Some experts believe that every runner has an injury threshold and that once you exceed that threshold, you get injured. Your threshold could be 10 miles a week or 100, but once you exceed it, you get injured. Various studies have identified injury thresholds at 11, 25 and 40 miles per week. Every individual has a different threshold — yours is waiting for you to discover it.
The problem occurs when runners do too much, too soon and too fast. The body needs time to adapt to training changes and jumps in mileage or intensity. Muscles and joints need recovery time so they can recover and handle more training demands. If you rush the process, you could break down rather than build up. Running experts have recognized this problem, and they long ago devised an easy-to-use 5-10 percent rule: Build your weekly training mileage by no more than 5 to 10 percent per week. To build your mileage by 5 percent, if you run 10 miles the first week, do just 10.5 miles the second week, 11 miles the third week, and so on. If you are recovering from an injury or are brand-new to running, it is best to stay close to the 5 percent limit. Otherwise, you'll run the risk of injury or reinjury. More experienced runners who have no history of injuries can safely train closer to the 10 percent limit.
Keeping a detailed training log can help you gauge your personal training threshold. Record your weekly mileage and how you feel after your runs. Look for patterns. For instance, you may notice that your knees ache only when you're logging more than 40 miles a week.
This is perhaps the oldest and most widely repeated advice for avoiding injuries, and it's still the best: If you don't run through pain, you can nip injuries in the bud. Most running injuries don't erupt from nowhere and blindside you. They produce signals — aches, soreness and persistent pain — but it's up to you to not dismiss them and take appropriate (in)action.
At the first sign of an atypical pain (discomfort that worsens during a run or causes you to alter your gait), take three days off. Substitute light walking, water training or bicycling if you want. On the fourth day, run half your normal easy-day distance at a much slower pace than usual. Success? Excellent. Reward yourself with another day off and then run a little farther the next day. If you're pain-free, continue easing back into your normal routine. If not, take another three days off and then repeat the process to see if it works the second time around. If not, you've got two obvious options: Take more time off and/or schedule an appointment with a sports-medicine specialist.
Strength training helps keep your body properly aligned while you are running. According to many experts, it is particularly important to strengthen the core and the hip muscles. When you strengthen the hips — the abductors, adductors and gluteus maximus — you increase your leg stability all the way down to the ankle while also helping to prevent knee injuries.
You don't want to train for bulging muscles. You need just enough core, hip and lower-leg strength training to keep your pelvis and lower-extremity joints properly positioned. If you don't have muscle balance, then you lose symmetry — and that's when you start having problems.
Stretching should be an important component of any runner's regime. Runners tend to be tight in predictable areas. They get injured in and around those areas, and therefore, they should increase flexibility in those areas. The muscle groups at the back of the legs — the hamstrings and calf muscles — stand atop most lists of the best muscles for runners to stretch. Flexibility in the hamstrings and hip flexors seems to improve knee function (several reports link poor flexibility in those areas with "larger knee-joint loads"), and calf flexibility may keep the Achilles tendon and plantar fascia healthy.
There is little evidence to indicate that stretching prevents overuse injuries. That said, knee and Achilles-tendon problems are among runners' most frequent complaints, so experts recommend increasing the range of motion of muscles that can strain these areas if there is underlying tightness. Just don't do static stretches (holding an elongated muscle in a fixed position for 30 seconds or longer) before running. Stretching is best done after a warm-up period of 10-15 minutes, after your muscles are warm or at the end of your workout.
Here's an important note about stretching after long runs (longer than 15 miles): Do not stretch immediately following your run. Your muscles have hundreds of microtears in them, and stretching them could turn some of these into macrotears, causing significant damage. Instead, cool down, take a shower, eat a good meal and drink plenty of fluids. Then it will be OK to stretch later in the day.
