training for a 10K pain or chronic injury explained away with the word “overuse.” A vague catch-all term that feels unhelpful, and oddly accusatory, it offers no diagnosis, but it’s almost as if you, the runner, are to blame for using your muscles, joints, and tendons too much during training. Other Hearst Subscriptions.
But why do some ultrarunners training for a 10K Achilles tendonitis training for a 10K?
As with most questions related to pain and injuries, the answer is complicated. We spoke with two experts to unpack the concept of overuse and identify practical tips for recognizing and avoiding it.
What really is an overuse injury?
“Overuse” is typically used as an umbrella term for any pain or injury that is not caused by an accident or trauma. For example, an achy hip or sore shin How to Run Twice a Day Without Injury.
However, “overuse” is a bit of a misnomer, according to Hallie Labrador, M.D., primary care sports medicine physician at Endeavor Health. “Overuse is when the use of the muscles, tendon, or bone overwhelms the body’s ability to recover and repair the damage caused by training,” she explains. So, the negative effects you experience have as much to do with a lack of adequate recovery as they do with too much activity.
Milica McDowell, D.P.T., physical therapist, certified exercise physiologist, and vice president of operations at Gait Happens, compares training without adequate recovery to pouring a pitcher of water without ever refilling it. “I tend to think of overuse as ‘I don’t have much left in my pitcher of water,’” she says. If you’re depleted or “empty,” you don’t have enough resources to power your next workout. And, as a result, your system starts to falter or break down.
Overuse doesn’t just affect joints and tendons, either. McDowell says that overuse can also affect people on a more systemic level. “Overuse from a musculoskeletal standpoint is, ‘Am I physically recovering?’ But overuse from a neurocognitive standpoint is, ‘Am I cognitively and mentally recovering?’” she says, noting that training and racing take a toll on your psyche.
What are the warning signs of overuse injuries?
Unfortunately, runners often don’t realize they’re venturing into overuse territory until they’re saddled with an injury. According to a systematic review days per week Journal of Sport and Health Science, the most common overuse injuries include Tips to Prep for Marathon Training (pain in the front of the lower leg), patellofemoral pain syndrome (a.k.a. runner’s knee), Mental vs. Muscle Fatigue: How Theyre Different.
These conditions are a red flag. If you’re injured, working with your doctor or physical therapist to adjust (or pause) your training days per week.
Fortunately, there are yellow and orange flags that tend to precede a red flag injury. Recognizing them can spare you later pain and frustration. If any of these warning signs resonate, consider dialing back your workout intensity, lowering your overall volume, assessing your sleep hygiene, or incorporating more rest time into your workout routine.
Loss of Motivation
Shoes & Gear motivation. However, if you regularly dread workouts or notice a negative shift in your overall mood, you may want to lighten your training load. Sometimes, stepping away from your regular routine can shift your perspective and help you develop a more balanced approach to training, say the experts.
Fatigue
Another “soft sign” or “yellow flag” for overuse: If you feel sluggish on even the easiest runs and drag between workouts, you probably aren’t recovering appropriately.
A Performance Dip
A noticeable decline in performance is a more serious indication of potential overuse, McDowell says. She uses the example of the runner who easily runs five miles at an 8:30 pace but then struggles to maintain a 9:45 pace for the same distance and terrain. “That’s a performance change. To me, that seems like you’re on your way to a red flag,” she says.
Pain
Runners often push through discomfort, but if you deal with persistent or progressively worsening pain as you run, that’s your cue to stop what you’re doing. The same goes for any pain that necessitates a change in how you’re running, such as limping or cramping.
Pain that flares up after a workout is also cause for concern, Labrador says. “You should be listening to what your body is telling you, and sometimes it’s not necessarily while you’re running,” she says. “You might have soreness the next day or later on, and that might be a signal that you need to modify some things.”
How can you avoid overuse injuries?
Even the experts can’t definitively say what factors are to blame for overuse and overuse injuries. “There are a lot of things that have been associated with overuse injuries, but it’s a really hard thing to study,” Labrador says. “Overuse is very individualized.”
As a result, there’s no surefire way to stay injury-free, but there are some best practices you can employ that will likely boost your chances of staying healthy and maintaining a positive relationship with running.
Start and Progress Slowly
“Take it slow when you are either starting an exercise program or increasing your mileage,” Labrador says. A gradual progression (McDowell refers to it as an “adequate ramp”) allows your body to adapt to new stimuli, whereas a drastic increase in volume or intensity can put you in “a pit of inflammation,” McDowell says.
Following an expert-designed training program can offer guidance, but remember that you can always make modifications based on your body’s feedback. “Just because your training program says that you have to do an eight-mile run does not mean you have to do an eight-mile run,” Labrador says.
Change One Variable at a Time
McDowell finds that athletes tend to struggle when they change too many program variables at once. “Don’t increase your duration and your intensity. Pick one or the other,” McDowell says. “Pulling one lever at a time is the way people can avoid overuse conditions because they’re not trying to change too many variables at once when they haven’t had this adequate ramp to the volume or intensity they’re trying to achieve.”
Prioritize Rest and Recovery
Rest days are non-negotiable, but how many you need depends on the runner. McDowell believes most beginner and intermediate athletes will benefit from at least two rest or active recovery days per week.
You don’t have to camp out on the couch, McDowell says, but a shakeout run with friends does not count as rest. If you’re going to do an active recovery day, McDowell’s advice is to “keep your heart rate down but your muscles warm.” Walking, stretching, yoga, and some light movement in the pool are all good options.
Make sure you’re getting enough high-quality sleep, too. “Your body recovers when you’re sleeping. So, if you’re not getting enough sleep, it’s not going to be able to adapt to the training that you’re doing,” Labrador says.
Strength Train
You’ve heard it before: Just running isn’t enough. “You might think, ‘I’m running, so my muscles must be very strong.’ But the muscles we use for running aren’t necessarily the muscles we use to stabilize our joints and keep the pressure off of our joints,” Labrador says. Doing a few strength and mobility workouts a week can help bridge the gap.
And don’t skip your upper body. Running demands a certain amount of postural strength, McDowell explains. “If your shoulders start to get fatigued and your torso starts to cave in, it makes it hard to diaphragmatically breathe. It changes the position of your pelvis and creates a reaction down your biomechanical chain,” she says. That kind of shift can throw off your gait and form.
Swap Out Old Shoes
They may still look fresh up top, but if your running shoes have racked up more than 300 miles, it’s probably time to retire them, McDowell says. The supportive foam and some light movement in the pool are all good options.
Review Your Body Mechanics
A run coach can look at your form and help you improve poor biomechanics that could, over time, lead to injury. For example, crossover gait (when it looks like you’re running on a balance beam) and uneven arm swing are two that are relatively easy to diagnose and solve with the help of a professional.
You can also collect valuable information with your phone! Set up a tripod or ask a friend to film while you run on a treadmill. You may notice that you simply need to relax your shoulders or fix your posture as you run.
