Common Running Injuries and Techniques to Avoid Them

Running is a great cardiovascular workout, but it can harm your body if done improperly.

There are many running injuries that are completely preventable if you take the time to learn a few tricks to avoid them. Running injuries are never fun, because they can prevent you from reaching your fitness goals and even affect your work performance if they are severe enough. Some injuries are not preventable, but every injury I have had in my 9 years of competitive running has been preventable. Below are some typical running injuries that you may experience if you fall into running pitfalls; there are also proactive tips for avoiding injuries as well as what to do once you have sustained one.

The Shin Splint

The most common running injury experienced is probably the shin splint. This injury is characterized by a terrible jarring and stabbing pain in the front or side of your shins that is exacerbated with each pounding footstep. If it hurts this bad, you have been pushing it further than you should have already. You will also probably notice severe pain when you stumble, land from a jump, or do any activity including walking that involves dorsiflexion of your foot (flexing your foot up closer to your shin as you do in running or walking). People with flat feet (little to no arch in the foot) typically experience the problem most easily.

Shin splints are a type of overuse injury that occurs from weakened muscles surrounding the shin. The first thing to do to avoid experiencing this injury, which I will repeat with every new injury I mention, is to RAMP UP YOUR TRAINING SLOWLY. If you start back from not running by running 5 miles on your first day, then continuing to 6 the next and 9 by the weekend, then you are a likely candidate for shin splints. As a runner who has been in training cycles for Cross Country that surpass 60 miles per week for two months or more at a time (often without incident), I have started with 50 miles per week from nothing and rapidly developed shin splints almost every time. This is why running coaches stress that you start your summer running with light mileage (often 30 or less, but relative to you and your body).

Shin splints are also often caused by repeated impact on the legs and shins. Running is a high impact sport, but their are ways to reduce its impact. If you usually run on concrete, switch to asphalt, a track or gravel when an option, or grass or a trail if you are really lucky. Each of these surfaces are progressively less hard from first to last. It is obviously difficult for city dwellers to change their running surface at times. If you don't change surfaces and continue to exercise, however, the consequences can be quite extreme: the pain will likely get worse, often prohibitively so. If you continue to ignore it after this, then the pain can get even worse, and you can suffer a stress fracture. This means that you have actually sustained a small crack in your bone. I know a girl who kept running even after this point; she suffered a true break of her hip eventually, and was out for more than six months. Do not push through this kind of pain. It can take weeks or months for shin splints to get better, and often twice that long for stress fractures.

Muscle Pulls

The muscle pull that I have experienced twice now is a hamstring pull. This is very common for males, while women more often experience muscle pulls in the calves. Both times I sustained this injury, I was sprinting at maximum speed early in my training season. My legs were unused to the strain. There are several easy steps to avoid muscles pulls. First, you should RAMP UP YOUR TRAINING SLOWLY. You should hydrate well. Muscle cells are long cells, and if they are without water, they will be unable to perform their firing function properly and lose coordination. When the muscle cells pull different directions at different times, then you will experience a sensation called a "charley horse," which is usually characterized by an intense and painful tightening for the calf, and the same for the hamstring with the interesting exception that a hamstring charley horse tends to result in the leg shooting out of its own accord.

Besides getting adequate hydration and electrolytes, you should eat properly and stretch before and after every workout. This is an easy way to re-oxygenate and improve the flexibility of your muscles, which will lead to less muscular injury. Stretch all muscle groups, even the ones you don't feel like and that you don't think you need. You should also try doing some plyometrics; these exercises increase the flexibility and speed of your muscles.

The good thing about muscles pulls is that you will be very aware when they happen, and recovery time can be anywhere from a few days to a few weeks depending upon the severity of the injury. You will notice that muscle pulls often involve minor muscle groups on the back of your leg. This is because these muscles are responsible for pulling motions, like the normal pull and lift of your leg's back up into the next running stride. Bigger muscle groups like the quadriceps are rarely pulled, because they push your entire body's weight forward, and are consequently very strong.

Knee and Joint Injuries

Pure runners (distance and sprinting runners) usually do not sustain joint injuries. It is those who jump, land, fall, and pound on their joints heavily that are at the greatest risk for injuring knees, hips, and ankles. This includes individuals who are overweight. To give yourself the best chance of avoiding joint injuries, RAMP UP YOUR TRAINING SLOWLY. If you are significantly overweight, you should consider an alternate exercise that will not stress your hips and knees so badly. Running is a harsh, high-impact exercise. Biking is less so, but swimming is the best aerobic exercise to avoid joint problems. Try alternatives until you have dropped enough pounds to make yourself feel comfortable running.

Alternative exercise also applies to those who have a history of bad knees. There is a point when running is no longer an activity that you need to be doing. If you have had repeated injuries, I would move to exercise that does not stress your knees greatly. I have never had knee replacements, but I would encourage you to avoid activity that does not stress your knees if they are already suspect. If you have healthy knees and joints, however, there has never been real proof that running ruins them. It can certainly be possible if taken to excess, but you can feel reasonably confident that running is not going to affect your knees if you have decent ones. Once again, hard surfaces tend to inflame joint problems, so move to softer stuff if you need to.

Ankle Rolls

When you get tired, your running form collapses. When this happens, your stride can be altered to an inefficient posture that promotes injuries. One injury that I have experienced a dozen or more times now is an ankle roll. Like all injuries, an ankle roll only weakens the tissue and makes another roll or twisted ankle more likely. The most common form of ankle roll is an anterior (outside) roll. This is the roll I have experienced, and it has been on the left foot each time; it only gets worse each time that this happens.

An anterior roll overextends the ligaments and tendons on the outside of your ankle as it bends to an extreme angle. It causes a sharp pain when this happens. If you experience the pain, I recommend that you get to a flat surface as soon as possible and keep running for about 5 minutes. As long as you don't repeat the injury within that time frame, it has been my experience that continuing to run for just a few minutes after an ankle roll can keep the ligaments loose and lessen the degree of stiffening after the injury.

When you do stop running, depending upon how bad you rolled your ankle, you will probably notice immediate swelling and stiffness in addition to pain when moving the area. This stiffness will get worse after the first night, then gradually better after that point if you let it heal. I have generally been advised to use crutches, because this lessens recovery time and reduces the risk of repeated injury. If you have rolled the ankle extremely badly, you may notice purple liquid leaking down just below the surface of your skin all the way down from the site of the injury to your toes and heel. I have experienced this once; it is actually internal bleeding being pulled down to your toes by gravity. A picture below shows this happening.

As I continued to repeat the ankle roll, I isolated one activity of mine that made rolling the ankle more likely: I tended to pull my foot up behind me when performing the quadriceps or thigh stretch, thus stretching the ankle at the same time. The ankle is one area that you do not want stretched, because it makes the ligaments looser and more likely to roll. Try instead to pull on your leg itself at your ankle in order to stretch your thigh. If you continue to roll your ankles, you may want to try staying off of rough terrain, because it is easy to trip. For both ankle and shin splint injuries, there are some therapeutic exercises that strengthen the muscles and ligaments. These can involve picking up color-coded plastic pieces with your toes and placing them in buckets, or "writing your ABC's" with your toes pointed out into the air. To do this, simply imagine the image of the alphabet letters and trace them with your toes extended in the air.

If you do sustain an injury, be sure to take the maximum recovery time recommended, and try not to re-create the conditions that made it happen in the first place. Happy running to you!

SOURCES

http://commons.wikimedia.org/wiki/File:ANKLE_SPRAIN_02b.JPG

http://commons.wikimedia.org/wiki/File:Berlin_marathon.jpg

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