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March to June 2007 – Spring is just around the corner and with the warmer temperatures you will no doubt be tempted to get out and join the many runners who have been braving the elements all winter. If you already have been running through the winter, the temptation is always to double up on the mileage as the nice weather descends upon us.
There are many factors that can contribute to running injuries. Not necessarily in any order of importance, here are some of the most common factors that can lead to running injuries:
 Volume and Speed
Running Form
Body Alignment
Shoes
Flexibility
Strength
Running Surface
This article will discuss the first two factors and the remainder will be covered in subsequent articles.
Of the two, the number of miles you run will definitely influence your risk of developing injuries more than your running speed. Research has shown that running too far too soon is the number cause of running injuries. Your body has to be prepared to withstand the stresses of pounding the pavement. The big question is: How much is too much?
There is no simple formula to help in determining how far you should run when you start. It depends on your fitness, age, weight and whether or not you have done some running activities in the recent past. Generally you can run slowly, half the distance that you can walk at a brisk pace. You can increase the distance you run if you intersperse your run with brief periods of walking. If you are really out of shape and an inefficient runner than you should start out by including brief periods of running in your walk and over a period of weeks slowly introduce more running into your walks until you can run non stop for longer periods of time. If you are able to run more comfortably and cover more than 2 or 3 K then you should only increase your mileage by 10% per week. It is wise to take rest days during the week.
For the beginner it may mean not running at all for a day or two in between your run days. For experienced runners it may mean cutting back on mileage the day after a longer or harder workout. Another effective strategy, especially when you are preparing for a race is to run hard for three weeks and then cut back your mileage by 50% on the fourth week. This is especially effective when your race is at the end of that fourth week. Another important activity for runners is cross-training. It involves participating in another aerobic activity other than running. It can be a very effective tool to keep you fit without beating up your legs. In some cases the cross-training can strengthen your body to help you prevent injuries.
In most sports beginners are given advice and have coaches that help them with the mechanics of their activity. In running we just hand people running shoes and tell them to go out and run. Your running form will not only dictate your performance but also help you avoid running injuries. Like in any other sport one can make dramatic changes in one’s technique.
First of all you need to know or see what you are doing and then have a coach point out your flaws and show you how to correct them. You then have to practice these changes and voila, you can change from a hippopotamus to a gazelle. The number one flaw that I have found in my years of analysing running form is over-striding or simply runners spend too long with their feet on the ground because their stride rate is too slow. Your stride rate should be 90 beats per minute for each foot. It doesn’t matter if you are 7 feet or 4 feet tall or you are running a 100 metre dash or a marathon, each foot should hit the ground 90 times per minute. The faster you run the longer your stride will be.
To check your stride rate, use your stop watch and count how many steps you take in 30 seconds with the same foot and multiply that number by two to get your stride rate per minute. People with a slower stride rate tend to land more on their heels creating a braking force when their foot hits the ground and tend to hop from one foot to the other wasting energy by creating excessive vertical displacement.
People tend to run more efficiently when they are sprinting and guess what, they don’t sprint running heel-toe. Another interesting observation is that when we run in our bare feet, we also tend to run more on our fore-foot or our toes. The reason is that we get a bit lazy and the nicely cushioned shoes save our heels from the pounding. If you observe fast runners, the first thing you notice is that they are smooth. If you counted their stride rate is likely 90 steps per minute for each foot and they are quiet when they run. Their arms are carried at their sides in a comfortable position and their body and leg positions facilitate their efficient forward progression.
A good way to assess your running form is to watch yourself run in front of a mirror. Another way is to run with someone who you feel is a fairly efficient runner and compare your shadows on the road. The inefficient runner first of all will be noisier and also the shadow will reveal inefficient side to side or up and down bobbing movements. There are many drills and exercises that can help your improve your running form. Focus on your posture, even when you are tired. At the end of your run do a few strides which are short faster runs or approximately 100 metres at 50 to 75% of your sprinting speed. Running uphill will also encourage you to run more on your toes and to shorten your stride.
Like any machine, the human body will function best when it’s parts are properly aligned in order to perform the desired task. In the case of running we need to resist the stresses of gravity as you propel yourself forward. Doing so in an economical fashion requires proper functioning of the whole body’s musculoskeletal system:
the lower body has to deal with the ground reaction forces when your feet hit the ground and when you push off to propel you forward.
the upper body helps to keep your body properly positioned and balanced.
the major joints in the feet, the ankles, the knees, the hips and the lower back must all work in unison and have an optimal range of motion to function in order to prevent injuries.
