no matter how much you increase or decrease your mileage or intensity.

Trauma

Trauma is the sort of thing that can injure anybody at any time, whether they are running or not. It is caused by an external factor that causes you to hurt yourself such as falling down and breaking a bone, or twisting an ankle in a pot hole, or getting hit by a car. Injuries of this sort are usually pretty self evident and are outside of the scope of this article. Try to use some common sense and take precautions when you are running to minimize the chances of hurting yourself.

Common Running Injuries

These are the top 5 running injuries that you will hopefully manage to avoid:

1. Stress Fractures
2. Tendonitis
3. Plantar Fascitis
4. Runner’s Knee
5. Shin Splints

Stress Fractures

Stress fractures are cracks in the outer layer of a bone from repetitive stress. It is most often caused through over training by increasing mileage at too rapid a rate. Stress fractures can be exacerbated by excessive pronation or supination, which is usually caused by wearing inappropriate shoes.

Stress fractures will usually hurt in a very localized place and will begin as a dull ache that can easily be misinterpreted as a sore muscle. Rest is the best way to cure a stress fracture, although you may want to consider taking supplements with calcium and cutting back on diet soft drinks. They can inhibit your body from absorbing calcium.

Be sure to keep adequate rest in your training plans and to follow a gradual schedule of increased mileage. If you suffer from frequent stress fractures, then you are either not allowing yourself enough time to heal (1 to 3 months) or else you may require custom orthotics in your shoes. Stress fractures can be easy to miss with a common x-ray and may require a bone scan to detect.

Tendonitis

Tendonitis is excessive inflammation in your tendons. It begins with a dull aching after you finish running, which gets worse if left untreated. The tendon will begin to ache first thing in the morning after getting out of bed, and then while you are in the act of running. The dull aching will become more acute, until you always feel at least the original dull pain even when you are not working out.

Tendonitis is usually caused by running too far and too fast when your muscles are not flexible enough to support such a workout. The problem can be exacerbated by shoes that have worn out and cause excessive pronation.

To avoid getting tendonitis, be sure to warm up before doing any speed work, do not raise your mileage too fast, and try to stretch when you are done with your workouts. You can treat tendonitis by icing after your workouts, taking small amounts of ibuprofen to reduce swelling, and taking time off from running.

The most common form of tendonitis for runners is achilles tendonitis. The achilles tendon connects your heel to your calf, and will usually ache along the back of your leg just above your ankle.

Achilles tendonitis can be treated specifically by using small heel lifts until the pain subsides. Any acute pain, however, really needs to be checked out by a competent doctor.

Plantar Fascitis

Plantar fascitis is an inflammation of the plantar fascia, or the bottom of your foot. This tendon is very hard, like a ligament, and connects the heel of your foot to the ball of your foot.

Every stride that you take, whether walking or running, involves the stretching out of this tendon to absorb the impact of hitting the ground. Tight calf muscles can increase the stress on the tendon and cause increased micro trauma that can lead to inflammation.

The first symptom of plantar fascitis is the feeling of a bruise on the bottom of your foot. Left untreated, it can become painful any time that you are walking or running, and can also bother you if you stand for a long period of time. It will often hurt a lot first thing in the morning when you try to get out of bed.

Plantar fascitis is caused by over training and poor biomechanics. Icing, stretching, and replacing any worn shoes is very important in aiding the recovery process. Stretching should concentrate on the calves and on the foot. A hard, round ball with a bit of give (such as a tennis ball) can be rolled beneath your foot to stretch it out.

To aid recovery from plantar fascitis, you will want to decrease hill and speed work or take time off completely. If it is left untreated for too long, you may require custom orthotics in order to do any serious training in the future.

Runner’s Knee

Runner’s knee refers to any pain in the knee cap and is usually the direct cause of over training and poor biomechanics. The two most common forms of runner’s knee are patellar tendonitis and chondromalacia patella.

Patellar tendonitis is when the pain is localized to the tendon in your knee cap. Chondromalacia patallea means that scarring has occurred because the knee cap does not sit properly in its femoral groove, and the underside has worn down and become rough and deteriorated.

This can be caused by a lack of flexibility in any or all of the quadriceps, hamstrings, or calves. Most often, however, it is caused by a problem with the foot or ankle, usually due to excessively worn shoes and over training. The problem can be exacerbated by excessive hill work.

