Running Injuries -
Prevention and Treatment Tips and Techniques

Running injuries stink!

Just when you are beginning to see real improvement in your running and feel your normal stress level draining away, an injury occurs. You know that a few aches and pains are inevitable but this seems to be worse. You can't help but think, why me and why now?

Injured Runner

First, the bad news. Injuries are a part of the sport and almost everyone suffers an injury at one time or another. The good news, however, is that most running injuries can be predicted, and better yet, prevented.

So, now that we know injuries are predictable and preventable, let's go into some specifics and discuss:

Why Runners Get Injured

Overuse
The most common cause of running injuries is overuse. Overuse is described as doing too much, too soon, and too fast. It hits both beginner runners as well as veterans who suddenly increase their training thinking that their experience and smarts will keep them from injury.

Inconsistent Training
Another common training error occurs when you are inconsistent in your workout routine. Inconsistency occurs when you have missed several workouts in a row and then try to add on additional miles in subsequent workouts in order to catch up. Jumping right back into your training program after missing several workouts greatly increases your risk of a running injury.

Building Miles Too Quickly
Stick to the 10-Percent Rule. The 10-Percent Rule states that you should never increase your weekly mileage by more than 10 percent over the previous week. In addition, you should follow the 10-Percent Rule when building up the length of your long runs as well. Jumping straight from 7 miles to 11 miles is a mistake. Do 8 or 9 miles instead.

Repeating Hard Workouts with No Easy Workouts in Between
Do not run two hard workouts back-to-back. Hard workouts include long runs, hill repeats, races, speedwork and/or any other workout that overly stresses your body. Taking a one day break (day of rest, cross-training) in between hard workouts allows your body to recover and rebuild while limiting your risk of suffering a running injury.

Running on Uneven Surfaces
Many roads have good running surfaces but are often crowned so that water will run off its center. Running on a slanted road will cause one foot to pronate (roll inward) and the other to supinate (roll outward), therby increasing your chance of suffering one or more running injuries. Look for running routes over the flattest roads available.

Improper Shoe Type and Excess Shoe Mileage
Running in tennis shoes or a shoe type (Motion-Controlled, Stability, Cushioned) that is wrong for your feet will cause running injuries as well as running in shoes that have excess mileage (500 miles or more). Choose the right running shoes and replace them when the mileage reaches approximately 500 miles.

Running Injuries Prevention Tips and Techniques

Run on Softer Surfaces
Running injuries are minimized when you run on soft surfaces, such as packed dirt and grass, whenever possible. Running on packed dirt and/or grass, however, doesn't prepare you for the pounding of city streets that most of your training and races are run on. In that case, avoid concrete (such as sidewalks) and look for asphalt.

Avoid Tight Turns
Tight turns and indoor tracks are a common cause of running injuries. Look for slow curves and straight paths. Shins are especially stressed on indoor tracks due to the combination of a hard surface and tight turns.

Pay Attention to Injury Warning Signs
If you think you might be injured, immediately begin preventative measures in order to keep damage to a minimum and to speed your full recovery. Depending on the type of injury, this could mean using the RICE (Rest, Ice, Compression, and Elevation) method to enhance recovery, taking anti-inflamatory medication (aspirin, ibuprofen), and taking a day or two off of running to allow the injury to heal. Secondary running injuries often occur by continuing to run through pain, favoring the injured area, and thereby changing your natural running style.

Run in Shoes with Proper Cushioning and are Right for Your Feet
Improper and/or inadequate shoe cushioning will quickly lead to running injuries. It is imperative that you pick the right running shoe that does not have an inordinate amount of wear and tear (i.e. greater than appproximately 400 miles). Review the choosing running shoes page for additional details.

Only Run Miles Needed to Meet Your Goals
Accumulating additional Junk miles is a sure way to cause a body to break down and for running injuries to occur. Run only the miles you need to meet your goals. Following the mantra, more must be better will lead to injury.

Stay Hydrated
To avoid heat injury while running, remember to drink plenty of non-dehydrating fluids such as water, orange juice, or a sports drink. But don't overdo it, either. When running, drink until you hear sloshing in your stomach or feel that your stomach is full. When the sloshing sound goes away, resume drinking. For additional details on running in the heat and preventing dehydration click on the preceding link.

Use Fresh Shoes
Running on worn out shoes is a prime cause of many running injuries. When the mileage totals from your running shoes reach approximately 500 miles, it's time to purchase a new pair of shoes. High mileage shoes are a quick way to get injured. The shoe breaks down, and in turn, throws off your running stride. One tip to increase the life of your shoes is to purchase and use more than one pair of shoes. Running in different shoes on alternating days more evenly distibutes the stress on your feet and legs.

