Manage Running Injuries

By Dr. W. Scott Black for Mind & Body

Running is one of the most popular physical activities in the United States. It has many health benefits, including improvements in heart and lung function, stronger bones, and better mobility. It can also improve our mood and cognitive function. No special skill is needed so people of all ages and abilities can enjoy its multiple benefits. 

However, there is one thorn among all those roses. Runners are commonly injured. Most estimates suggest that 65 – 80% of runners have at least one injury yearly. Most injuries are not serious, and many do not require a runner to stop exercising to recover fully. Learning how to manage running injuries can contribute to a lifetime of enjoyment from the activity and minimize or even prevent time on the sidelines.

The best thing we can do is avoid getting injured in the first place. The saying "an ounce of prevention is worth a pound of cure" is never more appropriate. Most running injuries are overuse injuries and often result from an error in our training. Here are three tips to improve training and reduce the chances of injury.

Train Carefully.  Understand that overuse injuries are usually caused by trying to do too much, doing it too fast, or doing it too soon. Times of transition are especially high-risk times. For example, people transitioning from walking to running are often injured within the first few weeks. Competitive runners stepping up in competition by moving from high school to college are also particularly prone to injury. Recognize this and plan those transitions accordingly.

New runners should make sure they can walk before they run. Being able to walk at about 4 MPH is a great first step. At that speed, we can cover one mile in fifteen minutes. It is a good idea to work up to walking 2 – 4 miles in 30 – 60 minutes four or more days per week for at least six weeks before trying to run. After that, make the change gradually by including short bouts of easy running in the walks. Break the walk into 10-minute intervals and start by walking for nine minutes and running one. Each week, subtract one minute of walking and add one minute of running to each interval. The walk/run progression will look like this: 9/1, 8/2, 7/3, etc. Progression should only happen when ready, and we should never hesitate to hold for several weeks at a particular level if needed.

Competitive runners should be equally careful when stepping up in distance or competition. Increases in volume and intensity of training should be made slowly and methodically. 

Train Mindfully.  Being mindful means being aware of the present. This includes paying attention to how we feel before, during, and after a run. If we come into a run overly tired or sore, maybe it is best to walk, cross–train, or even take the day off. If something hurts during a run, make a mental note and spend a little extra time working on the sore body part during the cool-down. Some extra stretching or a little massage might take care of things right then. If pain persists after a run, especially if it is still present the next day, consider walking, cross–training, or taking a few days off to let things heal.

Appreciate the Power of Recovery. Physical and mental recovery is extremely important and is probably the most undervalued aspect of training by most athletes. Endurance is built, and speed is created during recovery. By intention, training produces physical and mental stress on the body. Our bodies, in turn, respond to that stress by becoming stronger and more resistant to future similar stresses. However, this only works if we give our bodies the chance to recover. At some point, inadequate recovery will result in either poor performance or an injury. Make recovery weeks a regular part of the training plan. New runners or, more frequently – injured competitive runners can make every third week of their training plan a recovery week. During that week, the training load can be reduced by 25 – 50%, and more time can be spent on other activities like walking or easy cross–training. Even advanced runners can benefit by taking a recovery week every four to six weeks. Finally, we can’t fully recover if we’re not sleeping. Adults need about 7 hours of restorative sleep each night, and teenagers require even more. Try to get at least this much sleep regularly.     

W. Scott Black, MD, is a primary care sports medicine physician with Owensboro Health Medical Group Lifestyle and Sports Medicine.