How to run happily ever after....
Around 50% of runners will get injured at some point. With it being such a simple sport you would think runners are at less risk of issues but unfortunately it remains a high risk sport for injuries. Having said that there are simple steps you can take to prevent problems arising.
I do not claim to be a 'good' runner but I have done 7 marathons in the last 6 years and I have not been held back by injuries. This I put largely down to being sensible with training, I knew I wanted to do the London marathon someday so I built up from 0 to 5K then 10, 1/2 and full marathon distance over 2 years. If you have a good baseline fitness level it might not take you that long but for me I needed the build up time.
Some people are just lucky biomechanically, when patients wonder 'why me?' when they see runners with awful form, I liken it to smoking. Some people can get away with it but the majority of us would end up with all sorts of medical issues if we smoked 20 a day. So assuming you are not in the naturally can run 30-40miles a week with no issues group let's explore the answers to this question..
Surprise surprise my first answer is going to be strength training to be able to run pain free. As I said, running is a very one dimensional activity so you need to make sure your muscles can tolerate the repeated loads. So many runners that end up seeing me have no strength training in their routine. Mostly this is due to time constraints and the thought that running has to be prioritised over everything else. In reality runners need to fit in at least one strength session a week if not two even when marathon training to be able to maintain and improve strength. The sorts of strength exercises that are useful are:
Lunges - walking, forwards, backwards, lateral
High step ups with weights
Single leg sit to stands/pistol squats
Dead lifts/single leg dead lifts
Depending on your goal with running you'll need to tailor your sets and reps to the event. For example if you are training for a marathon you will need to include some endurance sets with reps over 15 compared to training for 5K runs where you'll need more speed based strength work.
Watch your load...
The second part to my answer is monitoring your load. This really is the key to preventing any injury. If your load exceeds your body's capacity then you will break down.
This is where the strength training provides the buffer to changes in load. If you are only just strong enough to tolerate running 12miles a week, if you start to run 14miles a week you are likely to run into trouble. However if you are way stronger than you need to be to run 12 miles then running 14 won't be such a problem.
A general rule of thumb when increasing your training is to add 10% per week but even this can be too much so it's tailoring it to you. It's also remembering that load does not just refer to mileage, if you change your trainers or your running terrain for example these will need to be introduced gradually to give your body time to adapt.
Including plyometric (jump) training in your routine is a good way to make you a more efficient runner. By being more springy your impact as you hit the ground is decreased which can protect your joints from injuries. The ideal step rate often quoted is 180 steps per minute. This is quite quick if you are running at an easy pace but it is something to monitor and work towards if yours is under 165. You can use free apps such as metro timer if you want to be bored to death listening to a set beat or you can listen to songs that have the pace you're looking for. Spotify even has playlists set to 180 beats per minute to help guide you.
The type of exercises you could include are:
Step taps at desired cadence
A,B,C,Ds (running drills)
People often think stretching is the main thing that prevents running injuries. The research is fairly mixed on whether you can change the length of a muscle by stretching and what impact it has on injuries. There are even some studies implying it can increase the risk of injuries! That being said, with running being very one dimensional I still recommend stretching of the key muscle groups to my clients. Static stretches should be done after exercise when you are already warm and dynamic stretches (high knees, butt kicks, kick walks) can be done beforehand. Foam rollers are another good way to keep on top of tight spots particularly in the iliotibial band (ITB), quadriceps and calves.
Find the shoe that fits...
A brief word on running shoes as it's such a hot topic. As a physio footwear is not my specialism however from experience the shoe that is the most comfortable is the best one! It sounds stupid but if you have a trainer that you get on well with and have had no issues it's likely to be suiting your feet and running style well. It's worth paying attention to the design of the shoes i.e. are they built for heavy, over-pronating runners or very lightweight for races. If you are training for a marathon, shoes like Nike Frees are unlikely to be supportive enough. There is a good argument for barefoot running being the most economical, therefore suggesting shoes closest to barefoot are best. However given that most of us have been raised in and have adapted to shoes, transitioning to 'barefoot' trainers can be a big ask and needs to be done very slowly to avoid foot and calf injuries. I like the shoe shops that let you try trainers out and that offer some guidance on styles but take their input with a pinch of salt as they are generally not trained in biomechanics so will be quite limited in their approach.
Running is a fantastic exercise and it's something I am very passionate about. To run injury free is definitely achievable but it requires you to train smart and be disciplined in including strength and plyometric work when all you want to do is run! The beauty of including strength training in your routine not only makes you less prone to injuries but will make you a more efficient and potentially faster runner so it really is a win win.
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