Injury Prevention for Runners

I have been involved with the SunRun clinics in Burnaby and Vancouver for the past 8 years as a guest speaker on injury prevention.   The clinics are always a great group of runners, walkers and leaders, all out to support each other on reaching their fitness goals.   I have shared some of the highlights from my presentation in this blog.  Many thanks to SportMed BC for their assistance in the preparation of this material.

The most common injuries to runners are:

• Patellofemoral Syndrome – pain or tenderness underneath or along the sides of the kneecap.
• Plantar fascitis – pain under the sole of the foot or the heel due to overstretching of the plantar fascia.
• Shin splints – aching along the inside of the shin due to overstressing of the lower leg muscles.
• Iliotibial band (ITB) syndrome – pain along the outside of the knee.
• Achilles tendonitis – pain along the back of the Achilles tendon due to stress in the area and build-up of scar tissue.

There are individual hints for each of these conditions, but prevention is the key to avoiding most injuries.

Warm-up

A good warm-up reduces the tension in your muscles, allowing much easier movement and preventing strains.  It also prepares the muscles for the upcoming activity.  A warm-up should include:

• 5-10 minutes of light exercise (low intensity walking, slow jogging or cycling).
• Approximately 5 minutes of light stretching. Be gentle with the stretches during the warm-up as your muscles are not yet as warm as they will be later in the workout.

Cool-Down

The main focus of a cool-down period is to ensure that blood does not pool when you stop activities too quickly.  Make sure that you gradually decrease the intensity of your workout.

For runners, follow this progression: running, slow jogging, fast walking, slower walking , stretching.  A similar progression is possible with most sports.

This is also a good time to work on your flexibility, as the muscles are warm. Spend approximately 15 minutes stretching at the end of your workout.

Stretching Tips

• Move slowly into stretches, paying attention to avoid bouncing.
• Hold each stretch for at least 15 seconds (30 seconds or up to 2 minutes is even better). Repeat the stretch at least 3 times.
• Be sure to breathe slowly and exhale when holding a position.
• At no time should pain accompany any of the stretches. If it does cause pain, discontinue and ask for assistance. There are always adaptations and different positions to try to stretch each muscle group.  Please ask me for specific stretches suited to your activity and needs.

Footwear and Running Surface

• The ideal running surface is soft and level, such as a gravel road and a bark mulch trail. Uneven roads, uphill and downhill routes all have their own concerns. Use caution when you run on them.  If you run on a sloping road, change directions on alternating days.
• Proper footwear is an important component. Think of your shoes as part of your exercise equipment. Monitor the wear pattern on your shoes to see if you are placing more weight on the inside or outside of your feet.  If you notice any strange wear patterns or find that your feet are consistently sore during your workout, speak to a trained staff member at a running store.
• If you over-pronate (roll onto the inside of your foot), look for a motion control shoe.
• If you require further support, consider being evaluated for orthotic use.

Cross Training

• Ensure that you have an adequate stretching and strengthening program. This should be in addition to the stretching done with your runs.
• While running increases the strength of the calf, hamstrings, and back muscles, it does not focus on the development of the shins, quadriceps and abdominal muscles. Additional conditioning that stretches the first set of muscles and strengthens the second set will help accommodate for the strength and flexibility imbalances developed with running.  Gym workouts are a good option.

Taking Care of Yourself

• Be nice to your body. While it is great to have ambitious goals, physical activity has to be increased gradually.  Speak to the SunRun leaders if you are having difficulty with the progression of the program.
• Pay attention to any pain that you experience. While some muscle soreness can be expected, do not ignore any potential injuries.
• If specific areas are consistently bothering you after a run, have it looked over by health care professional such as a Chiropractor, Physiotherapist or Registered Massage Therapist. Book an appointment sooner rather than later. It is much easier (and less time consuming) to treat an injury in the early stages than it is to deal with a condition that becomes chronic.
• Do not try to run through an injury or illness. Take a few days off if you are suffering intense pain or if you have a fever associated with a viral infection.
• Get extra sleep and rest. You will need it as you increase your physical activity level.
• If dealing with a chronic or recurring injury, you need to focus on reducing inflammation. Modify your activity as needed, decrease the intensity of your workouts, and correct training errors to ensure that you are not irritating the area further. Ice the area for 20 minutes at a time several times a day, particularly after an aggravating activity (such as running).

Dealing with an Injury

Despite our best efforts, some injuries do occur. When dealing with an acute injury, remember RICE: Rest, Ice, Compression, and Elevation.

• Rest – stay off the injured area and seek diagnosis and treatment from a health care practitioner.
• Ice – for 20 minutes at a time, with an hour between applications. Ensure that a towel or cloth rests between the ice and your skin.
• Compression & elevation. If you have injured an extremity, wrap an elastic tensor bandage around the area and rest it above the level of the heart. This will help to reduce swelling. Remove the bandage before going to bed.
• Do NOT apply heat to a new injury for the first 72 hours. This includes hot baths, whirlpools and heating pads.  Heat can result in increased inflammation.

Returning to Activity After an Injury

• The first step in assessing your recovery is performing pain-free range of motion. If you are experiencing pain when simply moving your low back, ankle or shoulder, you will not be able to tolerate the demands of your sport.
• Compare your strength, speed and coordination to your other side. Most sports have return-to-injury guidelines established. Speak with your personal trainer, coach and/or therapist regarding your specific activities.
• Return to exercise SLOWLY. Overcome the frustration of starting back slowly – your body will thank you for it.   You will need to modify your workouts to avoid any aggravating movements.
• Continue with any rehabilitation exercises you have been given. Many people believe that they do not need to keep up with these exercises once they are back in the game.   Those exercises are often the key to stabilizing injury-prone areas, increasing core strength, stretching, and avoiding strained muscles.