Unlike other sports that may be prone to traumatic injuries (for example twisting your knee playing football), running injuries tend to be related to overuse. This basically means pushing your body too hard, too quickly, for too long. Soft-tissues that are pushed beyond their normal limit are prone to microscopic tears. It they are not given enough time to recover, these tears and strains develop into injury. Imbalances in your running style, or weaknesses in your legs or your feet can cause certain structures to fatigue and breakdown more quickly, and hence be more prone to injury.
Prevention is better than cure! The best course of action is to prevent the injury from occurring in the first place- most overuse injuries are caused by faults in footwear, training, muscle strength, flexibility or biomechanics. Some can be addressed with a few simple changes, others are more complicated and may require more thorough assessment and treatment. Some of the basics in injury prevention are:
FOOTWEAR AND BIOMECHANICS
The importance of footwear cannot be over-stated- many injuries can be caused purely from problems with footwear. When you are running, your feet should have the support that they need, to encourage better alignment of the legs and trunk. Choosing appropriate footwear partly depends on what kind of foot that you have.
In normal stride, the foot strikes the ground on the outside of the heel and moves in as your weight travels forwards, with you eventually pushing off the ball of your foot at the end of your stride. A foot that does this is a neutral foot, which would generally be considered to be ideal. Very few people are like this! Generally people with neutral feet suit a neutral running shoe.
With a high-arched or supinated foot, the weight will stay more on the outer part of the foot as you run or walk. This foot type is quite rigid and lacks flexibility. Uncorrected, this can lead to shin pain or stress fractures. People with this kind of foot should opt for footwear with some cushioning which encourages more foot flexibility.
A flat or overpronated foot is the most common. The foot rolls inwards excessively, flattening the inner arch of your foot as you run. If this is not controlled, it can lead to a multitude of problems, including foot, shin, knee, hip or back pain. Choosing a stability running shoe can help to give you the arch support that you need.
Go to a shop that specialises in footwear for runners, and the staff there should be able to advise you on which running shoe is right for you, and if it is an appropriate fit.
Another common problem is that people don’t replace their shoes or runners regularly enough. For runners, the general advice seems to be to change your footwear every 300-500 miles run, or every 6 months, whichever comes first. I would say that how quickly people go through their shoes is highly variable- weight, activity level, running style, terrain and weather conditions can all contribute to footwear losing adequate control. Look at the heels of your runners or shoes- if they are slightly worn down, it is probably time to go shopping.
If you are having symptoms related to your foot biomechanics that cannot be controlled by appropriate choice of footwear, orthotics may be an option. These are custom-made inserts that you can put into all of your footwear, correcting the alignment of your foot to give you the control that you need while running.
TRAINING
Our body responds best to gradual changes in training- this gives the leg and trunk muscles adequate time to recover from one training session before the next, and allows them to get stronger in keeping with your growing fitness.
Sudden step-ups in training, such as building mileage, speed or hill-work too quickly, overly surprises the body, and can lead to certain muscles being overworked. This causes build up of micro-tears within the muscles, which don’t get time to recover, and leads to muscle breakdown and injury.
People following training programmes for a marathon often get caught in the trap of trying to catch up on mileage that they couldn’t do- try not to give in to temptation here, you will lose alot more mileage if you get injured.
MUSCLE STRENGTH AND FLEXIBILITY
Better strength in the muscles of your trunk will help to improve your posture and maintain good alignment of your pelvis and legs while running. Therefore doing regular exercises to improve your core stability will reduce your risk of injury.
Imagine if you were standing on a broken chair (an unstable base). Think how much your body would have to move to adapt to that. Now imagine that unstable chair is your trunk- think about how your body would move to adapt to that “wobbly” base. So the term “core stability” really refers to having a well aligned trunk with good muscle support to hold a good steady posture, allowing the arms and legs to move more efficiently and hit the ground in an ideal pattern.
Core stability or strength is not only useful in injury prevention, but in performance enhancement. If you think of your body working like a machine- the less energy it uses up by trying to adapt to a “wobbly” base, the more efficient it will move, and the faster and stronger you will be!
WARM-UP AND COOL-DOWN
Before you run, your tissues need to be warmed-up, for example doing a light jog/brisk walk, anything that gets the blood flowing. A common misconception is that people need to spend a lot of time stretching before they run- in fact static stretching is more important as part of your cool-down and recovery. Adequate time needs to be allowed for both the warm-up and cool-down- this can vary from 5-15 minutes, but make sure you feel the benefit before you stop.
This article is taken and modified from Catherine Cradock’s articles in the Irish Times marathon series in 2007 & 2008.
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