It’s important to realize that nobody is created perfectly – no person has identical foot alignment. In most people one foot is bigger than the other and 60% of people have a leg-length inequality. The major issue with foot alignment is whether you have over-pronated feet (when your feet turn in too much causing your foot to flatten out) or whether you have over-supinated feet (high-arched feet). Both of these alignment problems will put extra stress on your feet, legs, and back and eventually will not only slow you down, but will cause injuries as well.These problems usually require a change in shoes or special shoe inserts (orthotics) to help realign the feet.
Your lower leg and knee alignment is also important. Individuals who are valgus (knocked-kneed) or varus (bow-legged), can have altered mechanics of the foot, knees, and hips and should make an attempt at correcting this problem. Unfortunately it is not that easy. You really can’t straighten out a crooked bone unless you operate on it, so the best you can do is minimize the effect that it has on you in the same way as you straighten out altered foot mechanics, with shoes and orthotics.
You can also minimize the effect of abnormal lower leg alignment with exercises to strengthen your quadriceps muscles and, in some cases, with braces. Altered hip alignment may be congenital in which case you can’t straighten it out but only minimize its effect, again with specific shoes and orthotics. In some cases the hip alignment is the result of muscle imbalances and can be corrected through exercise. Leg-length inequalities can be corrected with the use of heel lifts or orthotics. Pelvic and lower back alignment issues can be corrected with spinal or pelvic manipulation or mobilization techniques or with exercises.
Most people run on hard surfaces and land on their heels first when contacting the ground. For these people, a modern technical shoe will make their running more enjoyable and safer. The first thing you need to know is your foot type and your foot shape.
Foot types include: neutral foot, over-pronated foot and over-supinated foot. Shoe companies have made shoes to suit these foot types:
For the neutral foot and the over-supinated foot, you have neutral shoes.
For the over-pronated foot you have stability shoes for the moderate over-pronators and motion control shoes for the more severe over-pronators.
Your foot shape will help to determine which style of shoe you should get:
The shoe shape should match your foot shape. Shoes can have a straight last (shape), a semi-curved last, or a curved last.
There are many other features in the shoe that can help to make your run much more comfortable.
The width of the heel and the toe box should match your feet. Women for instance tend to have a narrow heel and a wide forefoot. Only a few companies make shoes with these features.
Companies use different materials and designs in their shoes which help to cushion your foot plant, give you more flexibility and responsiveness on push-off. There is not one shoe that is better than others because every foot is different.
You should find out from your health practitioner, who is knowledgeable in this area, what your needs are and then go to a running shoe store where trained staff are on hand to assist you:
It’s advisable to buy your shoes later in the day when your feet have had a chance to spread out a bit.
You should always try on a few pairs of shoes before deciding on the ones you will purchase.
You will always be the best chooser when it comes to shoes.
Don’t look at the colour, don’t look at the price and forget what everybody told you to get.
You should always choose the shoe that “feels” the best on your feet. If you have orthotics then try them on in the shoes.
If you have wide or narrow feet, some companies will offer their shoes in different widths – just ask the salesperson. You may have to order it and wait a few weeks but it will be worth it.
You should also be aware that shoe companies will change their models and what used to suit you may not any longer. Your needs may also change so when you go back to get a new pair of shoes by all means try on the previous model but you should also try on new ones to make sure that you are getting the best model for your needs. It is also wise to own more than one pair of shoes and rotate them when you run – this is especially true if you get your shoes wet.
Shoes are like cars – their value diminishes as soon as you start to use them. Your shoes may still look good but the shock absorption qualities of the shoes may have diminished drastically. Shoes will wear out at different speeds depending on the runner but on average should be replaced between 300 to 600 miles (500 to 1000 km).
Strength prepares you for the job of resisting the effects of gravity when your foot hits the ground and flexibility allows you to position your body in the most appropriate position so that your muscles can propel you forward.
In the past there probably has been more emphasis placed on stretching with running injuries than there has with strengthening exercises. I suspect that this has occurred because with most injuries, muscles tighten up, which are painful and stiff, and stretching provides some relief. Research has shown that stretching before a run doesn’t necessarily
prevent injury from occurring. However, we have been taught that warming up improves our performance and prevents injury, so why doesn't it?
Stretching and warming up are not synonymous. Warming up involves increasing the temperature of the tissues which are going to be exercised (mostly muscle) and this is done with movement to bring more blood into the tissues.
