Running Injuries and How to Avoid Them

The daily anticipation of being the first one to trot down the dark lane, to breathe the cool air before the sun turns the desert into an inferno, and to witness the red-gold glow of sunrise spurs me out of bed for over 25 years.  How have I been able to stay injury free for most of those years?  How can you avoid running injuries as you set and reach your goals for the next 3 K race or marathon? Whether you run for fitness and fun or are a fierce competitor, there are a few things one should know before heading for the track or the road.

Almost without exception, running injuries are from overuse, overtraining, shoddy footwear and body mechanics faults.  Many runners are eager to get in shape quickly and improve their time or distance dramatically.  This is a beginner’s mistake.  Seasoned runners who love the sport can mistakenly believe that they are immune to such errors. I knew one running addict that daily climbed a chain link fence to get into the local high school track to run 3 miles before his school day began.  When he slipped and sprained his ankle, he ran the three miles anyway! Even though pain jabbed him like the repetitive thrust of a knife, he hobbled along in anger, with the running injury demon conjuring up weeks of rehabilitation in his mind.  Of course, his decision to “run through the pain” increased both the severity of his injury and the length of his recovery.  Knowing the types of injuries common to runners and their causes can help both beginners and experts avoid the couch.

The most common runners’ injuries are:

  1.  Ankle sprain—torn ligaments when the foot suddenly twists while still weight-bearing.  Swelling, discoloration, ankle immobility, and severe pain results. Causes:  Uneven running surface or sudden shift in weight, such as stepping on a rock or into a pothole in dim lighting.
  2. Plantar fasciitis—degeneration of the fibers in the fascia covering the bottom of the foot.
    Causes:  high or low arches, over pronation or rolling in of the foot, excessive running or jumping in poor footwear.
  3. Achilles tendonitis—irritation or tears in the Achilles tendon that attaches at the heel.  A sharp pain located at the back of the heel or up the tendon.  Either acute or chronic, it is very slow to heal. Causes:  Too fast, too soon increases in speed, incline, or distance; the stress of running up hills.   Change of footwear.  Shortened calf muscles caused by wearing high heels frequently, then when running shoes are worn; it causes an unusual stretch.  Weak calf muscles also contribute.
  4. Runner’s knee–Iliotibial band is a wide fascia that inserts below the knee. If it tightens, it rubs again the outside edge of the knee causing inflammation and swelling. Causes: Naturally wide or tight IT band or weak gluteal muscles. Excessive downhill running, overuse, over-pronation or uneven leg length are other causes.
  5. Shin Splints—Inflammation of the sheath surrounding the lower tibia. Causes:  Body motion errors such as landing wrong on the foot—over-pronating or over-supinating, running on hard surfaces, increasing training too quickly or wearing inadequate shoes.
  6. Stress Fractures—Hairline fractures of the leg or feet bones.  Causes:  Overuse, over fatigue, changes of surface during training bouts—grass to pavement, track to dirt, etc.
  7. Patellofemoral pain—gradual increasing pain behind the kneecap. Causes:  narrow kneecaps that don’t track smoothly, weak quadriceps muscles, overuse.  (,, 3/10/12)

As overuse is the most common cause for running injuries, the first goal for every runner should be to create a moderate training program. recommends that “training should be increased by 10% a week” to avoid injury. (3/10/12)  If an injury happens, the treatment is RICE—Rest, Ice (first 24 hrs), Compression, Elevation.  Work out in a pool or on an elliptical while healing.

There are some things can be changed and others cannot.  External factors like shoes, running surface, lighting, warm-up/cool-down, and core strength can be modified easily.

Choose a shoe that laces up, has good traction, and excellent support.  Use insoles or orthotics for extra support.

A soft, even running surface and adequate lighting are optimal for protecting you from problems.  If you must run on pavement, avoid concrete, and wear insoles or orthotics in your shoes for extra cushioning.

Warming up before running and cooling down afterwards with a few stretches and/or walking a lap is a proven preventative measure.  Do not over-stretch.  Four of my favorites are:

  1.  Place your legs shoulder width apart, bend knees slightly and roll down to touch your toes; hold on 5 secs and straighten your knees.  Bend and straighten 3 times, roll back to standing.  Stretches the back, spine, and hamstrings.
  2. Quadriceps stretch:  Bend your knee, grasp your foot with your hand behind you and gently pull.  Relax the quads.  Release.
  3. Calf Stretch–Stand with one foot in front of the other.  Bend the front leg; keep the back leg straight, heel into the floor 10 seconds. Alternate.
  4. Stand on one leg, bend the knee and relax the foot of the lifted leg. Roll foot out 3 times and in three times.  Repeat on the other foot. Roll shoulders, shake arms and you are ready to run!

Proper nutrition is essential.  Enjoy whole grains, fruits and veggies and lean meats daily.  Drink 8 oz. water every 20 minutes during a run to stay hydrated.

Lastly, proper bone alignment through good posture and strong muscles is one of the most important aspects of a healthy runner’s body.  Although your bone structure cannot change, powerful muscles help you use your body correctly.  Keep your core strong through abdominal exercises, strength or dance training.  Age is another intrinsic factor that affects running injuries.  Listen to your unique body rhythms; learn how it works; its strengths and weaknesses.  Be wise and run well for years.