Runner’s knee begins as a dull pain after the run that gets worse over time. Treating it early is very important to prevent permanent damage. Stretching tight muscles after your workouts and icing frequently helps.

Shin Splints

Shin splints are any pain in the shins and is usually tibial stress syndrome. There are two types of shin splits, anterior and posterior.

Anterior shin splints are really an inflammation of the tendons that attach the front of the shin bone to the outside. It begins as a dull ache on the outside of your shin bone as you run and can get worse until it is painful to walk.

Posterior shin splints are an inflammation of the tendons that attach to the inner side of the shin bone and causes pain in the inner surface of your shin bone extending down to the arches in your feet.

Shin splints can often mask an underlying stress fracture, especially when there is acute pain and swelling. Unless it is really a stress fracture, shin splints are rarely caused by too much mileage. They can be caused by too much hill work or speed work before you are ready for it.

Tight calf muscles and excessively worn shoes are often the root cause of shin splints. Stretching your calves several times a day and laying off of the speed work can usually make your shin splints go away in short order, and I recommend icing after every run while your shins hurt and for a few weeks after the pain has gone away.

Preventing Injuries

As you look over the most common running injuries, you will notice that there are some common themes amongst the different injuries. That is why I began the article by explaining the 3 ways that most people injure themselves. Because most running injuries are caused by the same thing, they can be pretty easy to prevent if you follow the following steps on a consistent basis.

Diligence in identifying and treating an oncoming injury and some simple precautions can go a long way towards preventing the worst of the injuries from ever bothering you.

Don’t increase your mileage too quickly.

Be very careful how fast you increase your mileage. Always put in a cut back week once per month so that you can give your muscles a chance to recover from the stress that you have been keeping them under.

It is better to take a little extra time preparing for a race than to miss the race because you are side-lined.

Prepare a proper base before doing speed work.

Do not jump straight into interval or tempo sessions until you have laid the groundwork that will allow your muscles to cope with the stress of speed work. If you are a relatively fit person, then a month of base training is probably enough. If you have not been keeping yourself in shape for a few years, then give yourself at least a few months before you jump into repeats.

Remember that hills and wind are speed work in disguise. Until you have a good base, try not to strain yourself too much by fighting a head wind or powering up a hill.

Wear the proper shoes.

Choose shoes that fit your biomechanical needs, and replace them before they become too worn. Most shoes will last between 200 and 500 miles before they need to be replaced. Ask an expert at your local running shoe store about how long you can expect your shoes to last when you are getting fitted, and then log when they do actually wear out so that you can predict it with your next pair.

A tip to keep in mind is that a more expensive shoe is not necessarily a better shoe. The price of a shoe is most often related to how much it costs to manufacture and not necessarily how high the quality of the shoe is. The more motion control that your feet require, the more that you are going to pay for your shoes.

I also recommend purchasing more than one pair of shoes and rotating between the two pairs for each run.

Warm up before runs and stretch after runs.

Warming up before your run will loosen your muscles and prepare them for your workout or race. Gentle jogging and then a few striders is a great way to ease into a workout. If you are running any sort of repeat, then take the first couple of them easier than your goal pace. For example, if you want to run 90 second quarter mile repeats, you should warm up at an easy jog for 10 or 15 minutes before starting and then run the first repeat in 115 seconds and the second one in 100 seconds before settling in to run the rest at or around 90 seconds.

When you finish running, cool down and give your muscles a chance to loosen back up. Do some gentle stretching when you finish.

I do not personally recommend stretching before a workout, because I believe that it can lead to decreased performance and more chance of injury. There is research pointing at both the benefits and detriments of pre-workout stretching, so it may work better for you than it does for me. Almost every study that I have read, however, points at the benefits of stretching afterwards.

Ice early, and ice often

Any time that you are more sore than you think that you should be, you should ice your muscles. Not every type of injury is going to be helped by icing, but 90% of them will be and if you aren’t sure what is wrong then you are more likely to help yourself than hurt yourself by applying ice.

Icing your muscles when an injury is coming on may help you prevent the injury from fully developing. Icing will usually reduce any swelling so that fresh blood can reach the sore parts of your body to help you repair the damage that you have done.