Stretching merely helps to lengthen the tissues. In some cases when you try to lengthen an injured or very stiff tissue, you will irritate it and cause further pain and restriction – note, some of the soft tissues are more stretchable than others. The muscle tissue proper (contractile tissue) can be lengthened more easily than the tendons and ligaments or even the fascia which holds the muscle fibres and muscle bundles together.
There are many different types of stretching exercises and they all work for different reasons. It’s important to know which tissue you need to lengthen and that will dictate what kind of exercise you should perform. Recent research has shown that muscle tissue responds better to gradual static stretch, whereas fascia, tendons and ligaments respond better to active stretching which involves repeated movement gradually and gently stretching the soft tissues.
Strengthening, on the other hand, is often the last thing on a runner’s mind. The truth is, studies have shown that strengthening the running specific muscles reduces fatigue and injuries in those muscles which means that they won’t be as stiff requiring continual stretching and massage therapy. When we run for long distances, we tend to stiffen up more – muscles fatigue from the repetitive muscle action. If the muscles were stronger they wouldn’t fatigue, nor would they result in stiffening up.
For the average runner the muscles that tend to weaken most regularly are the gluteal and hamstring muscles. Of course if you want to run fast, the propulsive muscles need to be strengthened. It is also important to work on core strength. The strength required for running is muscle endurance. In order to achieve this you need to do a lot of repetitions with lower weights.
Always do both stretching and strengthening exercises but, depending on your situation, you may need to do one more than the other. An easy way to tell if you need to focus on stretching or strengthening is by analysing the onset of pain when you run.
If you are stiff and sore when you start to run and loosen up after a bit of running, then you need to stretch before and after you run.
If the pain comes on towards the end of a long run, it is the result of fatigue and you need to do more strengthening exercises.
Another way to look at it is to realize that stretching helps you after you have developed an injury and are stiffening up, strengthening helps to keep you out of trouble by keeping you strong and healthy so that you don’t become injured and stiffen up so you won’t need to stretch as much.
If you are injured, you should stretch as often as you can – the more the better, providing you aren’t overstretching (you know you’re overstretching if it hurts during or after stretching). If you aren’t injured, then work on the areas that aren’t as flexible and do your stretches once daily. As far as strengthening is concerned, you need to be on your game all the time.
In order to maintain adequate strength you need to workout four to five times per week. Your workouts should be organized so that you can gradually increase the resistance and variety of exercises so that you can be motivated to continue and that you are gradually increasing your strength. Of course there will come a time when no further improvement is possible. At that point you should continue to workout so that you can maintain your gains as long as possible.
You should do stretching exercises daily and strengthening exercises at least three times per week for maintenance. De-training will start to take place after a two week lay-off.
As mentioned previously, the more the exercise mimics the running action, the better. When it comes to stretching it makes sense to spend most of your time on the muscles that either are tight or that tend to tighten up on you. These usually include the muscles on the bottom of your feet (plantar muscles), your calves, hamstrings, and gluteal muscles. Active stretches are very good for runners.
Some of the more specific exercises in this class include:
The standing leg cycle action. This involves standing on one leg while the other leg completes a cycling action by bring the knee up to waist height, stretching the leg forwards reaching out as far as possible forwards with your foot and then pulling the foot back as far as possible and finishing the cycle by pulling your heel up to your buttock and start the cycle over again. Try to repeat one cycle per second and do 30 per leg. Eventually you can perform two or three sets of these. This exercise works the hamstrings, gluteals, thigh muscles and hip flexors.
Another very effective active stretch is the Duck Walk. This involves walking while keeping your heels on the ground as long as possible and flexing your knees. It looks a bit like Groucho Marx’s famous walking style. This helps to stretch and strengthen your calves and plantar muscles as well as your thigh muscles.
Yoga style exercises are also very effective and relatively safe exercises to perform. The same principle of specificity applies for strengthening exercises. It is therefore best to do your strengthening exercises while you are standing.
Squats, either two legged or better still on one leg are excellent. Make sure you keep your feet flat on the floor which helps to reduce the stress on your knees. The one legged squat increases your strength and helps to improve your balance and core strength.
Lunges are very effective and graduating to lunge walking is especially effective.
Bench step-ups are also excellent for strengthening your running muscles and core strength. Any exercise that is meant to improve core strength is beneficial to runners.
As mentioned previously, you want to do more reps to improve muscle endurance and strength so work up to sets of thirty reps and eventually do two to three sets.
Article by Dr. John DeFinney for SayItCornell.com
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