Injury Prevention

BorgessSportMed_PMSOVERUSE injuries are the most common injuries seen in runners. While there are many factors that play into getting an overuse injury, the most common cause of overuse injuries is doing too much, too fast. This may be adding too much mileage per week, increasing speed too quickly, or running too many consecutive days. The training plans that have been developed increase mileage by about 10% per week, gradually add in more intense runs (speed work or interval training), and incorporate rest and cross training. Even if you are in good cardiovascular shape, if you are new to running, you will be encouraged to do the lower mileage plans to allow your muscles and bones to adapt to the new sport of running.

Other RISK FACTORS for running injuries:

  1. Poor core strength: Core strength affects your posture, running gait, and foot strike. While your body can adapt to many stresses over time, poor posture can put undo stress on bones, joints and muscles. Core strengthening exercises are an important part of a training plan.
  2. Decreased flexibility: While every person is different in terms of their flexibility, imbalances from side to side can affect ones gait pattern and potentially cause altered gait patterns. Stretching after activity may be beneficial if you have flexibility imbalances.
  3. Improper Warm-up: An active or dynamic warm up where you move your joints through a full range of motion is important prior to running. Static stretching should be reserved for after your workouts once your muscles are “warmed up.”
  4. Running form/ biomechanics: how you run affects your risk of injury. Learning “proper” running form is important—Good Form Running gives insight into this. Your running form can be changed with shoes/orthotics, strengthening, stretching, and increasing your fitness level.
  5. Equipment: for running, this means shoes (and potentially orthotics).
  6. Running surface: canted roads; “tight” curves on tracks, “slushy”-snowy surfaces, trails, concrete, asphalt… all can cause different stresses on the body.

“GOOD” Pain: When a person starts a new activity, it is normal to have some pain and soreness—delayed onset muscle soreness. Generally speaking, this pain is bilateral, without
swelling, and is achy in nature, involving a broad area (muscle). It is good to stretch the sore muscles and continue exercising—including running. This pain usually lasts 3-7 days and gets progressively better.

“BAD” Pain: an injury. This is not normal and differs from good pain in that it is generally unilateral (one side) and point specific (not a broad area). It may be associated with other symptoms such as swelling, numbness/tingling, instability, weakness, and often gets worse (not better) as you continue to run/exercise. The pain may cause you to alter your running form (leading to more injuries) or start affecting activities of daily living. If you are injured:

  1. Rest! Take some time off from running. Cross train (bike, swim, elliptical, etc.) if it doesn’t hurt. Often taking time off at the front end of an injury (rather than “pushing through” the pain) leads to less time off overall.
  2. Ice the affected area, especially if there is swelling. Ice also acts as a pain reliever.
  3. Stretch the surrounding muscles to maintain/improve joint range of motion
  4. Ease back into running as pain improves. Start slower with less mileage
  5. Consider seeing a physician if you are concerned about returning too quickly or if pain continues to recur despite rest. Borgess Sports Medicine physicians, Dr. Vajgrt and Dr. Goodwin, not only diagnose injuries, but also look at potential risk factors that may contribute to recurring injuries. Our goals are to keep people active while allowing an injury to heal and preventing future injuries.

COMMON running injuries include:

  1. Shin “splints”: shin pain that generally occurs in both legs. This is a tendonitis that often improves with stretching and certain foot and ankle exercises.
  2. Stress fractures: these can occur in any bones, but frequently occur in the lower leg and foot in runners. These often cause a one-sided point-specific pain that worsens with activity. Rest allows the bone to heal.
  3. Achilles tendonitis: pain in the back of leg/heel that worsens with running. May improve with stretching, strengthening, shoe inserts, and avoiding hill work outs.
  4. Iliotibial (IT) Band Syndrome: Can cause pain either on the side of the hip or the outside of the knee. Often affected by running downhill or on sloped surfaces. Can be very debilitating. Resting, stretching, icing, and strengthening hip/core muscles can help.
  5. Patellar Femoral Syndrome (Anterior Knee Pain): pain in the front of the knee, right behind the knee cap. This is VERY common, and an underlying factor is a person’s biomechanics at the hip and knee. Can be helped with hip, core, and leg strengthening, stretching exercises, and gradually increasing distance and intensity.

KEYS to help remain INJURY-FREE:

  1. Keep the “long” runs easy. They are meant for your body to adapt to distances.
  2. Start SHORT. Ease in to the mileage, and gain base mileage, gradually progressing.
  3. GRADUALLY add in some short harder intervals once you have some base mileage.
  4. Cross train with biking/swimming/elliptical or other low impact activities.
  5. Do core strengthening exercises.
  6. Do dynamic warm-ups.
  7. Stretch sore muscles after your run.
  8. REST at least one day per week.

RECOMMENDED to see a sports medicine physician if:

  1. an injury is not improving despite a trial rest/self-treatment
  2. an injury is significantly worsening or recurring
  3. an injury is associated with other symptoms as described above
  4. an injury (especially in the lower leg or foot) is becoming very point specific
  5. an injury is causing altered mechanics which is leading to other aches/pains
  6. YOU want reassurance that it is okay to return to running