Stretch Regularly
Lack of stretching or improper stretching can lead to running injuries. Stretching is an important complementary aspect of any running program. We know that running creates stress on certain muscle groups. Soon after you stop running, muscles that have been stressed begin to tighten. The best way to avoid stiffness and eventual soreness from stressed, tightening muscles is to stretch after your run.

Cross-Train
Cross-Training is a great way to avoid running injuries. Be sure to include some cross-training/aerobic exercises that supplement your regular running program. Cross-training will develop parts of your body that running neglects, fights muscle imbalance injuries, burns additional calories, and increases aerobic capacity. Some examples of cross-training include cycling, swimming, cross-country skiing, stair machines and hiking.

Make Use of Recovery Techniques
Take time to take care of yourself. Common recovery techniques can help you avoid running injuries. Some ideas for recovery from stressful runs and the cumulative effects of hard training include getting a massage, pouring cold water on tired legs after a long run or race, soaking your legs in a warm water whirlpool (wait two hours after a race or long run), going for a walk or taking an easy bike ride.


Recommended Injury Prevention and Treatment Guide Books


Commom Running Injuries, Causes and Treatments

You've trained intelligently and followed all the injury prevention techniques but you've still suffered a running injury.

What should you do now?

Let's take a look at some of the most common running injuries, their causes, and how to treat those injuries.

Runner's Toe
Runner's Toe occurs when the nail is either pressed down too much on the bed underneath it or the nail tears from the bed itself. Either condition causes blood to pool between the nail and the bed. The nail eventually turns black.

Runner's Toe can be caused by poor fitting shoes (most common cause), excessive downhill running, and wet shoes. Typically, the longest toe is pressed against the front of the shoe causing damage to the nail and/or nailbed.

The primary treatment is to ensure that your shoes are long enough and fit correctly. If bleeding continues and pressure builds beneath the nail, you will require professional advice to release the fluid.

Plantar Fasciitis/Heel and Arch Pain
Plantar Fasciitis is an inflammation of the plantar fascia, a fibrous band of tissue that runs from the heel to the toes. Pain is felt along the inside bottom of your foot anywhere from the heel through the arch.

The plantar fascia typically becomes inflamed when it works through more of a range of motion than it's designed to do. Runners with tight Achilles tendons, who overpronate, have high arches, have rigid feet, and inflexible running shoes are most likely to suffer with Plantar Fasciitis.

The best treatment for Plantar Fasciitis is to ice the bottom of your foot from heel to ball and to make sure that your shoes have the proper combination of motion control and cushioning.

A great source of foot injury products is: FootSmart!

Stress Fractures
Stress fractures are very small, incomplete breaks or cracks in a bone. Runner's most often get stress fractures in their feet.

Stress fractures are caused by continuous stress on bones that become overworked. Common running errors such as building mileage too quickly, wearing shoes without enough cushioning, and running too much on hard, non-forgiving surfaces are common contributors to a stress fracture running injury.

The treatment for a stress fracture injury is to stop running. Continuing to run will make the injury worse and could result in a complete break. If you know you have a stress fracture, take two weeks off from running while severely limiting other weight-bearing activities. If you have pain after you restart running, stop and see your physician.

Achilles Tendinitis
Achilles tendinitis is a painful inflammation of the Achilles tendon. This large tendon is an extension of the two calf muscles and runs down the back of the lower leg and attaches to the heel bone. The Achilles tendon connects the strong leg muscles to the foot and gives us the ability to rise up on our toes, facilitating the act of walking and running.

Achilles tendinitis is caused by many of the same things that lead to plantar faciitis as well as overpronation, tight calf muscles, and shoes that fit too high against your heel.

Typical treatment include icing, taking anti-inflammatory medication, cutting back on running if your normal stride is altered, and wearing lifts in your street and running shoe heels until the pain subsides. In rare cases, severe Achilles tendinitis may require surgery and lengthy rehabilitation. Surgery involves removing the tendon's inflamed outer covering and reattaching the torn tissues.

A great source of insoles, heel lift and active wrap products is: FootSmart

Shin Splints
Shin splints are tiny tears of the front lower leg muscles away from the shin bone and are one of the most common running injuries for beginner runners.

