If you run, chances are that you will get injured! A review of the literature shows that up to 70-80% of runners will get injured per year. Here are some proven strategies for injury prevention.
1. Training Program
A poorly planned training schedule is the number one reason for running injuries. The body is only good at doing what it has done lately. Tissues such as muscle, tendon and bone are all capable of adapting to progressively greater loads but only with gradual increments. If significant increases are made over too short a period the recuperative mechanisms of the body are overtaxed and breakdown will occur. The ‘10% Rule’ is generally a safe approach to meeting the demands of a training program. Do not increase
weekly or daily mileage by more than 10% . Also, adding more than one change per week (running more often, running longer or running faster) can also influence injury risk. A qualified running coach can help develop a training program that will maximize performance and minimize injury.
Although there are a variety of running styles, certain techniques are associated with increased risk of injury. Landing on the midfoot or forefoot allows for a lighter and more shock absorbent contact with the ground. Comparison studies show that heavy heel strikers (versus midfoot and forefoot strikers) may have increased incidence of injury and also may not run as efficiently. For distance running, slight forward body lean with shorter stride length promotes the foot landing closer to your centre of gravity minimizing stress on the foot and knee. Try to feel symmetrical with arm swing and listen for a light and even impact sound when each foot contacts the ground. Cadence, or foot strikes per minute, of 170-180 is an indication of running efficiency. Evaluation by a running coach can help provide valuable technique feedback.
Movement patterns of the foot influence the mechanics of knee, hip and trunk. The purpose of a running shoe is to provide cushioning, support, protection and comfort. Shoes are often marketed according to the amount of rigidity or control of foot motion that the shoe provides. The amount of support required will vary according to foot mechanics, running style and training / racing distance.
The current trend is towards ‘minimalist’ shoes which keep the runner’s foot close to the ground with little support or cushioning. The belief is that greater connection of the foot to the ground facilitates more natural running technique. Advice on shoe choice from a knowledgeable healthcare provider in conjunction with shopping at specialty running stores will help streamline your shoe selection.
Orthotics are custom made foot beds which can alter distribution of forces in the foot and improve lower body alignment. Not everyone is a candidate for orthotic support but feet that have structural issues such as excessively low or high arches may benefit from this intervention. Foot problems like plantar fasciitis, Achilles tendonitis and calf strains may be alleviated by temporary use of orthotics. Orthotics should be comfortable to wear and made by a certified pedorthotist or podiatrist. Orthotics do not replace the need for keeping feet, calf and shin muscles strong and flexible. Generic foot beds are also available for less cost and can be used temporarily or to see if an orthotic may be helpful.
5. Core Stability
The powerhouse region of the trunk and hips creates a stable base to propel the arms and legs forward. Exercises like planks and bridges activate core stabilizer muscles and should be performed slowly and with holds up to two to three minutes. Use of a fit ball or BOSU ball can increase the level of difficulty for core training. These exercises are very effective for building muscular endurance and postural strength to control the back and pelvis during long runs and intense speed efforts. Weak hip and trunk muscles are often related to back and knee problems in runners. A ten to twenty minute session of core exercises should be performed two to three times per week to assist in injury prevention.
6. General Strength Program
Just because you run doesn’t mean your legs are strong and in balance. As a result of the unidirectional nature of running some muscle groups get used more than others. A strength program involving squats, leg press, hamstring curl, hip abduction exercises and calf raises for the lower body will complement your core training and toughen up your muscular system for the demands of running. Isolating one leg at a time with squats and lunges can be beneficial as this minimizes any left to right muscle imbalances. For well rounded fitness don’t ignore the upper body. Strong upper torso and shoulders will facilitate better posture and open up the chest for better breathing. Utilize off-season for strength training. Rest weeks are also a good time to get to the gym.
The joints of the back and legs need a certain amount of mobility to allow the body to run efficiently. If hips lack range of motion, the body compensates by straining other areas such as the back or knees. Due to running’s repetitive nature, certain muscles tend to get worked more than others and consequently get tighter. Typical shortened lower body muscles in runners are the calf, hamstring, quadriceps, hip flexors, and buttocks. Daily stretching combined with yoga are essential to your longevity as a runner, especially as you age. Everyone is unique with their inherent flexibility. Evaluation by a sport specific health practitioner can be beneficial for developing an individualized flexibility program for injury prevention and performance enhancement.
8. Cross Training
Elite runners may be able to run twice a day, six days a week in order to maximize their fitness and performance. They are generally younger, genetically gifted with good natural running mechanics and have more time for rest and recovery. For the rest of us, utilizing low impact alternatives such as swimming, biking and cross country skiing can help boost overall fitness while moderating the repetitive stresses of running. Nothing can replace the specificity of running, but giving tired joints and muscles a break from impact by doing other forms of exercise can be very beneficial in injury prevention. This is especially true for older runners (>40) and those with history of lower limb joint trauma.
9. Soft Tissue Care
Learn about foam rollers, Travel Rollers™ and trigger point balls and The Stick™. Most runners will use these tools to loosen tight muscles in response to repetitive strain and muscle imbalance. This equipment allows the user to simulate acupressure therapy on the tight bands in the muscle. To keep your muscles functioning optimally, massage therapy and other forms of muscle release treatments can be adjuncts to your strength and flexibility program. Icing sore muscles and joints after tough workouts can also minimize inflammatory responses and enhance recovery.
10. Rest and Recovery
Sleep is when our body heals and rejuvenates. Short changing yourself on sleep will negatively influence recovery processes and deplete energy reserves. Frequent exposure to emotional and physical stress can cause hormonal changes that weaken immune systems and retard recovery processes. Overtraining is a state that occurs when the body is overwhelmed by too much training stress and not enough recovery. Symptoms of overtraining are mood disturbance, sleep dysfunction, decreased performance, lack of motivation, illness and injury. Sometimes a few days off can reverse these effects. When severe, reversal of overtraining can take months of recuperation.
Each runner requires a unique training regimen for optimal performance and injury prevention. The best strategy is multifaceted. Listen to your body, learn from the experts and keep running for the joy of it!
(Originally published in the Calgary Marathon Race Guide 2011)