How can I prevent running injuries?

Many of the common injuries seen in runners can be prevented with a proper corrective exercise and flexibility program. The most common running injuries are patellofemoral pain, IT Band friction syndrome and medial tibial stress syndrome (shin splints). Many of these injuries are caused by 2 things: Repetitive motion and poor mechanics. Correcting faulty biomechanics to achieve optimal functional motion will be beneficial in preventing running injuries.

A good way to correct faulty mechanical patterns is to perform self myofascial release and static stretching before and after every exercise program you perform. The self myofascial release will “shut-off” overactive muscle tissue and stretching will allow muscle to elongate to optimal length. If you perform these to activities before and after activity it will reduce your risk of running injuries.

Dr. Vonda Wright, MD
Orthopedic Surgeon

The most common running injuries are bursitis over your hip bone (ITB syndrome), anterior knee pain, Achilles tendonitis, shin splints and plantar fasciitis (sharp heel pain when you first get out of bed in the morning). What you need to remember is that we are a kinetic chain from our toes to our backs; in other words, everything is connected and works together. This means that even something simple like having a stiff big toe that will not flex when you roll through a stride can force your weight to the outside of your foot, which changes the forces across your knee while bending it by pulling your kneecap to the outside. This increased patellar force can put too much pressure on the kneecap cartilage or on the patellar tendon below the kneecap and cause them to become irritated. The pain is worse when your quadriceps are not strong enough to keep the kneecap on straight. Tight hamstrings can cause you to have a shorter stride or walk with bent knees. This will force your hips to bend more and may cause low back pain.

So what does a runner have to do to stay injury-free? Start with your big toe. Flex it up and down and move it all around in a circle. To land correctly, you need 70 degrees of flexibility in the big toe. Next, make sure your calves, hamstrings and quads are well stretched. Our muscles are most efficient and most supple at their optimum length. Next, even runners need to work on keeping their legs, hips and cores strong.

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Most running injuries are caused by overuse and ignoring your body. After an injury, many runners look back on their training and recall yellow flags of pain or stiffness that lead to an injury. Spend an extra 5 to 10 minutes stretching or completing a few exercises today—they may prevent a visit to your doctor or physical therapist tomorrow.

The key to beginning a running program involves a lot of walking. If you are new to any type of physical activity, it’s a good idea to start slowly. In fact, a beginning running program is really a walk/jog program. The idea is to train your body to run a little at a time so by the end of the program, you are running 30 to 35 minutes, or approximately a 5K without stopping.

It’s also important to wear the proper shoes fit for your body. If you are serious about running, or plan to run routinely, your best bet is to be fitted for a proper running shoe by a professional at a running shoe specialty store. There, they will be able to tell if your foot is neutral, over-pronated (leans in) or supinates (leans out) as you run. Also, the type of arch you have on your foot, as well as your weight will make a difference in what type of cushioning you require.

Finally, your shoe specialist may recommend you get a shoe that’s ½ size larger than what you normally wear to account for your toes, which may push forward as you hit the ground running.

Dr. Darin Padua
Sports Medicine Specialist

There are several different types of injuries that commonly occur in runners:

  1. Patellofemoral pain (pain underneath the knee cap, typically on the outside portion)
  2. IT band friction syndrome (tightness of the IT band causes it to constantly rub over the femur as the knee flexes and extends during running and then causes irritation)
  3. Plantar fasciitis and/or Achilles tendonitis (excessive stretching or tightness of the tissue that connects into your heel/calcaneus)

Each of these injuries may be caused by different factors, but in general these injuries are associated with tightness and weakness of specific muscles combined with faulty movement patterns.
The best way to prevent these injuries is to regularly perform a corrective exercise strategy before and after you run. This will allow you to maintain proper flexibility and strength while achieving optimal movement quality.
Perform self-myofascial release followed by static stretching for the following muscle groups (30 second hold for each stretch):

  1. Calves
  2. Hamstrings
  3. Hip flexors
  4. Hip adductors (groin region)

Perform strengthening exercises for each muscle group (1-2 sets of 15 repetitions at a slow and controlled pace) with light resistance:

  1. Side lying leg lifts (be sure to keep leg in line with body and toes point straight ahead)
  2. Hip bridges
  3. Heel raises with foot rotated inward (toes pointing in)

Once completing these exercises then complete your corrective exercise program by performing one to two integrated exercises that utilize functional movement patterns. The most important aspect of these exercises is to focus on body control and to perform the exercises in a slow and controlled manner.

  1. Single leg squat (keep knee over toes and control your trunk motion)
  2. Single leg balance with reaching (keep knee over toes and control your trunk motion)

Regularly performing a corrective exercise program as part of your overall running program will help you maintain the required amount of muscle flexibility, strength and neuromuscular control. This will reduce the stress on your body and assist with preventing those injuries commonly associated with running. 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.