Shin splints are caused by tired or inflexible calf muscles, weak shins, overstriding, overpronation and running on hard surfaces such as concrete sidewalks.

The best treatment for shin splints is to ice the inflammed area, take anti-inflammatory medication, cut back on run mileage, run on soft,forgiving surfaces whenever possible, and to wear a Pro-Tec® Athletic Shin Splint Compression Wrap that takes the pressure off your shins.

My top injury treatment recommendation for shin splints is the: Pro-Tec® Athletic Shin Splint Compression Wrap.

Iliotibial Band Syndrome
Iliotibial Band Syndrome is inflamation and pain on the outer thigh from the knee to the hip. The iliotibial band is a thick ligament that runs from the pelvis to the outside of the thigh connecting just below the knee. It stabilizes your thigh muscles and knee when you run.

Causes of Iliotibial band syndrome are bowleggedness, overpronation, worn-out running shoes, running on uneven surfaces, and excessive downhill running.

Treatment for iliotibial band syndrome includes backing off run mileage, taking anti-inflammatory drugs, and icing it often. Specific prevention tactics are to increase the band's flexibility through stretching and running on even surfaces.

For additional ITB cause, prevention, and treatment options check out Your IT Band Syndrome and Iliotibial Band Syndrome - A Runner's Guide

Hamstring Tears
A hamstring pull is actually a type of muscle strain. Muscle fibers are torn either partially or completely. Hamstring problems for distance runners are typically low-grade, chronic microtears that build up over time.

Hamstring problems are typically caused by poor flexibility and a neglected stretching routine.

Treatment strategies to help heal this common injury are icing, anti-inflammatory medication, no running during acute stages of injury, gentle stretching, and strengthening.

Runner's Knee
Runner's Knee or Chondromalacia is a softening, wearing away, or cracking of the cartilage under the kneecap. This softening and inflammation prevents the kneecap from riding smoothly over the knee. Pain typically occurs around or behind the kneecap and worsens when sitting with legs bent for a long period of time or climbing stairs.

Runner’s knee is caused by several factors, including a high quadriceps angle, wide hips (female runners), and pronation of the feet. Most often, week quadriceps muscles will be the problem, as they do not absorb a sufficient amount of the impact or running, passing down the impact onto the knees.

Common Runner's knee treatments include icing the area around the knee, using running shoes with better motion control, utilizing orthotics, and avoiding anything that requires the knee to stabilize itself (such as running on uneven surfaces, steep downhills and tight turns).

Chafing
Defined by Webster as "soreness or irritation of the skin caused by friction." Often a taboo subject among runners, chafing is one of those major irritants that only comes to mind once its "too late". Primary areas of concern are the inner thighs, groin area, and nipples.

Tips to prevent chafing include:

  1. Wear clothing that fits well. Too tight shorts, sports bras or shirts can constrict the skin and too loose fabric can create friction with constant rubbing. Seams can be bothersome also. Some people wear socks inside out so the seam is not touching their toes.

  2. Moisture wicking material helps. Cotton fiber soaks up sweat/water and keeps it causing a heavy/sticky shirt that rubbing t-shirt. Technical shirts wick away moisture and help the moisture evaporate.

  3. Specific preventative solutions are petroleum jelly and Body Glide. Apply liberally to sensitive spots prerun for best results.

  4. Use band-aids or Nip Guards for nipples especially on runs of 10K distance or longer.

  5. For training runs, have an extra set of clothes ready if needed. If chafing begins it will give you a chance to change clothes.

  6. On race day, remember the mantra "Don't wear anything new!"

Top Recommendations

Listed below are my Top Recommendations for Running Injury Prevention and Treatment:

  1. FootSmart
    Smarter, better products for lower body health for those times when you are injured. 120-Day Satisfaction Guaranteed!

  2. Running Injury Free and Running Doc's Guide to Healthy Running
    Great desk reference guides that covers running injuries, prevention and treatment in greater detail. Both books speak to the issues and concerns of both the recreational and competitive runner at a level anyone can understand.

Conclusion

As we've already discussed, running injuries are a common occurrence and, more than likely, you will suffer an injury at some point. However, by following the tips and techniques listed above, you'll be back up and running in a flash.


Additional Running Injury Articles/Resources:

Runner's Knee - Symptoms, Prevention, and Treatment
Orthotics - Do I Need Them?
How to Return from Running Injuries
Ilitibial Band Syndrome (ITBS) - A Runners Guide
Tips for Running in the Heat and Preventing Dehydration
How to Prevent Osteoporosis through Exercise



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