What causes running injuries? There are four periods of time when runners are most vulnerable to injury:

• During the first four to six months of running
• Upon returning to running after an injury
• When the quantity of running is increased (distance)
• When the quality of running is increased (speed)

Most running injuries are caused by recurring factors that runners can often prevent or avoid themselves:

• Training errors are the most common source of injury, particularly lack of adequate stretching; rapid changes in mileage; an increase in hill training; interval training (going from slow speeds over long distance to faster over less ground); and insufficient rest between training sessions.
• When selecting a running shoe, the athlete should look for a style that will fit comfortably and that will accommodate his or her particular foot anatomy. When a shoe’s mileage exceeds 500 to 600 miles, it should be discarded for running.
• Hip disorders typically manifest themselves in groin pain.
• Back discomfort that radiates down the leg is cause for referral to a sports medicine specialist.
• The patella (knee cap) is a common site of overuse injuries that can benefit from a 20-minute ice massage, a program of stretching and strengthening of the hamstring and quadriceps, and a short course of an over-the-counter anti-inflammatory medication. Surgery is rarely indicated.
• Ankle laxity can lead to frequent ankle sprains and pain. Beneficial treatment includes muscle strengthening to increase stability, shoe modification to alter gait and changing the running surface.
• Foot problems in runners are related to foot types. Non-operative treatment such as orthotics and shoe modifications should be used if necessary.
• During warmer, humid weather, increase fluid intake; in cool weather, dress appropriately. It is often helpful to weigh yourself before and after running on a hot humid day. One pint of water should be consumed for every pound of weight lost. Avoid running during extremely hot and cold temperatures or when the air pollution levels are high. When running at high altitudes, the runner should gradually acclimate to the lower oxygen levels by slow, steady increases in speed and distance.

How are most running injuries treated?

• The basic approach to treating running injuries includes rest or modification of activity to allow healing and reduction of inflammation. Gradual return to running (10 percent increase in mileage per week) can be allowed after flexibility, strength and endurance have returned. When severe pain, swelling, loss of motion and/or other alterations in running form are present, immediate medical treatment is advised.
• The goal of rehabilitation is to return the runner safely to the desired level of running. Remember, training errors constitute the most common cause of injuries. A well-planned program prevents injury while benefiting the athlete.

How can I prevent running injuries?

Warm up: Warming up is often overlooked but should be part of your injury prevention routine. A good warm up will:

• Increase the temperature of muscles
• Increase blood flow and oxygen to muscles
• Increase the speed of nerve impulses
• Increase range of motion at joints, reducing the risk of tearing muscles and ligaments

A good warm-up will help you improve your running performance as well. A warm-up should consist of:

• Gently jogging to circulate blood oxygen that supplies the muscles with more energy.
• Stretching to increase range of motion at joints. Emphasis should be on stretching the hip flexor muscles, quadriceps, hamstrings, lower back, adductor muscles as well as those on the outside of the hips.
• The warm-up should last 10 to 15 minutes.

Cool down: Cool-downs are also often overlooked in favor of a refreshing shower. But they are necessary to avoid injuries and boost performance. The aim of the cool-down is to:

• Gradually lower the heart rate
• Circulate blood and oxygen to muscles, restoring them to the condition they were in before exercise
• Remove waste products such as lactic acid
• Reduce the risk of muscle soreness

The cool-down should consist of a gentle jog followed by light stretching.

Nutrition and hydration: Proper nutrition is important. A bad diet will prevent you from recovering from training sessions and make you prone to injury. A balanced diet is what you should aim for:

• Carbohydrates are an important energy source.
• Protein rebuilds muscles.
• If you become dehydrated, then less blood will flow through muscles. The muscles will be more prone to injury.
• Vitamins and minerals are required for a number of reasons related to recovery.

Training: Not allowing your body to recover properly from training will eventually result in injury. You should increase weekly mileage by no more than 15 percent over the previous week. Your body needs time to rebuild before the next training session. Remember, you are training when you recover! Sleep is also an important part of your training.

Running, pregnancy and nursing mother: In general, running and other exercise are not contraindicated for pregnant women. Pregnant women should exercise at a sub-maximal level and most importantly, discuss the issue with your obstetrician. The same would be true for the nursing mother.

For more information about improving your running performance, injury treatment and prevention strategies, call a Saint Vincent Sports Medicine specialist at 814-835-2035.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a health care professional.