Running Training: What You Need to Know

Monique Serpas, PT, DPT, OCS

If you’re reading this and you’re a runner, chances are you’ve felt pain.  Most runners experience pain at some point, with research indicating 79% of runners will be injured and 46% will have recurrence of the problem.

Common running injuries are patellofemoral pain, IT Band syndrome, hamstrings strains, achilles tendinitis, stress fractures, and plantar fasciitis.  Though running can be associated with these painful conditions, it can also boost mood by the infamous “runners high” and it is a great form of “free” exercise that helps reduce blood pressure, control blood sugar levels, and manage weight, just to name a few of the benefits.

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Reduce risk of injury by running smart and steering clear of these five training errors.

1. Improper conditioning.

Many of the guidelines to train for 5Ks and half marathons give guidance on how to run in order to prepare for a race, though skimp on information about cross training in order to improve performance and reduce injury.  It takes more than just running in order to train well.

Many recreational runners believe stretching is a key factor to prevent injury, though there is little research to support this belief.   It is possible to have good alignment and still be at increased risk of injury due to inability of the muscles to absorb shock if they are weak or fatigue easily. Strength training is an important component to reducing injury, especially in the hips and core. Runners with patellofemoral pain syndrome, pain at the front of the knee, were found to have weaker hip abductor muscles compared to controls and in a study of sprinters, weak hip extensors and hamstrings were associated with hamstring injury.

2. Doing too much too soon.

This is a biggie.  Increasing distance more than 30% over a two week period was found to be associated with running injuries, unlike those who increased their distance by less than 10%.  Generally, I recommend sticking by the 10% rule.

There are other factors to consider other than distance, such as running pace, interval training, sprint training, and elevation/descent (running on hills or levees).  Sudden changes to any of these factors could put a runner at risk of injury.  Run smart and don’t ignore what your body is telling you.  Allow time for your body to adapt to new distances as well as recover from intense training.

3. Overstriding.

Running with a wide stride and hitting the ground with the heel of the foot first, or a heel strike pattern, creates a braking effect to running, increasing joint loading as well as making a run less efficient.  In a study where heel strikers with knee pain were trained to run with a more mid or forefoot strike pattern, pain was reduced. In order to improve your speed, increase your run cadence.  Take more steps with a shorter stride and this will increase speed without increasing joint impact loads.

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4. Running on the same side of the road.

Road camber is the slope of the road with the highest point in the center and lowest on the edges in order to promote good drainage.  When running on the left side of the road, the left leg is on the slope which restricts healthy pronation and the right leg is encouraged to overpronate.  The left leg is also relatively lower than the right leg which sets your pelvis at unequal heights and if you always run on the same side, then you could create muscular imbalances which may put you at increased risk of injury.

If you must run on the road, run out and in on the same side, or switch sides of the road halfway if you are running a circular route.  You could switch up your running surface to grass, sidewalk, walking or biking paths, a track, top of the levee, or the treadmill for a more level surface.

5. Running in old shoes.

Wearing old shoes is associated with the development of stress fractures in a study of training in military recruits.   Replace shoes around 300-350 miles in order to reduce your risk of this injury. You may also want to try shock-absorbing insoles if you’re having problems with shin splints as research indicates they can reduce pain.

Avoiding these five training errors will hopefully keep you from experiencing painful running injuries. If you are thinking about starting to run and not sure where to start or you are having pain with exercise, ask your doctor to refer you to physical therapy.  A physical therapist will do a whole body evaluation and can help you develop a customized exercise program with the goal of health promotion and injury prevention.

Learn more about preventing sports injuries.

Serpas-MoniqueMonique Serpas, PT, DPT, OCS. is a physical therapist and board-certified Orthopaedic Clinical Specialist practicing at Touro Infirmary in New Orleans, LA. Monique realizes how difficult it can be to overcome an injury or manage a chronic condition and is focused on helping her clients achieve wellness through a physically active lifestyle. Monique treats orthopaedic, balance, and vestibular disorders using a combination of hands-on manual therapy, therapeutic exercise, and education. This enables patients to assist in their own recovery and injury prevention. Monique holds a Doctor of Physical Therapy from Concordia University Wisconsin (2008) and a Bachelor of Science in Kinesiology from Louisiana State University (2004). She is a member of the American Physical Therapy Association (APTA), Louisiana Physical Therapy Association (LPTA), and the Orthopaedic and Neurology sections of the APTA.
References
1. Powers, C & Davis, I. (2011). “Biomechanical Factors Underlying Running Injuries: Proximal and Distal Factors” presented February 10, 2011 at the Combined Sections Meeting of the American Physical Therapy Association, New Orleans, LA.
2. Yeung SS, Yeung EW, Gillespie LD. (2011). Interventions for Preventing lower limb soft-tissue running injuries. Cochrane Database of Systematic Reviews 2011, Issue 7. Art. No .: CD001256. DOI: 10.1002 / 14651858.CD001256.pub2.
3. Dierks, TA, Manal, KT, et. al. (2008). Proximal and Distal Influences on Hip and Knee Kinematics in Runners With Patellofemoral Pain During a Prolonged Run.  J Orthop Sports Phys Ther 2008;38(8):448–456. http://www.jospt.org/doi/pdf/10.2519/jospt.2008.2490
4. Sugiura,Y, Saito TJ, et. al. (2008). Strength Deficits Identified With Concentric Action of the Hip Extensors and Eccentric Action of the Hamstrings Predispose to Hamstring Injury in Elite Sprinters. J Orthop Sports Phys Ther 2008;38(8):457–464.
5. RØ Nielsen, ET Parner, EA Nohr, et al. (2014).  Excessive Progression in Weekly Running Distance and Risk of Running-Related Injuries: Association Which Varies According to Type of Injury.  J Orthop Sports Phys Ther. 2014 Oct;44(10):739-47.
6. Roy T.H. Cheung and Irene S. Davis.  Landing Pattern Modification to Improve Patellofemoral Pain in Runners: A Case Series. J Orthop Sports Phys Ther 2011;41(12):914–919.
7. Warden SJ, Davis IS, Fredericson M. (2014).  Management and prevention of bone stress injuries in long-distance runners.  J Orthop Sports Phys Ther. 2014 Oct;44(10):749-65.)
8. Richter, Randy R,PhD., P.T., Austin, Tricia M, PhD,P.T., A.T.C., Reinking, Mark F, PhD, PT,A.T.C., S.C.S. Foot orthoses in lower limb overuse conditions: A systematic review and meta-analysis – critical appraisal and commentary. Journal of Athletic Training. 2011;46(1):103-6.

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