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Injury prevention for runners

Ashley Crossman, Ph.D. is a certified RRCA running coach and ACE personal trainer. She owns her own coaching business, She Runs Strong, and has been the running coach for two charity training teams in Phoenix, Arizona: the MS Rockstars (...

Tips for safe training

Knowing how to train properly and safely is crucial to staying injury-free. Here are some tips to help prevent injuries from ruining your training.

Woman hurt during race

Know your limits

Some experts believe that every runner has an injury threshold and that once you exceed that threshold, you get injured. Your threshold could be 10 miles a week or 100, but once you exceed it, you get injured. Various studies have identified injury thresholds at 11, 25 and 40 miles per week. Every individual has a different threshold — yours is waiting for you to discover it.

The problem occurs when runners do too much, too soon and too fast. The body needs time to adapt to training changes and jumps in mileage or intensity. Muscles and joints need recovery time so they can recover and handle more training demands. If you rush the process, you could break down rather than build up. Running experts have recognized this problem, and they long ago devised an easy-to-use 5-10 percent rule: Build your weekly training mileage by no more than 5 to 10 percent per week. To build your mileage by 5 percent, if you run 10 miles the first week, do just 10.5 miles the second week, 11 miles the third week, and so on. If you are recovering from an injury or are brand-new to running, it is best to stay close to the 5 percent limit. Otherwise, you'll run the risk of injury or reinjury. More experienced runners who have no history of injuries can safely train closer to the 10 percent limit.

Keeping a detailed training log can help you gauge your personal training threshold. Record your weekly mileage and how you feel after your runs. Look for patterns. For instance, you may notice that your knees ache only when you're logging more than 40 miles a week.

Listen to your body

This is perhaps the oldest and most widely repeated advice for avoiding injuries, and it's still the best: If you don't run through pain, you can nip injuries in the bud. Most running injuries don't erupt from nowhere and blindside you. They produce signals — aches, soreness and persistent pain — but it's up to you to not dismiss them and take appropriate (in)action.

At the first sign of an atypical pain (discomfort that worsens during a run or causes you to alter your gait), take three days off. Substitute light walking, water training or bicycling if you want. On the fourth day, run half your normal easy-day distance at a much slower pace than usual. Success? Excellent. Reward yourself with another day off and then run a little farther the next day. If you're pain-free, continue easing back into your normal routine. If not, take another three days off and then repeat the process to see if it works the second time around. If not, you've got two obvious options: Take more time off and/or schedule an appointment with a sports-medicine specialist.

Strength training

Strength training helps keep your body properly aligned while you are running. According to many experts, it is particularly important to strengthen the core and the hip muscles. When you strengthen the hips — the abductors, adductors and gluteus maximus — you increase your leg stability all the way down to the ankle while also helping to prevent knee injuries.

You don't want to train for bulging muscles. You need just enough core, hip and lower-leg strength training to keep your pelvis and lower-extremity joints properly positioned. If you don't have muscle balance, then you lose symmetry — and that's when you start having problems.

Stretching

Stretching should be an important component of any runner's regime. Runners tend to be tight in predictable areas. They get injured in and around those areas, and therefore, they should increase flexibility in those areas. The muscle groups at the back of the legs — the hamstrings and calf muscles — stand atop most lists of the best muscles for runners to stretch. Flexibility in the hamstrings and hip flexors seems to improve knee function (several reports link poor flexibility in those areas with "larger knee-joint loads"), and calf flexibility may keep the Achilles tendon and plantar fascia healthy.

There is little evidence to indicate that stretching prevents overuse injuries. That said, knee and Achilles-tendon problems are among runners' most frequent complaints, so experts recommend increasing the range of motion of muscles that can strain these areas if there is underlying tightness. Just don't do static stretches (holding an elongated muscle in a fixed position for 30 seconds or longer) before running. Stretching is best done after a warm-up period of 10-15 minutes, after your muscles are warm or at the end of your workout.

Here's an important note about stretching after long runs (longer than 15 miles): Do not stretch immediately following your run. Your muscles have hundreds of microtears in them, and stretching them could turn some of these into macrotears, causing significant damage. Instead, cool down, take a shower, eat a good meal and drink plenty of fluids. Then it will be OK to stretch later in the day.

There are a few rules when it comes to stretching:

  1. Pain is never acceptable when stretching. Stretching should be comfortable and relaxing but never painful. If something hurts, you're not in the right position or you've stretched too vigorously. Back off and check your position, then try again more gently.
  2. Slow and steady wins the race. Making slow movements into the position of stretch will help avoid stimulating the stretch reflex, and it will allow you to tune into your muscle signals. Don't rush it. Once in position, hold steady — do not bounce.
  3. The position of stretch should generally be held for about 30 seconds.
  4. Be consistent. The more consistently you perform these stretches, the more effective you will be in increasing your flexibility. Stretching daily initially and then three times a week for maintenance is a good rule of thumb.

RICE

RICE stands for "Rest, Ice, Compression and Elevation." When you've got muscle aches or joint pains, these four things are best for immediate treatment. These measures can relieve pain, reduce swelling and protect damaged tissues, all of which speed healing. The only problem with RICE is that too many runners focus on the "I" while ignoring "R," "C" and "E." Ice reduces inflammation, but repeatedly icing and running without giving the tissues enough time to heal is a little like dieting every day until 6:00 p.m. and then pigging out. So it is best to stop running until the injury is better.

RICE is most effective when done immediately following an injury. If you twist your ankle or strain your hamstring, plan to take a few days off from running. Apply ice several times a day, for 10 to 15 minutes at a time. If you can, elevate the area to limit swelling. Compression can also further reduce inflammation and can provide pain relief, especially when you first return to running. An ACE bandage is the simplest way to wrap a swollen area.

Up next: Tips on speed, shoes, stride and more >>

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