. If you are a person who regularly runs, it is likely that you have experienced some type of injury at some point during your time as an athlete. According to research, approximately half of all people who recreationally run get injured at some point, with many of those injuries occurring in the Achilles tendon or calf. Other research has shown that the knee, ankle, lower leg, and foot/toes are also common areas where runners experience pain or injuries.
There are several possible reasons why we might get injured while running, including the way we run, the shoes we wear, and sitting all day. Other factors include repeating training mistakes, such as big jumps in mileage, running the same route at the same time in the same not-so-good shoes, or skipping out on strength work.
There are strategies that have been proven to prevent running injuries, however it may take some time to figure out which ones work for you. “An injury can occur when multiple factors, such as a training error, anatomical issue, and wrong shoes, come together,” says Joseph Hamill, Ph.D., a biomechanist at the University of Massachusetts, Amherst.
Every runner has a different anatomy and injury history, which is why injury prevention is challenging, says Anthony Luke, M.D., M.P.H., director of the Human Performance Center at the University of California, San Francisco.
And now scientists are focusing on not just treating injuries but preventing them. Studies are being done on runners who have not been injured to try and figure out who gets injured and who doesn't and why.
To reduce your risk of injury while running, you need a strong body, good form, and the right shoe. This can be achieved through exercises, form tweaks, and shoe advice.
5 Steps to Preventing Running Injuries
1. Add strength training to your weekly schedule
The best way to avoid getting injured when running is to have strong muscles, ligaments, and tendons. These will help reduce the impact on your body, improve your form, and make your gait more consistent. Having strong muscles also helps to keep your movements the same with each step, which your mind and body will be able to recognize and respond to more easily.
The brain tells the muscles to brace for impact before the foot hits the ground when a strong body is running. The glutes and core contract to steady the pelvis and leg and the foot and ankle muscles are activated, providing a solid foundation to land upon.
If one of the stabilizer muscles isn't strong enough or active, other muscles have to work harder, which disrupts the natural flow of movement, says Eric Orton.
According to Jay Dicharry, most runners lack strength in at least one muscle group and in the communication between their brain and body. This communication is important because it helps muscles fire more efficiently and in quick succession, giving the runner more control and stability.
This list provides exercises that, when done regularly, will strengthen the key muscles used in running, as well as the neural pathways associated with them. You can do the routine as a whole a few times a week, or pick and choose a few exercises to do more often.
The text is saying that you should do the moves barefoot if possible, and that Movold demonstrates each move so you can do it correctly. Do as many reps as listed in the text, or the time prescribed.
Donkey Kick With Yoga Block
The yoga block or bar helps to keep your back straight while still firing the glutes, which is important for running. It also strengthens the transverse abdominis, a muscle that helps to keep your core stable.
Begin by kneeling on all fours with your wrists and knees aligned with your shoulders and hips. Place a block or bar across your lower back and raise one leg up so that your knee is bent at a 90 degree angle. Keeping the block steady, raise your heel up towards the ceiling and then lower it back down to the floor. Repeat this process 10-50 times for each leg.
Wall Press
The reason this exercise is effective is because it activates the gluteus medius muscle in a bent-knee position, similar to the position used when running. This muscle is responsible for power and pelvis stabilization, both of which are important when running.
Stand next to a wall on your right side and bend your right knee 90 degrees so it's touching the wall. Push your knee into the wall and hold for 20-30 seconds without moving your body or leaning your shoulder against the wall. Repeat 2-3 times on each side.
2. Start incorporating plyometrics into your workout
Performing jumping exercises regularly will increase your elasticity, making you feel lighter and more bouncy when running. In addition, these exercises will also teach you how to minimize the impact of your landing. If you are not currently strength training, start by mastering bodyweight moves without jumps. After eight weeks, add these plyometric exercises to your program.
Squat Jump
The jump squat is an effective exercise because it targets all the muscles in your legs and also gets your body ready to handle impact.
Stand with feet shoulder-width apart, lower into a squat by hinging at the hips and pushing them back, then quickly jump up and land with soft knees, bending them to lower right back into a squat. Repeat the movement 10-20 times.
Lateral Jumps
This exercise is effective for runners because it forces them to use different muscles than they would in front-to-back motion. This lateral motion works muscles that are not often used, making this a good move for runners.
To do this exercise, place a long object on the ground and quickly jump over it side to side, staying on the ground as little as possible. Do 3 sets of 10 reps total. To make the exercise more difficult, switch out the pole for something taller, like a foam roller.
Lunge Jumps
This exercise helps improve your single-leg explosiveness, which is useful for increasing your power and speed while running.
Stand with feet hip-width apart, then step right leg back and lower into a lunge. Both knees should bend at a 90-degree angle. Next, explosively jump up, switching legs in midair and landing in a lunge with right leg in front. Keep alternating legs and lunge 10-20 times total.
3. Incorporate mobility work into your warmup and cooldown—and throughout the day
If you don't stretch after a run, your muscles can become tight and restricted, making you more susceptible to injury. These exercises increase mobility in areas that are especially prone to problems for runners. Do them after your run to help keep your muscles healthy and prevent injuries.
Kneeling Hip-Flexor Stretch
If you have tight hip flexors, it can limit the back swing of your leg, which can contribute to overstriding (landing too far out in front of your body). This puts more stress on the leg joints.
To do this stretch, kneel on one knee with your pelvis tucked under. You should feel a stretch in the front of the thigh of the leg that is on the ground. For a deeper stretch, rotate your front foot slightly out. Hold this position for 1-3 minutes.
