As a physical therapist whose patient base includes about 75% running athletes, I commonly see training patterns that lead to injury. Most of the time, these running injuries are self-inflicted due to a person’s desire to reach new goals, try new gear, or change their form based on advice from a magazine or YouTube. Here are the top five reasons why runners get injured and have to see a physical therapist, and my recommendations to avoid injury:
- Sporadic mileage without clear planning or goals. Running injury prevention doesn’t have a clear cut answer even though it has been widely studied. One theory says that runners who increase their mileage by more than 10 percent per week have a higher incidence of injury. Another theory says that runners who run one long run with a total mileage that’s greater than their total mileage per week also have a higher incidence of injury (hello marathon training!). Neither of these theories have been proven in all cases. My advice would be to follow a good training plan, and map out your mileage periodization from the first week of training to race day. Your running mileage doesn’t need to focus towards racing, but it should be planned and recorded.
- Not enough recovery time. All too often, I have heard patients say: “I recently ran [insert race mileage], but I didn’t PR or qualify so I assumed I was already trained for [the same race mileage], and so I ran it again two weeks later.” Sometimes race day blues happen and you won’t perform your best, but remember that all races need a deloading phase in training for proper recovery. Pushing this is playing with fire.
- Poor nutrition. It’s no secret that running burns a lot of calories and requires energy storage through a healthy diet that includes all your common basic food groups─especially carbohydrates. You cannot only survive on supplements! I encourage my patients to discuss nutrition planning with a nutritionist to match your mileage volume and BMI. Stress fractures are common due to improper diet. The Female Athlete Triad (caused by energy deficiency) is real and can have severe, detrimental effects later in life. A physical therapist can refer you to someone he or she trusts to address this.
- Lack of run training variation. Varying speed and running hills increases muscle activity in the posterior chain (such as the glutes or hamstrings) and increases the demand on the core. This is all very good for distance runners. Tempo runs, Fartlek (continuous training combined with interval training), or varied interval training are all beneficial for varied race distances, even marathons! It’s important to incorporate this into your training even if your race is flat.
- Not maintaining your body’s soft tissue. All too often, runners come to me saying they don’t warm up properly, cool down properly, and don’t see anyone for soft tissue treatments regularly. Keep in mind that professional athletes get consistent care for their bodies on a daily basis, and I would argue that if you are training for a marathon, the stress on your body is similar to what a professional athlete endures. Make sure to warm up before you run, whether it’s an active warm-up or running drills, and cool down with jogging or stretching.
Runners typically come to us after an injury has occurred, but preventative visits can ensure you aren’t experiencing imbalances that lead to muscle tension or loss in range of motion. Visiting someone you trust on a quarterly basis can detect faulty mechanics early on and keep you running at peak performance!
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