Running-related injuries may be common, but the right training strategies can make a big difference, reducing the risk of injury or preventing it entirely.
Lower extremity injury estimates for runners range from 19.4–79.3%. The most common running injury is anterior knee pain most often relating to the overloading of the knee cap, and a lot of iliotibial band syndrome around the knee, Achilles tendonitis and plantar fasciitis.
At the hip, injuries including proximal hamstring and gluteal tendinopathy, and medial tibial stress syndrome or ‘shin splints’ are common.
Understanding the key causes of running injuries and strategies to prevent them can help avoid initial injuries, as well as reducing the risk of chronic and recurrent ones.
INJURY RISK FACTORS
Age, previous sports activity, running on a concrete surface, participating in a marathon and weekly running distance (48–63kms) are all associated with a greater risk of injury in women.
There is one major risk factor underpinning most running injuries: poor load management, Every time you run, you’re damaging the body on a microscopic scale, and many people do more damage than the rate at which their tissues can recover, so instead of the tissues repairing, they gradually degenerate, leading to tendon problems, stress fractures and other issues.
MANAGING LOAD
Proper load management is a useful preventative strategy that fitness professionals can easily put in place that makes a big difference to injury risk. A simple rule is to not increase total weekly training load by more than 10%.
Biggest elements of load are volume or how many kilometres a person has run, vertical – for instance if they are running up steep inclines – and speed.
WELL-BALANCED TRAINING
1. Strength training
Running will build strength, but it should be complemented by a strength training program.
Incorporating resistance training into a fitness program will ensure you have the strength to generate force and absorb loads, in turn improving running performance and reducing injury risk.
2. Mix up the intensity
Cross-training is a useful principle to avoid repeatedly loading the same tissues and muscles. You also want to be running frequently enough to produce the desired conditioning, which is protective against injury. With most runners, around
20–25% of their training volume should be high-intensity, and the remaining 75–80% should be easier, recovery-type running. running ability should aim for two intense running sessions a week, balanced out with some recovery-based training sessions.
RUNNING RETRAINING
1. Preventing overstriding
Taking shorter, faster steps will usually lead to a reduction in how far you land in front of the centre of mass, and therefore the impact forces and load going through the tissue.
2. Relaxed arms and upright posture
Ideally we want an arm action that looks relaxed, with arms that aren’t crossing the midline of the body. Posture should be upright, because trunk lean can lead to a shorter stride length and prevent proper hip extension and glute activation.
3. A natural footstrike
A Harvard study of endurance runners found that those who habitually rearfoot strike have around twice the rate of repetitive stress injuries. However, forefoot strike isn’t the solution; if you are doing this and overstriding, it can lead to injuries like stress fractures.
We should land in a way that feels natural to our body, and most people find that as their running speed increases, they’ll move to a mid forefoot strike.
