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On the Run

Nothing gets in the way of a good run like pain. Unfortunately, running-related injuries are common in runners of all levels.

Article
Lindsay Morris
Photos
Courtesy
Posted
March 28, 2020

Has the spring weather given you a wave of inspiration and motivation to get in shape? Maybe you’re using this as an opportunity to try a new form of exercise — running.

Running seems to be something people either love or hate. Maybe you’ve hated running your whole life but are determined to try to like it because you know what a tremendous calorie-burning form of exercise it is. Or perhaps you don’t mind running but just haven’t found the time or motivation to start a running program.

If your goal is to run a 5K, 10K, half-marathon, or maybe even a marathon this year, keep reading.

Running is one of the simplest and most effective forms of cardiovascular exercise. It gets your heart working, and it engages multiple muscle groups. It’s a complete exercise.

While the benefits of running are innumerable — cardiovascular health, mental clarity, and improved lung capacity, to name a few — there can be a risk for injuries, from mild to severe. For many runners, muscle strains, shin splints, and other overuse injuries might be the norm, but they can also be prevented.

Most running injuries (see sidebar) are the result of overuse, or repetitively putting stress on a muscle or bone, rather than one traumatic wrong move. They can be exacerbated by many things, like a high volume of training or the wrong kind of sneakers. But paying attention to your body and adding a few simple things to your training routine can help you avoid a lot of these overuse injuries — so that you can keep feeling good and strong as you run and train for your next race.

Amanda Lynch, a physical therapist and athletic trainer at Tulsa Bone & Joint Associates who also regularly runs ultra-marathons, provides some tips to help you prevent running injuries.

Ease into every run
Always take time to warm up. Begin with a brisk walk or slow jog, then gradually pick up speed. Once your heart rate is up, and you’ve started to break a sweat, then you can go full force into your run. Also, be sure to cool down and stretch once you’re done.

Avoid training errors by  doing too much too fast and too soon
“If you’re training for a specific event, follow a training plan and keep track of weekly mileage,” says Lynch. You may also want to consider joining a running group, which can encourage accountability. You’ll be more likely to stick with it. And you will also have some folks to eat breakfast with after your runs.

Give yourself enough time
Don’t expect to be able to run a half-marathon after training for a week. Lynch recommends that if you’re training for a 10K, you start training two to three months in advance. If you’re training for a half-marathon, give it at least four months of training. Any distance greater than that will need even more time.

Increase your weekly mileage slowly
Avoid increasing your weekly mileage by more than 10%, especially when starting. You need to work your way up to the longer distances over time. You should also build your mileage before incorporating any speed work. “If you are looking to increase your pace to achieve a goal time, add speedwork once a week,” Lynch says. Balance training runs with low-impact core and hip-strengthening exercises. Try cross-training workouts like cycling or swimming. By continuing to strengthen your muscles and improve aerobic capacity, your running can still improve without your feet having to hit the pavement quite as often.

Listen to your body
You need to incorporate rest days into your weekly training. Don’t be afraid to take a day off to let your body rest. Also, when you are running, you need to make sure you aren’t going too fast. Training runs should be slow enough that you can hold a conversation.

Strength training is essential
Lynch recommends focusing on hip strength, particularly the glutes, as well as core strengthening. “These provide leg stability and promote proper running mechanics. Weak hips can sideline a runner and cause various injuries,” she says. Cross-training — which can include swimming, cycling, or rowing — is also essential, especially if you are not able to run due to an injury. It’s important to do something to maintain your fitness levels and stay active.

Consider a gait analysis
If you experience pain while training, consult a physical therapist who specializes in working with runners. He or she can analyze your gait to correct any faulty mechanics. Lynch says that overstriding is a common error that new runners often make. “Simply shortening your stride by even a small amount can decrease impact force and help prevent many injuries,” she says.