Calf Smash
Calf muscles that are knotted are not as effective in absorbing shocks. This move will help to loosen them.
Position a foam roller under the calf of your extended leg. Roll the calf over the roller and when you find a spot that is painful, press into the roller. Hold this position until the pain goes away. Move slightly and repeat the process.
4. Work to improve your running form
If you want to get people arguing in your running group, bring up running technique. People who advocate for minimalist-style running or other methods believe that just like there is a correct way to swim or swing a tennis racket, there is a right technique for running. However, other experts say that the way we run is individual, and trying to change it invites injury.
There is some middle ground that both sides agree on and that is that parts of form, like having good posture and a proper stride, can help prevent injuries from occurring.
Here’s a look at the gait cycle and where things can go wrong:
PRELANDING
The muscles need to be prepared for impact just before the foot hits the ground. If the brain doesn't send a signal to the muscles to prepare them, they won't be able to stabilize the joints.
IMPACT
Some studies say that the stress of the touchdown phase can cause fractures and other injuries. It is agreed by experts that a greater hazard is overstriding- when the foot lands way ahead of the knee.
MIDSTANCE
Pronation is when the foot moves inward and downward upon impact with the ground, and this is when injuries are most likely to occur because of the high amount of force being exerted on the joints.
TOE-OFF
If the hip flexors are tight, the hip cannot extend fully, which will cause the back to excessively arch.
Should you try to change your foot strike?
The opinion on whether it is better to land on your mid- or forefoot when running varies among experts. Some experts believe that it greatly reduces injury risk, and some data supports that. Others believe there’s a strong chance you’ll trade one injury for another because landing on the forefoot increases impact forces on the calf and Achilles tendon.
This matter is further complicated by studies which show it can be difficult to determine how you strike the ground. Some experts say it is more productive to focus on not overstriding.
The most important thing to remember is that if you are not injured, there is no need to change the way you run. However, if you are constantly injured, changing your footstrike could help you recover and prevent injuries in the future. If you do want to try this method, make sure to do it gradually and while also strengthening your feet, ankles, and calves.
Can strength training fix faulty form?
According to Irene Davis, strength training can improve your form, but it cannot fix biomechanical problems. If you have knock knees, for example, you will need to retrain your body to run differently through a process called gait retraining.
In two studies, Davis gave runners visual and verbal cues to correct their movement patterns. The runners were able to maintain the new improved mechanics after just eight training sessions. Davis advises seeking out a physical therapist with gait-retraining experience instead of attempting it on your own.
5. Find the right shoes for you
Why is it important to find the right shoes for you, and what is the best way to go about doing that? We asked experts to share their take on the matter.
Can a shoe help prevent injury?
Shoes can help reduce injury risk by changing your form and the way repetitive forces are applied to your body. For example, studies have shown that the firmness of shoe cushioning can affect the stiffness of your legs, which can impact the muscles, bones, and joints.
If you're wearing shoes that apply force in a way that your body can manage, and the shoes are a good match for your training, they can help reduce your risk of injury.
You should try running in different types of shoes to mix up how force is applied and reduce stress in the legs and feet. This means rotating among a few pairs, such as a trainer for long runs, grippy shoes for trails, flats for speedwork, and minimal shoes for form drills.
Training loads can be measured in different ways
Sport scientists typically measure physical training loads (ie, physical ‘work') alongside internal training loads (ie, physiological or perceptual ‘response'). External training loads may include total distance run, weight lifted, or number and intensity of sprints, jumps or collisions (to name a few).16 Internal training loads include ratings of perceived exertion and heart rate. The athlete's individual characteristics (eg, chronological age, training age, injury history and physical capacity) in combination with the applied external and internal training loads determine the training outcome.16
This is an example of how two people can have different internal training loads from the same external training load. For example, an overweight middle-aged man will have a more intense response to an 800 meter run than a trained runner. This is because the older, unfit individual will have a higher internal training load. Therefore, it is important to prescribe training on an individual basis.
External training load—‘tracking’ every metre!
GPS devices have changed the game when it comes to monitoring external loads. These devices, which are typically no larger than a mobile phone, are worn by athletes during training and match-play activities. GPS provides information on speed and distances covered, while inertial sensors (ie, accelerometers, gyroscopes) embedded in the devices also provide information on non-locomotor sport-specific activities (eg, jumps in volleyball, collisions in rugby and strokes in swimming). Importantly, most of this data can be obtained in ‘real-time’ to ensure athletes are meeting planned performance targets.
Internal training load—the athlete's perception of effort
At the completion of each training session, athletes rate the intensity of the session on a scale of 1-10. This number is then multiplied by the duration of the session to find the training load, measured in “RPE units×minutes” or “exertional minutes”. The value of session-RPE will depend on the goal of those measuring it.
Monitoring individual athlete well-being
It is common practice in high performance sport to monitor athlete well-being.19-21 A wide range of subjective questionnaires are used, many of them employing a simple 5, 7 or 10-point Likert scale.19-23 Longer, more time consuming surveys are also employed.24,25
The purpose of these questionnaires is to gauge how ready team sport athletes are to train. The athletes report their mood, stress level, energy, sleep, and diet, as well as how sore they are in their upper-body, quadriceps, hamstring, groin, and calf. The total of the questions reveals the athlete's well-being, which practitioners can use to modify the training prescription for the player on an individual basis.
Relationship between training loads and injury
In recent years, it has become popular for athletes in high-performance sports to monitor their training loads to make sure they're getting an adequate workout and to avoid negative consequences such as injuries or overtraining. In the section below, I'll discuss the relationship between training loads (both internal and external loads) and injuries in athletes who play team sports.