RICE stands for "Rest, Ice, Compression and Elevation." When you've got muscle aches or joint pains, these four things are best for immediate treatment. These measures can relieve pain, reduce swelling and protect damaged tissues, all of which speed healing. The only problem with RICE is that too many runners focus on the "I" while ignoring "R," "C" and "E." Ice reduces inflammation, but repeatedly icing and running without giving the tissues enough time to heal is a little like dieting every day until 6:00 p.m. and then pigging out. So it is best to stop running until the injury is better.
RICE is most effective when done immediately following an injury. If you twist your ankle or strain your hamstring, plan to take a few days off from running. Apply ice several times a day, for 10 to 15 minutes at a time. If you can, elevate the area to limit swelling. Compression can also further reduce inflammation and can provide pain relief, especially when you first return to running. An ACE bandage is the simplest way to wrap a swollen area.
Another factor that could have a significant impact on running injuries but that has been rarely studied is road camber. No doubt, you always run on the left side of the road, facing traffic. That's good for safety reasons, but it also gives you a functional leg-length discrepancy since your left foot hits the road lower on the slope than your right foot does. You're also placing your left foot on a slant that tends to limit healthy pronation and placing your right foot in a position that encourages overpronation. And you're doing this — running in an unbalanced way — mile after mile, day after day and week after week. That could lead to hip injuries.
If you can, try to do some of your training runs on a level surface like a bike path or dirt trail. A local track also provides a firm, essentially flat surface that's great for slow-paced running. Also consider the treadmill — it's the perfect surface for balanced running. At the very least, a treadmill provides a great surface for beginning runners, runners who are recovering from an injury and perhaps even marathoners aiming to increase mileage without increasing their injury risk.
Researchers have found a correlation between injuries and frequent race efforts. This connection might extend to speed work since intervals also require a near-maximal effort. So if you train fast once or twice a week and then race on the weekend, that's a lot of hard effort without sufficient rest, particularly if you follow this pattern week after week. Some experts are cautious about recommending regular speed training for certain runners, especially those who get hurt easily. It's fine for those chasing podium placements or age-group awards, but not for mid- and back-of-the-packers. You might get 5 percent faster, but your injury risk could climb by 25 percent — a bad risk-to-benefit ratio.
Give yourself plenty of recovery time (one day for each mile raced). If you are trying to quicken your pace for a specific goal, add a weekly speed-work session to your training plan, but be judicious about it. It is also important to never add speed work into your training plan at the same time when you are building your distance. You should first build your mileage base and then incorporate speed work into the latter part of your training, when your weekly mileage is at its peak.
Most experts agree that most runners benefit from at least one non-running day a week, and they also agree that injury-prone runners should avoid consecutive days of running. Cross-training offers a great alternative.
Use cross-training activities to supplement your running, improve your muscle balance and keep you injury-free. Swimming, cycling, elliptical training and rowing will burn a lot of calories and improve your aerobic fitness, but be careful not to aggravate injury-prone areas. If you are injured, let pain be your guide to which activities are OK.
Shoes are the most important equipment that you need to run, so having a pair that fits you properly is crucial to your running success. There is no one shoe that is right for every runner, and there is no shoe that is guaranteed to eliminate an injury. To find the right shoe for your feet, go to a specialty store to get advice. The best running stores will watch you run and analyze your gait and stride to put you in the proper shoe. As a general rule, you should replace your shoes every 300-500 miles.
A December 2009 study reports that runners who shorten their stride by 10 percent could reduce risk of tibial stress fracture by 3 to 6 percent. The basic idea: Overstriding is a common mistake that can lead to decreased efficiency and increased injury risk. If you shorten your stride, you'll land "softer" with each footfall, incurring lower impact forces. A shorter stride will usually lower the impact force, which should reduce injuries.
If you've had frequent running injuries, you might want to try running with your normal stride while shortening it slightly — by about 10 percent. This will help reduce your stride so you have more turnover. The number of foot strikes or repetitions trumps having a longer stride because it reduces your impact load. When making this change, start with a short distance — like a quarter mile — to see if you notice any changes.
Read more of Ashley's helpful tips on her blog: SheRunsStrong.com
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