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Tips To Avoid Running Injuries

by Stephen M. Pribut, D.P.M.

We could probably list 100 ways to minimize your risk of injury, but we'll try to keep it to the top ten. The majority of running injuries occur from overtraining or improper training. With a careful and gradual increase in your running you should be able to avoid many overtraining injuries.

It is important to pay attention to your body and to avoid the "terrible too's": too much, too soon, too often, too fast, with too little rest. The key once again is: "avoid doing too much too soon." Your progress in mileage and speed should be a gradual one. An unrelenting increase in mileage from one week to the next will ultimately result in a break down. It is important to keep in mind the principle of hard days and easy days being interspersed and also hard and easy weeks. Mileage should usually only be increased approximately 10 per cent per week. And it is at least as important that every third week, you should cut your mileage for that one week. For most runners somewhere between one and three days a week, should be devoted to rest or non-running activities. This gives your body a chance to recover and strengthen itself. It is helpful to maintain a running diary. This should contain your mileage, course and brief note on how you felt. It may help trace the origin of problems related to overtraining.

Avoid doing too much too soon!

You should always ease into speed work. One way to ease into speed work would be by throwing in a few short distance surges into your normal runs. Gentle hill work, prior to speed work has also been recommended by some coaches. Fartlak runs may also be used. Track work outs should occur after you have accomplished some faster paced running during the course of your routine runs and should not be overly ambitious at first.

Replace your running shoes frequently. Shock absorbing capability will diminish gradually and may be inadequate after 350 to 550 miles. The upper of the shoe may not show much wear, but the shock absorption may still be gone. If you are running 20 miles per week, you should be replacing your shoes between 4 and 8 months depending upon your shock absorption needs. It is always cheaper to replace your shoes than to make a visit to the doctors office.

Make sure that you eat a healthy diet. Avoid fad diets and unbalanced approaches to weight loss. Be certain to take in an adequate amount of calcium and that your vitamin requirements are met. Many young, active professional runners add calcium supplements to their diet to make certain that their calcium needs are achieved. To assist in dieting, strength training is often helpful.

Regular stretching, after running, may also help reduce injuries. Runners frequently develop tightness in the posterior muscle groups. This includes the hamstrings and the calf muscles. The quadriceps and anterior shin muscles may become relatively weak, due to muscular imbalance. The abdominal muscles also tend to be weak on runners who do not exercise them.

Let's get to the list before we have a long essay to read.

Top Ten Ways To Avoid Running Injuries:

1) Pay attention to your body.

Don't ignore what your body is telling you. If something is hurting pay attention to it, find out why, and change what is making it hurt. Rest if necessary, but if the pain doesn't fade, don't forget a visit to the doctor's office if necessary.

2) Avoid the terrible "too's".

Don't do too much, too soon, too often, too fast, too hard, with too little rest.

3) Don't change things that are working.

Don't look for the latest and greatest running shoe or even training method. Don't switch from slow and steady to suddenly doing an all interval workout because someone says you will lose weight quicker and with only 20 minutes of "cardio". Shoes may be cautiously changed and training should be gradually and sensibly changed. Of course slow and steady is not the only way to train, and for most runners it will not be.

4) Increase training slowly.

The 10% rule for most people is the maximum increase per week, not the minimum. Every third week drop your mileage significantly before moving ahead again from the previous week. The recovery week will allow your body to repair while having a "relative" rest week.

5) Wear running shoes (sport specific shoes) and change them frequently

Don't run in tennis or cross trainer shoes. Some people like to alternate pairs of shoes to retain their shock absorbing capabilities. But whatever you do, make certain to replace your running shoes every 350 - 450 miles of running. If you run over 30 miles per week, and perhaps even less, make sure you use your shoes exclusively for running, so that you do not waste them with walking miles. The walking is admittedly easier on the shoe than running, but still creates wear and tear.