Invest in a quality pair of footwear
Instead of buying a pair of running shoes that are “pretty” or “cool,” visit a local running store to ensure you are in the right shoes for your foot type. You may need to increase your running shoe size by a half size of what your everyday shoes are. To help prevent injuries, you should change your shoes after 400 to 500 miles of running.

Learn how to hydrate and eat during workouts properly
Especially as your workouts get longer and your mileage increases, you need to learn what works best for your body as far as drinks and nutrition go. “Drink water and electrolytes before, throughout, and after your run,” Lynch recommends. This is critical during hot and humid days, as well as the dry winter. A lot of people don’t take in enough calories, especially when you get to longer runs.

Be careful what you eat and drink before runs
Keto diets are all the rage, but if you plan to do endurance running, you will need to include carbohydrates in your diet, Lynch says. Starting about 48 hours before race time, be particularly careful about what you eat or drink. Limit your alcohol to avoid dehydration.

Have fun
If you are training for your first big race, you must make it fun, or else you might not want to stick with it. Find people you enjoy running with, and get to know them while running. Consider rewarding yourself in small ways each time you reach a milestone — for example, an ice cream sundae or a massage when you reach 10 miles.  

Common Running Injuries

Many overuse injuries can be treated at home using the RICE method: rest, ice, compression, and elevation. If pain persists or becomes chronic, it is important to see a doctor and discontinue running until you know what is causing the problem. Running while injured, even if the injury is mild, can compound damage and extend healing time.

Tendonitis
Tendonitis is common among athletes and occurs when a tendon becomes inflamed or irritated because of overuse. Tendons are tissue that connects muscles to bones. Runners are most susceptible to Achilles tendonitis, in the Achilles tendon that attaches the calf bone to the heel, and patellar tendonitis, in the patella tendon that connects the kneecap to the shinbone.

Plantar fasciitis
When heel pain strikes the bottom of your foot, it most likely involves your plantar fascia, which can become inflamed with repetitive stress or overuse. However, this is one of the most preventable running pains. Keep your feet safe by wearing shoes with lots of support, stretching your feet, and getting plenty of rest to heal.

Pulled muscles  
With a pulled muscle, tendons and fibers are strained or torn. A minor injury will feel stiff upon movement, and a major one will be painful. For runners, calves and hamstrings are frequent targets. Pulled muscles are usually a result of overuse, inflexibility, or the lack of a warmup or cool-down. Yes, it sounds obvious, but the No. 1 way to avoid a pulled muscle in the first place is to stretch before and after your workout.

Runner’s knee  
This type of knee pain can be misleading. The discomfort tends to show up gradually and feels minor at first. Your knees might feel completely fine during a run, and then worsen when you kneel, squat, sit cross-legged, or walk up or downstairs. It usually happens due to overuse, and it is typically caused by muscle imbalances, such as hamstring tightness and weak quadriceps or hips, which put additional pressure on the knee. Knee injuries can be minimized by staying light on your feet while running, and again, wearing the proper shoes. Reduce mileage, wear a knee brace, try knee tape to help treat the pain, and avoid downhill running, when possible.

Stress fractures
When you overtrain your muscles, they stop being able to absorb shock — and then any stress that hits your bones can lead to a crack or fracture. The best way to prevent stress fractures is to watch how much you’re training and listen to your body. This type of injury is relatively common for runners, particularly in their feet, legs, or pelvis. Be sure to cross-train with low-impact exercises like yoga or cycling. Maintain high levels of vitamin D and calcium in your diet to promote healthy bones, too.

Shin splints  
Shin splints happen when the muscles and tendons covering your shinbone are inflamed. This leads to dull or sharp pain in your shin area while walking or running. Prevention is involved, but some research has found shock-absorbing insoles for arch support to help a little bit, in addition to wearing the right running shoes and running on soft, non-hilly surfaces whenever possible. If you’re actively dealing with pain, then icing your shins and keeping them elevated can help. In general, practice “proper load modulation” for injury-free runs. Prioritize easier runs (versus going hard all the time), add rest days to routine, and skip runs when you don’t feel well.