The Three Key Focus Areas for Running Injury Prevention

Increased awareness about running injuries and how to avoid them can help reduce the rate of injury among competitive and recreational runners.

Running injuries typically include those caused by stress and strain on the legs, hips, knees, ankles, and feet. Implementing conditioning and training before running, wearing the right apparel and footwear, and increasing awareness about how to adapt to different running environments, are three key areas of prevention that can reduce the instance of injury to keep runners on the track, and out of the doctor’s office.

According to Patrick Hafner, author of Injury Afoot: 30 Things You Can Do to Relieve Heel Pain and Speed Healing of Plantar Fasciitis, the two most common running injuries are plantar fasciitis and Achilles tendonitis. The repetitive motion of the legs and feet causes these injuries as they work to propel the body forward as you run.

“When the body is injured, it’s eager to heal itself,” Hafner said in a press release. “With a condition like plantar fasciitis, the body’s healing process basically needs as many odds as possible stacked in its favor, and it will take care of the rest.” Like Hafner, the American Academy of Orthopedic Surgeons (AAOS) has several tips for how to avoid injuries, like plantar fasciitis, centered on the three key areas of prevention.

Conditioning and Training
The AAOS advises runners to develop a running program that progressively becomes more intense. Warm-up exercises, lasting approximately five minutes, and stretching exercises are essential before running to get the muscles ready to move. According to Hafner, this is especially true if you plan to run outdoors during the cooler months.

“It takes longer for a runner or other exerciser to warm up, and the resulting stiff muscles and joints can cause additional strain on the connective tissue in the ankle, heel and foot,” Hafner said in a press release. “This can contribute to the incidence of plantar fasciitis or Achilles tendinitis occurring.”

Runners should also stretch following a run to prevent microtears, small tears in the muscles of the legs caused by strain. Hydration before, and after a workout is an essential preventative measure. According to the AAOS, the average runner loses between six and 12 ounces of fluid (sweat) for every 20 minutes of running. Runners should weight themselves before and after a run, for every pound lost a runner should drink one pint of fluid to replenish what the body lost from exercising.

Apparel and Footwear
Good running shoes will feature shock absorption and will provide stability and cushioning for the foot. Up to 60% of a shoe’s build-in shock absorption is lost after 250-500 miles of use, so a runner who averages 10 miles per week, should replace their shoes every nine to 12 months.
The AAOS recommends that there is a thumbnail’s width between the end of a runner’s longest toe and the end of the shoe. Running shoes should be purchased at the end of the day when the foot is at its largest.

There is a wide range of options when it comes to running clothes and apparel. Excessive clothing can stimulate the body to produce excess sweat, which cools the body rapidly and causes a loss of fluids. Instead, runners should dress in layers so they can remove pieces of clothing as their temperature fluctuates.

The innermost layer of clothing should be made of material that is designed to draw perspiration away from the skin. The middle layer (which is not necessary for the legs) should be made of cotton to provide insulation and absorb moisture. The outermost layer of clothing should be made of courser material protect against the elements like wind and rain.

Running Environment
The AAOS and Hafner both state that it is important for a runner to be familiar with the environment in which they run. If you run outside when it is cold, you are less likely to feel chilled if you run into the wind when you start running and run with the wind as you finish. Cooler weather can also be accompanied by lower humidity, which can let runners run faster and further than they would during hot, humid months.

Hafner advises that runners should know their limits and not be tempted to push themselves harder than they can go. “The long, fast runs are where proper flexibility and stability really become key,” says Hafner.

In hot climates runners should choose a path that is in the shade if possible, and avoid direct contact with the sun or blacktop. If the sun is unavoidable, runners should remember to wear sunscreen with an SPF of at least 15, and consider sunglasses and/or a hat. When it is hot, athletes should try to schedule their run for the early morning or evening to avoid the mid-day sun and the possibility of heat exhaustion or a heatstroke. The AAOS also advises that at high altitudes runners should gradually acclimate themselves to the oxygen level by slowly and steadily increasing their speed and distance.

Other safe running practices include running with a partner, carrying identification, and writing your name, phone number, blood type, and any important medical information on the inside sole of your running shoe in case of an accident. Someone should always know where you run, and you should stick to familiar areas that are away from traffic. Runners should choose a path that is smooth and resilient without a lot of cracks or potholes. Runners should also avoid hills because running on a slanted plane increases stress on the ankle and foot.

Considering the key three areas of running injury prevention, conditions and training, apparel, and environment can help reduce the incidence of running-related injuries.
-Erin Podolak


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