6) Eat healthy: Not too much, not too little, and a bit less junk

Don't forget to eat enough healthy foods. Make certain to have adequate calcium and healthy fats (such as the omega fats found in certain fish and fish oil capsules). Don't forget vegetables and protein sources. Check the origin of your food, particularly check farmed fish which may come from countries which have significant issues of safety with their food supply. (In actuality there are some problems, although different problems with farmed fish from all countries and certain safety issues with fish at sea.) Make sure you don't cut your caloric level too drastically while dieting. You need fuel to exercise.

7) Strength train two to three days per week.

Musculoskeletal fitness is one of the pillars of fitness. Strength training can be helpful for a variety of reasons. Core strengthening helps many people. And improving lean body weight by increasing muscle helps dieting indirectly and is good for your overall health. If you are a serious, competitive, long distance runner be extremely careful with lower extremity weights, and make sure to stop several weeks before a race. Carefully observe how your training sessions go, and make sure they are not slowing you down, or that fatigue from your strength training sessions are not limiting your long runs. It is probably best to do them before a rest day or an easy day. On days where you may be doing both running and strength training, run first, if you are primarily a runner.

8) Warm up gently before running, Stretch gently when finished

Stretching is not a warm up. It is a flexibility exercise. Evidence is mixed on whether it helps avoid injury, but studies of stretching before running do not show any benefit. Stretching works better after you are warmed up. Run easy for your first 10 minutes of running. Take short steps, move slowly, let your body gradually warm up and adapt to the stresses you are about to place on it. There are many changes that your body will be making to make your running go smoothly, efficiently and easily. Give it a chance to get prepared. If you are doing speed work, this 10 minutes will not be enough. You'll need a longer and more complex warm up.

9) Use a Carb/Protein mix after long runs and after hard runs or workouts.

This can be a chocolate milk shake or a protein powder mix. I find Metabolic Drive - low carb - mixed with a touch of chocolate milk to work well and taste just fine. But then again, in the 1990s, before studies showed the wonders of this mix, I used chocolate milk and brewers yeast (which many found to taste awful) as my post exercise drink.

10) Enjoy your runs and workouts.

This should ultimately be fun time, and something you look forward to. Find new paths if you need them, use old favorites if you prefer. Find something to enjoy on each run. Even the accomplishment of getting through a run on an extreme weather day (cold, rainy, not a code orange day) can feel great.

Stretching Notes:

The calf (achilles) and hamstrings should be gently stretched. The best stretch for the calf muscles is the "wall stretch". I recommend stretching one set of leg muscles at a time. One leg is back, knee straight, the other leg is forward with the knee bent. The leg that is back is being stretched. Ten repetitions holding for 10 seconds each is ideal. There are several different stretches to choose from for the hamstrings: Forward bends with the knees slightly bent, knee to chest or leaning forward with the leg out straight in front of you all work. It is important to not aggravate your back while performing hamstring stretches. The FAQ on Stretching is a good source of information about a variety of aspects of stretching.

George Sheehan recommended a revised set of his "magic six" in several of his columns and in his book "Running To Win", Rodale Press,1991. Follows is a slightly modified version of Dr. Sheehan's Magic Six:

Magic Six, Plus Two

Since almost no runner will perform 8 exercises, even if disguised as 6 + 2, I have selected 4 of the above exercises that really should be done and 1 more to do if you have "runner's knee". I call these the:

Hopeful 4, Plus One:

For those who still want to do the bent knee sit up, here is the description:


Lifetime Tips: Live Long and Exercise!

About Dr. Pribut: Dr. Pribut is a member of the Advisory Board of Runner's World magazine. He is a past president of the American Academy of Podiatric Sports Medicine (AAPSM). He served as chair of the AAPSM Athletic Shoe Committee for 5 years and has served on the Education Committee, the Research Committee, the Public Relations Committee and the Annual Meeting Committee. He is a co-Editor of the current AAPSM Student's Manual. Dr. Pribut is a past president of the District of Columbia Podiatric Medical Association, serving in that post for 4 years. Dr. Pribut served as a member of the American Podiatric Medical Association's Clinical Practice Advisory Committee and Internet Committee. Dr. Pribut is a Clinical Assistant Professor of Surgery at the George Washington University Medical Center.

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