Running Injuries: How to Avoid

Running is a great way to get in shape. But it can also lead to many different types of injuries. Knowing about common injuries and how to prevent them can keep you on track toward achieving your fitness goals.

“One way to help prevent injuries is to consult a physician or fitness expert before you begin your program,” says Richard Bonfiglio, MD. “During this visit, you’ll be able to identify your exercise goals and formulate an exercise plan. You can also uncover your injury potential and learn how to minimise your injury risk.”

Bonfiglio recommends the following strategies to prevent injuries.

Identify Your Running Goals

You may choose to begin running to improve your physique, lose weight, increase cardiovascular fitness, or socialise with friends. Whatever the reason, it’s a good idea to identify this goal when creating your exercise program.

“Your regimen will vary based upon your goal,” Bonfiglio says. Runners aiming to improve cardiovascular fitness often use quicker paces to raise heart rate, while those focused on weight or body-fat reduction commonly spend longer periods at a slower pace.

Depending on your goal, your physician or personal trainer may determine that a modest walking or jogging program is appropriate, he explains. “Setting goals helps you follow a safe pace and keeps you from overexertion, that usually results in injury.”

Build Up Gradually

Many running injuries come from doing too much, too soon. Increase distance, frequency, or intensity in small steps, keep easy days truly easy, and take at least one recovery day each week when starting out or returning after time off.

Have a Physical Evaluation

Certain health problems may hamper your running performance and increase your risk of injury. Specifically, osteoporosis, arthritis and other degenerative joint diseases can increase injury risk and are often addressed before beginning a running program.

Stretch Before and After You Run

Doing so can prevent some of the most common injuries. “It’s most important to stretch muscles that go across two joints,” Bonfiglio says. “These include the calf muscle, which runs across the knee and ankle and the hamstring which goes across the knee and hip.”

Begin each run at the pace of a brisk walk or gentle jog; cool down at the same pace at the end of your run.

Wear the Right Shoes

Buying shoes at an athletic store, where a trained salesperson can help you choose a shoe that fits your foot type and running environment, can help prevent injuries.

Common Injuries

The following injuries are common among runners. Bonfiglio describes ways they are typically managed. If symptoms persist, see a physician.

Achilles’ tendonitis

This injury is characterised by dull or sharp pain along the back of the tendon, calf tightness and early morning stiffness.

“Stretching can help prevent this injury,” Bonfiglio says. Many runners pause training while the discomfort settles and then resume gradually.

Heal pain

Pain in the bottom of the heal indicates an injury. Physicians use the terms plantar fasciitis and post-static dyskinesia interchangeably to refer to an inflammation of the plantar fascia; a thick, fibrous band of tissue at the bottom of the foot.

Heal pain can largely be attributed to the stress on the feet caused by daily activities and exercise that magnifies misalignment in the feet, particularly if improperly-fitted shoes are worn.

Excessive exercise and occupations that require people to spend a lot of time on their feet may stretch these structures beyond their limits. This stretching can lead to muscle tears and bone spurs.

Prescription orthotics — in-shoe fittings to support, align, prevent or correct injury, and improve function of your feet — are commonly used, sometimes alongside therapy, says Brian K. Tracy, BSK, a podiatric sports medicine physiotherapist.

Stretching, heel raises, anti-inflammatory medication and ice compresses are often used approaches. Many runners take time off training during recovery.

Shin splints

Shin splints feels like an aching pain along your shinbone. It typically occurs during and after exercise and is the result of overstraining muscles where they attach to your shin.

The most common cause is overuse or overtraining along with poor foot and leg biomechanics. Runners often pause activity when this occurs, and orthotics are sometimes considered to adjust running motion. Changes to training patterns are commonly made to avoid worsening symptoms.

Stretch with Movement

“Stretching decreases the risk of injury when exercising.”

This bedrock of sports medicine usually fails to mention an important fact: The wrong sort of stretching can actually increase the risk for injury when you exercise, and — unfortunately — many experts have been preaching the wrong way to stretch before a workout for years.

Slow, static stretching, where you hold a stretched position for some time, is at issue. Although many fitness experts recommend limbering up with such stretches before a workout, no systematic studies ever verified that they helped.

When sports physicians began testing the idea, they found that in some instances people who used static stretches before exercise had more pain or injuries afterward.

Static stretches relax muscles, which is great after exercising. Before a workout, however, a brief warm-up and active stretching warms up muscles and joints and increases blood flow. Active stretching simply means moving your body through its full range of motion, but without holding any position.

If You Get Injured: Hot vs Cold Packs

So when should I use ice vs. heat? This is a question many ask when suddenly experiencing sudden onset of pain, for example after playing sports or when doing chores around the house or after going for a run.

Timing is everything. Early use of ice is commonly discussed because the aim is to limit inflammation. Application within the first 24-48 hours is often mentioned in general guidance.

For acute injury and within the first several days, many sources refer to the rules of RICE:

R = rest

I = ice

C = compression

E = elevation

For a practical injury-prevention and return-to-running progression example (including a simple weekly build guideline), see Brigham and Women’s Hospital: Running Injury Prevention Tips & Return to Running Program (PDF).

Coolness First

One of the more effective and inexpensive ways to apply cold is to place cubed or crushed ice into a plastic bag. Wrapping the bag in cloth or a towel helps avoid direct skin contact.

By the way, crushed ice conforms to irregular contours of the body and may work best.

Applying ice “off and on” for 15-20 minute intervals is commonly mentioned during the initial 24 hours following injury. Shorter intervals are often discussed for hands or feet, particularly where circulation issues exist.

Heat for Healing

Applying heat can also be effective, but not following acute injury. This type of application promotes circulation and delivers healing nutrients to areas injured. Sounds like a great idea, but applying heat right away is often avoided because swelling can increase.

Warm moist compresses are often considered after a few days. Hot and cold application-type products are widely available.