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What You Need to Know about Running Injuries

Getting injured stinks. It’s also a very normal part of being a runner. In an email with Fleet Feet, “The Runner’s Mechanic,” Miriam Salloum, MPT, COMT, OCS, shares her insights on why runners get injured and what to do when you feel pain on the run. Salloum is the owner and director of the Runner’s Mechanic Physical Therapy Clinic in Asheville, North Carolina.

Injuries happen to almost everyone

Many runners think an injury is proof that they are doing something wrong. While injuries do provide valuable feedback about our training, getting hurt doesn’t mean you’re a bad runner.

Many researchers argue that injuries from time to time are just a natural part of being a runner. I completely agree,” Salloum says.

In fact, a 2015 study published in Sports Medicine showed that in large groups of runners, up to 75 percent experienced some type of running injury within a year-long training period.

Another study found recreational runners averaged 7.7 injuries per 1,000 hours of running. Novice runners averaged 33 injuries per 1,000 hours of running.

Why does this happen?


There are two basic reasons why runners get injured

Sudden changes in training

A dramatic increase in mileage or intensity are common culprits. The same goes for a drastic change in terrain. Maybe you went from flat roads to hilly mountain trails or spent your beach vacation running on slanted sand. A change of scenery can be a good thing, but be wary of extreme changes that require extra adaptation for your body.

Many coaches suggest that new runners stick to the “10 percent rule,” meaning that you increase your weekly mileage by no more than 10 percent of what you completed the previous week. If you ran 30 miles last week, you should run no more than 33 miles this week.

Insufficient recovery

After a run impacts the body, Salloum says, muscles need to repair and bones need to remodel. Bones, in particular, break down on a microscopic level and rebuild themselves to be stronger in response to the load of training. Running is excellent for your body, and the pounding helps you build stronger bones. That is, as long as you get appropriate rest and recovery. Without sufficient rest, the body breaks down. The higher the load (the more training), the more time a runner needs to recover, Salloum says.

Running with improper form or worn out shoes are common problems that put excessive stress and load on the body, slowing recovery and often leading to injury. In addition, everyone has slightly different physiology, and some runners need more recovery time than others.

Even if you have new shoes and perfect form, it’s important to schedule regular rest days into your training plan. It takes time to develop a training schedule that fits your needs. But if you generally feel fatigued and sore, chances are good that you need more rest and recovery.

Your body is constantly adapting to changes like physical and emotional stress, training load or even aging. “No variable ever remains constant,” Salloum says. “Once in a while, a hiccup occurs with our body’s ability to handle ever-changing loads, resulting in injury.”

It’s how we approach these injuries mentally and physically that makes all the difference.

What to do when you feel an injury coming on

Salloum recommends that you determine your perceived pain level while running (or after a run) on a scale from one to 10, then respond accordingly. The following are her recommendations. Check in with your own physician to learn what’s right for your body.

If the pain is mild (a four out of 10 or lower):
  • Reduce your mileage and intensity by 50 percent for a week.
  • Skip speed work until your pain subsides.
  • Use ice, massage, foam rolling and gentle stretching and strengthening as tolerated.
  • If your pain resolves, build back slowly with an approximate 10 percent increase per week. If you feel soreness the day after a run, back down again.
If the pain is more moderate to severe (a five or greater):
  • Seek treatment as soon as you can.
  • Switch to cross training and no running (aka “relative rest”) for five to seven days.
  • Opt for pain-free, non-impact or low-impact activities like walking, swimming, cycling or weightlifting, as long as they don’t exacerbate the injury.
  • Avoid plyometrics such as jump roping and burpee exercises.
  • Use ice, massage, foam rolling and gentle stretching and strengthening as tolerated during this time, or as advised by your doctor or physical therapist.
  • When you can briskly walk the distance of your typical easy run without pain, you’re ready to progress to walk/run intervals. Start with no more than 30 minutes total for your intervals. Rest for 24 hours between runs. You should not be sore afterward.

At what point am I considered injured?

Salloum offers the three following ways to know:

  • When your pain keeps you from training for a day or two. If it hurts too bad to run and a few days of relative rest doesn’t help, you likely need to seek treatment.
  • When your pain is at a level of five out of 10 or greater and it returns on your next run, despite self-treatment such as icing, foam rolling or stretching.
  • When pain alters your running form. This cycle is called a compensatory pattern. Salloum says there is a conscious or subconscious shift in the way your body accepts impact to unload painful injuries. It’s common for compensatory patterns to cause another injury and to hinder your performance. If you catch yourself compensating, stop running, switch to relative rest and seek treatment.

What’s the quickest road to recovery?

It’s hard to take down time when you’re in the habit of running regularly. But running through injury often means missing even more training down the line because you don’t give your body the recovery time it needs.

Take the time to listen to your body. Get properly fitted footwear and address any imbalances you may have in your body.

There is no better or faster way to return to healthy running than to address an injury early on, receive clear education on diagnosis and treatment, and to implement the strategies needed to prevent injury in the future.

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