Running without injury: can it happen?
I see it all the time, clients coming in with new onset severe pain that is keeping them from continuing training for something just a month short of the big race. Most of the time there isn’t a major cause of injury, and prior to onset of pain training has been running smoothly, so what happened?
There are lots of reasons for injuries sustained while running, and the chances of those increase when you are training for a distance event. In fact, in a 2019 study in the Journal of Orthopedic and Sports Physical Therapy found that 90% of runners training for a marathon or half marathon experience at least one running related injury during their training. So, what injuries are sustained? Is there a way to avoid it?
Common Running Injuries
There has been a great amount of research based on specific injuries caused by running, and the hypothetical predecessors. Overwhelmingly most common are knee and lower leg injuries, with women more frequently having knee problems compared to men. Specifically, the most common injuries in runners are patellofemoral pain syndrome, Achilles tendinopathy, and medial tibial stress syndrome (commonly referred to as “shin splints”).
Patellofemoral Pain Syndrome refers to a grouping of injuries that occur due to muscular asymmetries that result in pain in the front on the knee, around the kneecap. This is remedied with manual therapies to the quad and kneecap area as well as corrective exercise to improve the strength and control of the muscles on the outside of the hip and buttocks. Footwear can also be a factor, as with all running injuries.
Achilles tendinopathy is problem with - you guessed it - the Achilles tendon, which is behind the ankle. It can be due to inadequate warm-up/stretching, footwear, or motor control up the chain. For example, if your glutes aren’t fully functioning to extend the hip, the calf muscle has to work a lot harder, and will create problems at it’s tendon, the Achilles. This is again remedied with manual therapies and corrective exercise.
Medial tibial stress syndome (shin splints) is often related to poor training schedule/ramp-up, foot mechanics, and/or footwear. This can occur when someone first starts running, or if he/she suddenly ramps up training. The solution is once again manual therapy, corrective exercise, footwear modifications, and sometimes relative rest.
Injury Prevention for Runners
So based on what we know about common injuries and their causes, how do we prevent injury? In theory, by doing the following, a runner can prevent injury:
Wearing appropriate footwear. If you don’t know what type of shoe you should be in, see a physical therapist or go to a reputable running store that will look at your foot type and do a running assessment. Make sure your sneakers are not too old or worn.
Do an appropriate warm-up and cool-down. Your warm up should include something to increase blood flow, dynamic stretching, and activation/motor control exercises. Need help? See a performance physical therapist to get on a good program.
Ramp up your training at an appropriate rate to avoid injury. You should not be going from not running at all to running 8-10 miles the next week. There are ample training programs online, make use of them.
Cross-train. YOU NEED TO DO MORE THAN JUST RUN. (Louder for the people in the back!) Get on a good program to do on your off-days.
Recover. Your body needs a chance to recover. Minimum 1-2 days per week should be recovery days, which means no running. Maybe you do some gentle yoga or a light walk, but rest is not a “nice to have”, it’s a necessity.
Questions? Want to get your running pattern assessed? Send me an email, let’s talk!
Francis, Peter, et al. “The Proportion of Lower Limb Running Injuries by Gender, Anatomical Location, and Specific Pathology: A Systematic Review.” Journal of Sports Science and Medicine, vol. 18, 8 Oct. 2018.
Franke, Thierry P.c., et al. “Running Themselves Into the Ground? Incidence, Prevalence, and Impact of Injury and Illness in Runners Preparing for a Half or Full Marathon.” Journal of Orthopaedic & Sports Physical Therapy, vol. 49, no. 7, 2019, pp. 518–528., doi:10.2519/jospt.2019.8473.
Taunton, J E. “A Prospective Study of Running Injuries: the Vancouver Sun Run ‘In Training’ Clinics.” British Journal of Sports Medicine, vol. 37, no. >3, 2003, pp. 239–244., doi:10.1136/bjsm.37.3.239.