Most Common Runners' Injuries and Preventative Exercises
According to runningusa.org, 18.1 million people participated in road races across the US in 2018… just a few people… With this many people running, medical professionals and exercise professionals are commonly seeing people with running related injuries. Participation in any sport or activity always involves a risk of injury, running is no different. Injury rates tend to be higher among “novice” runners than recreational runners and significantly higher than elite runners. This may be due to a number of reasons including running mechanics, BMI, general strength and endurance. After glancing through some of the research out there, and through my own clinical experience, there are some common injuries that tend to trip runner’s up (no pun intended): patellofemoral pain syndrome/dysfunction (runner’s knee), IT band syndrome/hip bursitis/gluteus medius/minimus tendinopathy, piriformis syndrome, achilles tendinopathies, plantar fasciitis, and stress fractures.
First and foremost, proper running mechanics are crucial to preventing injury. Especially when athletes are tired and all technique goes out the window. No amount of rehab/PT/preventive/corrective exercises will help if the running technique continues to be sloppy. The average runner will take roughly 160-170 steps per minute. If they are running an impressive 7 minute pace over the course of a 10k, they would take at roughly 7000 steps. If you think the micro stress induced from a running stride is insignificant, I challenge you to apply that same principle to your car. Find a small pebble and throw it at the driver’s side door 7000 times… If you wouldn’t do that to your car why would you do that to yourself? If you are unsure about your running technique find a friend, coach, or another professional who can help you, it will be well worth your time.
The next important thing to injury prevention isn’t “preventative/corrective exercises”. Runner’s need to be mindful of RECOVERY. This starts the moment the run or workout ends. What are you doing to “cool down” your body and calm the central nervous system? You need to get out of sympathetic fight or flight mode and get back to parasympathetic resting and digesting. Yin yoga poses and mindfulness/meditation exercises coupled with breathing exercises or diaphragmatic breathing post workout can be a great way to do this.
Do you have healthy sleep habits? The number of hours of sleep needed varies based on age and intensity of training. The mayo clinic says most adults need 7-9 hours per night and if you are training you will be at the higher end of that spectrum. If you do not get enough sleep, your body does not have adequate time to heal itself. Before you lie down, get away from the cell phones, tablets, and TVs while in your bed. Remove any other stressors and actually give your mind time to decompress and rest.
Also, consider taking “active” recovery days. This means participating in another physical activity that you enjoy like yoga, hiking, biking, kayaking, etc. The best way to handle muscle soreness is with light concentric contractions. This is also a good way to maintain mobility and fitness levels without serious risk of overtraining.
Recovery also includes nutrition and hydration. I am always intrigued by people who do a hard workout/run and follow it up with garbage food and a beer. Poor nutrition and/or alcohol will basically be the minus to your plus. Best case scenario is to remain stagnant and break even. Don’t get me wrong, I enjoy some sliders and beer every now and then, but try to subscribe to the 90/10 principle of 90% clean diet, 10% social diet.
According to the Mayo clinic, males should consume roughly 3.7 liters of water a day and women roughly 2.7 liters. But, this is not giving consideration to replacing the water you lose while exercising.. That’s a lot of water! They go on to say not everyone necessarily needs that much…? Obviously body weight/size will have a large influence. Basically, find a water intake balance that does not wake you up every hour of the night to pee (as interrupted sleep is counterproductive), prevents the onset of thirst, and keeps your urine clear to faint yellow. Headaches can also be a symptom of dehydration that appears prior to thirst, so if you commonly have headaches, put down the soda and drink more H2O. Try carrying a water bottle that is 1 liter. This makes it really easy to mentally track how much water you have drank in a day. Also, some sources suggest roughly 1L of your water intake should come from the daily 6-8 servings of fruits and veggies… you are eating 6-8 servings of fruits and veggies every day right? Jokes aside, you should make a goal for yourself for daily fruit and veggie intake. Obviously, there is not enough time nor do I have the qualifications to go really into depth regarding hydration and nutrition, so please seek out other resources from better educated professionals regarding this topic.
So after addressing running technique, sleep, nutrition, hydration, we can finally discuss preventative exercises. Now a number of the injuries I mentioned at the beginning of this rant have similar root causes (patellofemoral pain syndrome/dysfunction (runner’s knee), IT band syndrome/hip bursitis/gluteus medius/minimus tendinopathy, piriformis syndrome). Lumbopelvic instability, hip instability, poor femoral control, can all manifest as these different injuries. Understand, the injury itself is not the problem, it is a symptom of a movement problem or stressor. People find different ways to compensate for their deficiencies and this gives rise to different injury manifestations from similar movement dysfunctions.
Given that running is largely a sagittal plane activity (all movement is 3 dimensional), muscle groups that act primarily in the frontal and transverse planes can become undertrained and over stressed. Undertrained by lack of specific use, and over stressed as repetitive stabilizers and rotators over thousands of strides. Please check out the video below which will take you through a brief warm up consisting of dynamic flexibility followed by movement integration and running technique exercises. From here we demonstrate exercises that attempt to promote lumbopelvic, hip, and femoral stability and control. We also demonstrate a couple lower leg exercises and a quick inhibition exercise for the plantar flexors (calfs) with respiration which would be great to do post workout.
With regards to achilles tendinopathies, plantar fasciitis, and stress fractures, these injuries can largely be attributed to improper running mechanics, poor training design, inappropriate spike in intensity/mileage, recovery issues, nutritional deficits, proper footwear/support, and running surface. A really easy way to help prevent the onset of these injuries is by making sure all the aforementioned areas are on the up and up. Additionally, it behooves runners to maintain good ankle mobility. Simply, runners need to maintain good flexibility of their “calves” and toes. Running long distances places enormous load onto the plantar flexors of the ankle and toe flexors, which can lock up the ankle and significantly alter gait, muscle recruitment, and other movement patterns.
Please don’t misunderstand me, no cookbook, cookie cutter recipe of exercises exists that will prevent or correct any of the aforementioned injuries. However, performance of these exercises helps to address some of the imbalances and movement dysfunctions commonly seen in runners. If you are having pain please seek consultation of a medical professional to help you get a handle on the origin of your problem and how to address it.
Check out the link below for another blog titled “Regions & Muscle Groups Runners Should Address” containing more videos specifically for runners.
https://kinesisptandperformance.com/journal/2019/9/10/runners-injury-prevention-exercises