Running and Injury prevention

Whether you’re a seasoned runner or training seriously for the first time, the way you structure your workout regimen is important in protecting you from injury. Most running-related injuries occur at the knees, feet, shins, Achilles tendon and calves; hip, low back and hamstring/quadriceps injuries are less common.

The most substantial risk factor for a running-related injury (RRI) is a history of prior injury; because of this, it’s important to listen to your body and correctly treat any injuries you have.

What to consider in your running program

Training errors can quickly lead to a running-related injury. Avoid these common mistakes when preparing your workouts and schedule:

Changing any variable too quickly

Your body needs time to adapt to new activities or equipment, and changing anything too quickly can lead to an injury or pain. For example, increasing the total number of miles you run in a week by more than 30% significantly increases your risk of injury[ME1] [SM2] . Instead, focus on increasing your mileage by 10% for the lowest injury risk, and no more than 20% at a time. This applies to your total mileage per week, but also for the intensity of your workout, differences in terrain, and even footwear. Be careful when choosing to add interval sprint training or altering terrain types—like concrete, treadmill, or trail running—into your routine if you’re not used to it, and use caution if you decide to go from a cushion shoe to a minimalist shoe, or from a stability shoe to a cushion shoe. The tissues and sensory system of the body take time to adapt; making these changes too quickly will overload your body and could eventually cause pain and/or tissue injury.

The good news is that you control how to progress your training schedule, so whether you’re just beginning a program or are making changes to an established running routine, you can make smart decisions to protect your body and meet your training goals.

Be aware of your body type and ability

Depending on your body type, you may need to consider progressing at a different rate. For example, recent research [ME3] [SM4] has demonstrated that overweight and obese runners who are starting a running program self-select the same total number of miles and days per week of running in the first week than runners of a normal body weight. While running is a great way to lose weight, heavier runners will impose more stress on their tissues and may require more time to adapt so that they can enjoy running for a long time without having to take time recovering from an injury.

Factors that increase your injury risk

Injured areas of the body have different factors to consider.

  • Bone stress injuries of the foot or Achilles and calf strain may occur when the transition from a rearfoot to forefoot strike pattern or going from cushion to minimalist shoes is done too rapidly.
  • Bone stress injuries of the foot and shin, and plantar fasciitis are associated with greater vertical ground reaction forces when the foot first hits the ground while running (ie, “pounding the pavement”)
  • Knee pain is commonly associated with overstriding—taking big steps where the foot is landing too far in front of the body

Benefits of running

While there will always be a risk of injury while running, the improvements to your overall health far outweigh them. Many people worry that running will lead to disability and pain later in life due to the stress that running puts on the body. Although this is a common belief and there are individuals who have joint problems associated with running, it is likely because an initial injury was not taken care of properly or as a result of one or more of the training errors indicated above.

Several studies support that most runners are in better health than individuals who do not exercise regularly. For example, in a systematic review that included 114,829 people, only 3.5% of recreational runners had hip or knee arthritis compared to 10.2% of individuals who were sedentary or who did not run. Runners who had been running recreationally for at least 15 years seemed to have the best hip and knee joint health, while individuals who were competing at an elite, ex-elite, or professional level for a long time had the highest rate of hip and knee arthritis.

Regardless of your goals, running is great for your overall health and there’s no better time to start than now. If you have a running injury or need help formulating a training program, our exceptional physical therapists at the Des Moines University Clinic can help. We are currently offering in-clinic and virtual appointments for patients, and have running and cycling specialists[SM5]  for all of your specific treatment needs. Visit the DMU Clinic website or call 515-271-1717 to learn more.

Disclaimer: This content is created for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health care provider with any questions you may have regarding a medical condition.

Shane McClinton, D.P.T., Ph.D., OCS, FAAOMPT, CSCS

Shane McClinton is a physical therapist in the Des Moines University Physical Therapy Clinic.

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