Overcome and Prevent Injuries

Injuries are the bane of every runner’s existence, yet it is extraordinarily rare to encounter a runner who has never been injured. While hindsight is always 20/20, the majority of common running injuries are entirely preventable when approached with a healthy dose of mindfulness and attention. Listed below are the common causes of injury, the most prevalent injuries that runners face, and how they can be avoided.

Common Cause of Injuries
The majority of injuries can be traced back to a handful of common causes. No injuries just magically appear, and many people begin to feel an injury coming on weeks in advance. Keeping a journal to track the way you feel during runs and workouts is an indispensible habit capable of creating mindfulness in an athlete. The following are risk factors that every runner should be aware of.

Improper/worn out shoes
It should go without saying that footwear is a major player in the comfort of a runner. If a particular running shoe is wrong for your foot or your stride, or if the shoe is nearing the end of its usable lifetime, a runner is more likely to experience injury.

Poor bio-mechanics
Bio-mechanics is a fancier word for form. If a runner has bad form, such as a non-neutral food strike, poor knee drive, arms that cross the core, or a bobbing head, these inefficiencies can lead to the expenditure of extra energy, the development of muscle imbalances, and an uneven distribution of stress across the body. Certain form drills, strength exercises, and mindfulness activities can help you improve your form, but the best way to evaluate whether your bio-mechanics are at fault is to schedule an assessment with a physical therapist or running coach.

Training overload
Many injuries stem from overuse, meaning that the body could not withstand the repetition of the constant pounding experienced on the roads. Every runner needs to take the occasional break to give the body a rest. Even elite and professional runners rest from time to time, typically 2 – 4 weeks per year. Scheduled down-time allows your body to recharge and return to running stronger than before. If you are in the midst of a training cycle and feel an overuse injury coming on then it may be wise to cut back on mileage or train on softer surfaces.

Poor nutrition
Nutrition can lead to injury in one of two ways: either an athlete is not eating enough throughout the day, or the athlete is primarily eating non-nutrient dense foods. Both scenarios are common among endurance athletes. There is a misguided school of thought that suggests lighter is faster when it comes to body weight. While this is true to an extent, there is a lower limit where additional weight loss drastically increases the risk of injury. When a runner is malnourished the body will shut down non-necessary processes, such as muscle recovery or calcium storage in the bones in favor of necessary processes such as heart function. When energy gets redirected the body is susceptible to developing disease or serious injury, including stress fracture.

Runners can also be susceptible to injury when they have poor diets. Running increases appetite, which can mistakenly lead athletes to believe they have free reign to eat whatever they would like. This increases the consumption of simple carbohydrates such as cookies and cakes, and does not leave much room for lean proteins, wholesome carbohydrates, and healthy fats. Filling your diet with non-nutrient dense foods can lead to vitamin and mineral deficiencies that ultimately lead to injury. For instance, Vitamin D, magnesium, and calcium are all nutrients that runners need in order to stay healthy, yet most athletes lack these essential vitamins and minerals in their diet.

Poor recovery
Recovering from workouts is just as important as doing the work. Athletes who are always on the move do not give their bodies an adequate chance to rest, which overworks already tired bones, ligaments, joints, and muscles. Sleep and rest are essential to letting your body absorb hard training, and without proper attention to these aspects runners can easily become injured.

Common Injuries
There are a number of injuries that are common among runners, and over the course of 5 – 10 years, every runner will experience symptoms from at least one of these ailments. Know the signs of these aches and pains in order to better take care of your body.

Shin splints
Perhaps the most ubiquitous of common running injuries, shin splints manifest as pain along the inside of the shin bone and is caused by tightness and/or microtears along the muscle that wraps around the shin bone. This injury is often brought on by running too much too soon, as well as increasing intensity too quickly. Other risk factors include running exclusively on hard surfaces and poor calf flexibility. To diagnose shin splints, stand with your feet shoulder width apart and raise your toes while keeping your heels planted on the floor. If you feel pain in one or both shins during this exercise, you likely have shin splints. The best course of treatment is to take a few days off from running while icing the affected area. Calf stretching is also recommended.

Stress fracture
Common areas prone to stress fracture among runners are feet, shins, and femurs. The root cause of a stress fracture is overuse and is often exacerbated by improper footwear, muscle imbalances, sudden increases in training load, training primarily on hard surfaces, and poor nutrition. A stress fracture can be expensive to diagnose because they do not appear on an X-Ray and require either an MRI or a bone scan. A stress fracture can be reasonably assumed if a dull ache is felt on impact during running and walking. Typically, stress fractures feel best in the morning upon waking and gradually feel worse throughout the day. A common test that doctors perform is to ask a runner to jump on the affected leg: reluctance to do so is often an indication of bone injury. Recovery involves 4 – 6 weeks of being on crutches or in a walking boot and the return to running can be a long, slow journey.

