How to Run Injury-Free
By Peter Poon, PT
Now that summer is in full swing, many of us will want to enjoy the sunshine by going for a casual jog or more vigorous run around the neighbourhood. Some may think running is not an exact science: just pick up a pair of (brightly-coloured) running shoes and…go. However, poor running form can lead to injuries down the road, much like how riding a bike with misaligned wheels will eventually wear down the bike and the rider. It has been estimated that between 4 – 18% of individuals have some kind of running injury at any given time. Common injuries such as patellar tendinopathy, tibialis posterior tendinopathy, tibial stress syndrome (shin splints) and achilles tendinopathy are usually due to improper loading during lower body exercises and may not yet be impacting you enough to seek out a physiotherapist.
Can technique be resulting in painful runs?
If you have been experiencing pain either during or after a run, ask yourself the following:
- Where is my pain? What does it feel like?
- I am in pain during my run. Does it go away quickly (with rest) or does it linger for days?
- I am in pain after my run. How long after does the pain start?
The above are all plausible signs that your body is not agreeing with your running routine. When your body experiences pain, it is generally a sign that it cannot cope with the stresses from that activity. You can reduce your risk of ending up with severe injuries if you identify subtle movements or habits that could lead to injuries and develop a proactive long-term injury-prevention strategy. During an assessment, physiotherapists can identify these factors and prescribe individualized exercises and tips to get you moving efficiently.
Could previous injuries be causing me running pain?
Imagine you have just sprained your ankle, instead of walking with a heel-toe pattern, your body compensates by doing a stutter step. Compensations are one of your body’s natural defense mechanism. Short term compensations are necessary to keep you moving with less pain. However not all compensations are ideal; in the previous example, walking with a stutter step will lead to decrease use of your calf and hip muscles to propel you forward. If left unchecked, it will lead to future muscle imbalances which could affect your running form. Even though you may feel no pain from your previous injuries, you could have developed subtle compensations, which could have abolished the pain but only “band-aid” the problem. During a gait assessment, physiotherapists can identify these changes and give you specific advice to keep you running on all cylinders.
Am I a heel, midfoot or forefoot striker (am I pounding away at the pavement or landing light as a feather)?
Different landing patterns will create different stresses on your foot and body; some patterns are better at absorbing shock than others and some can lead you susceptible to injury.
Am I taking laboured or big strides?
Taking laboured or big strides is an inefficient method to run or to run faster. This is due to a greater energy loss from lifting your leg (versus shorter strides) which decreases forward propulsion. Not surprisingly, big strides will increase impact on your feet when you land. While it may be okay for some sprinters, imagine the impact on your feet if you were to repeat this for 5-10km. Physiotherapists can easily identify this fault and give you specific tips to help improve your efficiency.
Did I suddenly change or increase the volume (time, distance or # of runs per week) or intensity of my run?
Sudden increase in volume of training is a catalyst for sprains and strains. Daily to weekly adjustments of the applied mechanical stress (either volume, or intensity) is the best way to avoid injury.
Calluses or getting black toes can be a sign of inappropriate shoes
The fit of the shoe is essential to stay injury free. Shoes that are too small or too narrow could lead to unwanted bunions and black toes.
Am I running the same circles in a track or same route every time? Do I run on different types of surfaces?
Not only does cross training on irregular surfaces or trails keep your muscles guessing, but it also helps improve balance and adds variety to your workout. The variation will increase strength and endurance in your foot and ankle muscles, which leads to less repetitive strains in the future.
A few final thoughts on Running
These are all valid questions to consider whether you are just picking up running, coming back from an injury or wanting to stay injury-free. A running gait assessment by a physiotherapist can help you with answers to the above questions. Not only do we conduct an interview at the beginning to find out your running routine, we look at your running form from head-to-toe to identify possible areas that needs to be addressed. With this information, physiotherapists can assist runners in developing individualized long term solutions to stay running injury free.
As always, contact us if you need any tips or advice.
Family Physiotherapy serving the residents of Thornhill, Markham and Vaughan
The physiotherapists at Family Physiotherapy have been providing high quality assessment and treatment techniques using safe and evidence based techniques to the residents of Thornhill, Markham, Richmond Hill, Woodbridge, Vaughan and Toronto. Our therapists are continually upgrading their skills and take the time to provide you with the one on one care necessary to quickly get you back to the activities you love doing.
Peter Poon is a registered physiotherapist at Family Physiotherapy.
 Lopes A, Hespanhol JLC, Yeung SS, Costa LO. What are the main running-related musculoskeletal injuries? A systematic review. Sports Med. 2012; 42(10): 891-905