For most people, it's an unavoidable reality of running: injuries will happen. But while some may be just down to bad luck, many are avoidable - and with sensible training, resting when necessary and working on the basics of strength and conditioning, you can make yourself as robust and injury-proof as possible.
Generally, you can divide injuries into two main types: 'acute' and 'chronic'. With an acute injury, you can normally pinpoint exactly when it happened - for example spraining your ankle or tearing a muscle. Chronic injuries, by contrast, tend to built up over time. These are actually more common in runners. The repetitive nature of running means that an initially minor niggle can be amplified until it becomes more of a problem. The good news, however, is that its much easier to predict - and thus avoid - chronic injuries.
train your deep core How many days a week should I run and The Runner's Expert Guide to Stretching, What is overpronation:
1. Overload
Your body is great at adapting to stresses, as long as those stresses are manageable. Things go wrong when it’s unable to cope with sudden or dramatic changes in mileage and/or intensity. You may have heard of the 10 per cent rule – not increasing your training by more than 10 percent each week. That metric is simple when you look at distance, but what about intensity? The same applies. Use a heart-rate monitor to track your effort and/or look at your training programme to ensure you’re not adding too many high-intensity sessions – eg hill sprints. If you do want to increase intensity, do so one session at a time, and work on a lower overall mileage in that period.
2. A lack of strength
If you’re a runner who just runs, you’re just asking for some time on the physio’s table. Our bodies respond to load by making us stronger, but after your body adapts to a certain level of load from running, your strength will plateau. And then all may be well - until you do something different, such as a cross-country run or hill reps.
What is overpronation that builds strength in both the prime movers and the accessory muscles (which help posture and control unwanted movement) means you are far less likely to overload these muscles and cause injury. And getting stronger will make you faster, too. The most effective strength moves for runners are single-leg squats, glute activation, calf raises off a step, deep-core activation Study reveals common injury in marathon runners.
3. Reduced flexibility
How many days a week should I run stretching. The practice has come under scrutiny recently, with some studies failing to show any benefit. But as a physio, my experience is that those who stretch, or practise yoga or Pilates, benefit from their long-term commitment. I’m such a believer in the benefits that I wrote a book, The Runner’s Expert Guide to Stretching, filled with self-tests to check your flexibility and exercises to improve it. Add a yoga or Pilates class to your weekly schedule and try to find time for these key stretches on a daily basis: subscribe to the magazine here, causes of hip pain and how to fix the problem and the soleus stretch against wall (30-40 Knee pain after running: How to spot and fix it).
4. Too little recovery
Runners often simply accept feeling knackered after a session and going into the next one, so it can be tempting to think you need to suck it up and cram in the miles when you are training for a race. But when you’re training hard, recovery is the most beneficial session of the week. Taking a well-earned day off, or a slow and relatively short recovery run, should form the bedrock of any good training programme.
5. Back-to-back sessions
Following a particular type of training (eg a speed or hill reps session) with another of the same type will overly fatigue specific muscles and energy systems, and leave you vulnerable to injury. Make sure your next session is of a different type to the last, and always follow a hard speed session with a recovery run, not another speed session. Mixing it up helps your body cope with different types of stress.
6. Fuel shortage
People tend to neglect this as a leading reason for injury. Starting sessions dehydrated and/or overfed but undernourished means your decision making is impaired, your muscle energy reduced and the likelihood of you making technical errors or simply overworking a struggling muscle group to the point of injury is increased.
Replenish your glycogen stores after heavy sessions so you’re restocked for the next time out. Protein is key for repairing muscles; little and often is the key here, so, as a rule, each meal should include a protein source similar in size to a deck of cards. Also remember that being just 5% dehydrated will impair performance, so keep an eye on your urine and make sure it’s a light-straw colour.
7. Muscle imbalances
This can refer to one muscle group being dominant over another (eg if the hamstrings are overused due to a lack of glute firing, this can lead to pain in the hamstring tendon). Or the imbalance could be between the left and right side of the body, leading to gait changes and potential overuse injuries on the weak side. Some work with a physio may be required, but for starters, check yourself for these imbalances:
Anteriorly rotated shoulders
Shoulders rolled forward is a curse of desk-bound lives. Do the IJWYT exercise (lie face down, arms at your side, then use your arms to make the shapes of those letters in order, holding each position for five secs) to improve posture.
Sway-back posture
Are you hanging off your hip flexors and appear from the waist up to be leaning backwards? If so, you need to subscribe to the magazine here to develop strength and straighten up. Your running will improve, too.
Quadratus lumborum
(Side flexor in your lower back) Bend to each side without leaning forward or back and see how far down your leg the hand slides. If one hand goes much lower than the other, you have an imbalance. Repeat the move to correct the imbalance.
8. Not rehabbing previous injury
The two biggest causes of injury I see in runners are previous injuries and increasing age. We can’t do much about the latter, but we can address the former. So many runners return to training before they have fully recovered. Everything ‘feels’ fine but without the specific treatments, exercises and time required to rehabilitate, that injury could well return within the first three runs, and then be even harder to recover from. So, listen to your physio!
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Kate is Runner’s World's acting commissioning editor. She writes about all things running, from deep dives into the science to the latest gadget reviews. Kate has worked in media and journalism for too many years to count. Before joining RW, she was Life and Style editor at the Guardian and has also written for everyone from World Athletics to Lonely Planet. She also worked in TV for 10 years. Kate is also a qualified coach, sub three hour marathoner, Guinesss World Record holder and has run all the Marathon Majors. She loves running around in 400m circles best, though.