Illiotibial band syndrome (ITBS)
The illiotibial (IT) band is central to ensuring our knees and hips function properly. However, the many stresses from running can make this tendon cranky, causing a myriad of problems. The most common implication of a tight IT band is knee pain, otherwise known as runner’s knee. This problem can manifest in a variety of ways, from mild stiffness and soreness to feeling as if the knee is “locked” and not having full range of motion. ITBS can be difficult to diagnose and a visit to a sports medicine doctor or a physical therapist may be the best way to determine the cause of pain. After ITBS is diagnosed, the injured runner will have treatment to relieve the tight IT band such as massage. Stretching and strengthening exercises will also be prescribed. With mild to moderate ITBS many runners are able to continue running while receiving treatment, as the condition is unlikely to get worse.

Tendonitis
Another overuse injury on this list, tendonitis can occur in any tendon (most often the Achilles tendon or patellar tendon) and causes extreme stiffness and pain while running. Tendonitis occurs when a small tear in the tendon forms and then becomes inflamed. While ice, heat, and massage can mitigate the pain and stiffness, full rest is typically required in order to eliminate the pain completely. Common symptoms of tendonitis include a “creakiness” or “crunchiness” in the tendon, pain that lessens throughout the day as the tendon “warms up,” and greatly reduced range of motion.

Plantar fasciitis
Plantar fasciitis (PF) is a form of tendonitis that occurs in the foot along the plantar fasciia that runs from arch to heel. Runners suffering from PF will feel a continual pull in their foot or heel while walking and running. Like tendonitis, this injury is caused by overuse and can be exacerbated by wearing worn out shoes or shoes that are slightly too big. In the early stages of PF foot strengthening and stretching can remedy the pain, but in moderate to severe cases full rest is required. If you are concerned that you may have PF it is best to see a doctor or physical therapist, as this injury can take a long time to fully heal.

Prevention
There are a number of exercises and activities that can prevent the majority of running injuries, but finding the motivation to complete these activities can difficult. Only after a runner has been injured a handful of times does prevention get taken seriously, as most people cite having limited time. When time is scarce, even cutting daily runs 5 – 10 minutes short in order to fit in necessary appointments or activities is worth running fewer miles.

Fix imbalances
Identify sources of weakness in your body and aim to fix them. Runners commonly have one leg that is stronger than the other which leads to injuries in the weaker leg. A second common imbalance is between hamstring and quad muscles. Runners often have relatively stronger quads and weak hamstrings, leaving them susceptible to strains or pulls. Recent sports science research has even suggested that weak hips are the culprit behind many common running ailments, so paying attention to hip strength can also be beneficial.

Self Care
Runners tend to neglect the simplest of activities and exercises that can pay huge dividends when scheduled regularly into one’s day. Examples of self care include foam rolling, using “The Stick,” or performing muscle flossing drills with a golf ball. Each of these activities aids in recovery, blood circulation, and the release of muscle tension, and even five minutes of self care per day can prevent injury.

Strengthen core
A strong core is the foundation of injury-free running, yet most runners could improve in this area. Hips, abs, lower back, glutes, obliques, and shoulders are all important muscles that are called upon during hard races, workouts, and long runs. Strengthening these muscles will improve posture, reduce muscle imbalances, improve body alignment, and propel you towards faster times. Benefits can be achieved in as little as five minutes per day or by completing fifteen minute workouts 3 – 4 times per week.

Orthotics
If a runner repeatedly experiences the same injury despite taking proper precautions then custom made orthotics may help. A podiatrist or sports physician will analyze your foot strike and stride and determine whether your bio-mechanics may be causing your injury. If so, a shoe insert will be made that provides motion control and gives your foot a neutral landing.

Cross Train
If you feel an injury developing, it is never a bad idea to cross train instead of run. Aqua jogging, cycling, and the elliptical are all good options. For runners whose bodies are unable to handle the stresses of higher mileage or intensity, preemptively taking a day or two off every week and replacing the mileage you would have run by following the formula of 10 minutes cross training = 1 mile of running is recommended.

Good nutrition
Approach eating from the perspective that you are fueling your body for performance. If you would not put low-quality fuel in a sports car, why do the same to your body? At every meal seek to eat a lean protein such as fish or chicken and a complex carbohydrate, like quinoa or wild rice. Fat is essential for runners for good muscle and tendon health, and sources such as olive oil, avocado, and nuts and seeds are great additions to any meal.

Listen to your body
Some days you will get into a run and your body will be screaming at you to stop. Do not ignore these signals. There is no shame in cutting a run or workout short if you are experiencing pain. A day off in time saves nine, and while listening to your body can be tough, sitting on the sidelines is much worse.