Marathon Blog

Injury-proofing your training program

Injuries are a concern when running, especially as runners increase mileage or train for a race. The risk is even higher for new runners and runners training for their first race. Consider the following five steps to minimize your chances of getting hurt.

1. Build a solid foundation. Follow a professionally created program that increases your mileage slowly and methodically from your current fitness level to a level that supports your goal race distance. There are several reputable websites that have running programs (some are free and some involve ongoing coaching for a fee) that you can tailor to your needs. Alternatively, work with a certified running coach to have a customized program created just for you. They key is to follow a program that:

• Starts from your current fitness level.
• Increases your workload gradually – no more than 10 percent mileage increase per week or per session.
• Includes a slow, methodical increase of long runs to a run length consistent with goal race. For example, marathoners should ramp to a long run of 20 miles; half marathoners should ramp to a long run of 12-14 miles and 5K runners should ramp to a long run of 3-5 miles.
• Includes a slow ramp up of speed training based on current fitness level. If you are a beginner, your initial running program should contain no speed work.
• Includes runs of different length, speed, running surface/terrain and hilliness – variety is important to prevent injury.

Also, be realistic. If you are a new runner, build your running base and run regularly for at least six months before attempting your first half marathon and for a year before attempting your first marathon.

2. Be consistent. Now that you have your training plan, follow it closely. Consistency is one of the keys to preventing injury. This doesn’t mean you can’t miss a workout occasionally, but if you find yourself missing a week of runs, this can be a recipe for injury. Try to stay consistent by keeping the number of runs and miles per week close to your plan. If you miss a week, ease back into the plan (possibly by repeating the previous week in the plan and proceeding from there) or work with your running coach to get safely back on track.

3. Develop good running form. It is difficult to “force” yourself into perfect running form and it can be dangerous, especially if your muscles aren’t prepared for that method of running. However, to prevent undue force on the body, landing with each foot underneath your body – instead of in front of your body – is usually associated with lower ground forces on the body resulting in lower injury rate. The easiest way to achieve this is to shorten and quicken your stride. If you find you are an overstrider, practice shorter, quicker strides with feet landing underneath you on a regular basis.

One way to do this is to practice “quick feet” running drills which increase your cadence (the number of times your feet hit the ground per minute) and minimize the amount of time each of your feet spend on the ground. Some people call this the “hot coals” drill since running on hot coals would certainly quicken your stride and shorten your foot strike time. Try practicing this drill a few times per week by doing 30 second intervals of “quick feet” followed by 30 seconds of “normal” running and repeat five times for a total of five minutes.

4. Strength train. Running is a very repetitive sport. As a result, it creates a high probability of overuse injuries. To prevent these injuries, strengthening and mobilizing key areas of the body are important preventive measures. Focus on these areas:

• Core: Strengthen the lateral (sides) and anterior (front) core with exercises such as plank and side plank variations.
• Hips/glutes: Strengthen the legs, glutes and hip stabilizers with exercises such as lunge variations, deadlifts and glute bridge variations, along with resistance band hip abduction work (such as clams). Also, keep the hips and hamstrings mobile with key stretches for those areas.
• Ankles/calves: Strengthen the ankles and calves with exercises such as calf raises, jumping/plyometrics and banded ankle work. Also, keep the calves mobile with calf stretching. Try doing some of this foot and ankle work barefoot for added benefit. A strength training program for runners, such as RunSMART can help you work on all these areas.

5. Make pace a priority. To avoid overtraining and injury, most running should be at a slow, conversational pace. Many people overtrain on their easy days and carry fatigue into their hard runs. Make sure you keep your easy days easy, even if you are a veteran runner. Following the pacing of your running program, as well as the distances, helps keep injury at bay.

These five key steps will help you avoid injury and have a great race season. However, even when a runner follows all the rules, they can still become injured. Injury rates among runners are fairly high, primarily because running is a repetitive, high-impact sport. You may still become injured despite being careful to follow your program, eat right, get plenty of rest and strength train.

So, you’re injured. Now what?

See the doctor. First, any nagging or lingering pain needs to be properly diagnosed. A bit of soreness is normal after difficult runs, but if pain persists over a few runs, worsens when you are running, is keeping you awake or is significant in terms of intensity, it is time to seek help from a medical professional. Depending on the injury, they may do a manual exam, take X-rays and/or do other types of testing and analysis (MRI, etc.) to make a diagnosis.

Ask questions. Once you have a diagnosis from the doctor, ask some follow-up questions:

• Can I run? Chances are you will get a “no” to this question, at least for a while.
• How long do I need to stop running? At this point, the answer to this question might be unknown.
• Can I do other activities? What would those be? This is an important question, as the answer will allow you to formulate a cross-training plan to preserve your fitness.
• Do I need physical therapy? Medication? Surgery? Immobilization/casting? What treatment options do I have along those lines? Depending on the injury, there may be multiple options. Your doctor may have a recommendation but be sure to ask what all the options are and discuss the pros and cons of each.
• What are the next steps regarding medical follow-up? Make sure you make and keep any subsequent doctor’s appointments.

Follow the doctor’s plan. The doctor may prescribe medication (such as anti-inflammatories), immobilization/casting, physical therapy, meeting with a specialist, etc. Make sure you follow the agreed-upon plan.

Create a cross-training program. Based on your doctor’s recommendations about what activities are acceptable while injured, create an exercise plan. Being a runner and not being able to run can be difficult, but it is important to find exercise that you can do to preserve your fitness. This will help you return to running more efficiently once your injury is resolved. Ideally this exercise plan will include some form of cardiovascular exercise and some form of strength training. Alternative forms of cardio that your doctor might suggest could include biking, swimming, walking, elliptical trainer, etc. Strength training options from your physician will likely avoid the injured area. For example, you may need to do upper body and core strength training only for a while. It is important to maintain these muscle groups as you are recovering. You may be told to “let pain be your guide.”  In that case, be aware that the pain may manifest itself during the activity, or it may show up that night or the next day. In all of these cases, the offending activity needs to be discontinued.

Take care of your body. As you are recovering, it is important to eat nutritious foods and to get enough rest. Be careful not to overeat (out of boredom or sadness over your injury) as weight gain will compound problems down the road. Try to minimize other stresses in your life. Your cross-training program can help with minimizing stress.

Return to sport. Once your injury is resolved and you receive your doctor’s permission to resume running, you should return to running cautiously. Don’t jump back into the training load you were doing when you got hurt. Depending on the amount of time you were injured, you may need to resume with a beginner’s program. Consult your physician for advice on how aggressively to return to running. You may also want to consult a running coach or fitness professional to help you create your return-to-running program. With a good plan and a little time, you’ll get back on track.