By Brett Cohen

 

June is Injury Prevention Month for runners, so as someone who has developed a program specifically designed for that purpose I decided to write an article on the topic I’m so passionate about. This article is a very abbreviated version of my upcoming book called; Ready to Run, Every Runner’s Guide to Staying on the Road and out of Rehab, and is reflective of the principles I currently use in my Ready to Run conditioning program. The Ready to Run program takes a pro-active approach to injury reduction using a holistic approach to fitness, wellness and conditioning. Whether you run to get fit, get fast, or just have fun-these principles will help guide you every step of the way.

Introduction

First, let me start off by saying I, nor anyone else can ‘prevent’ running injuries. Prevent literally means: to keep from happening or existing. The only way to prevent running injuries is to not run at all. But what I can guarantee you is that if you follow the principles outlined in this article you can dramatically reduce your injury risk potential and spend more time on the roads and less time in rehab.

 

1) Understand Your Risk (Know Before You Go)

I have read a lot of articles on preventing running injuries. And many of the suggestions I will make are made by other authors as well. But I have yet to read an article that suggests anyone considering taking up running get a physical screen to see what their individual injury risk potential is prior to beginning a running program. NEVER.

According to the CDC, prostate cancer is the most common cancer amongst men in the United States, according to 2009 numbers. About 1 man in 6 (16%) will be diagnosed with prostate cancer during his lifetime.

According to the American Cancer Society, breast cancer is the most common cancer among American women. About 1 in 8 (12%) of women in the U.S. will develop invasive breast cancer in their lifetime.

To help prevent these diseases the medical community highly encourages men and women to get screened regularly, especially after a certain age. For women, yearly mammograms are recommended starting at age 40. For men, most doctors recommend waiting until age 55 unless there is a family history of these diseases and then your risk is higher.

A 2009 runnersworld.com poll revealed that 66 percent of respondents had suffered and injury.. That’s 2 out of every 3 runners! Yet to become a runner all you need to do is tie your shoes and put one foot in front of the other. No screening necessary! Why is screening not encouraged by the medical community? There’s more money in treating injuries than there is in preventing them.

The sad fact is that most people that take up running to get fit aren’t even fit enough to run. They don’t possess the physical prerequisites; (joint mobility, muscular flexibility, muscular stability and strength) that are needed to survive the repetitive pounding this sport dishes out. Canadian Physiotherapist Diane Lee said it best, “You can’t run to get fit, you need to be fit to run.”

The best way to reduce your injury risk potential is to use a physical screening process that helps to identify how susceptible you are to injury in the first place. Using a movement screen helps to determine weak links in an athlete’s body by gauging and assessing human movement patterns: simply, watching how well you move. The screen becomes a predictor of future injuries as well as a confirmation of current complaints.

 

2) Improve Your Posture

You may not be able to give me a definition of posture but I’m sure you can easily identify someone who exhibits good or poor posture. Static posture can be defined as; the position from which movement begins and ends.. Dynamic posture is; the maintenance of the optimal working relationships of any/all working joints when moving, regardless of how fast you are moving.

A static misalignment will undoubtedly disrupt dynamic posture. When posture is poor, the joints no longer fit together the way they are supposed to and that non-optimal alignment contributes to degenerative joint conditions when accompanied by overuse. A runner who runs at a 7 minute/mile pace takes 750 foots steps per mile. If your joints are poorly aligned, the repetitive nature of running will cause uneven wear and tear, resulting in friction, irritation, pain and eventually permanent injury.

Poor posture always indicates the need for a stretching program to lengthen short/tight muscles and a strengthening program to tighten and strengthen long/weak muscles. “A person’s posture is the foundation of movement, and like a house, if the foundation is poor-the whole body will suffer.”-Chris Norris, Physiotherapist. As runners we want to get as close as we can to ideal posture; which is the position from which the musculoskeletal system functions most efficiently.

Whether your goals is to look better, feel better or perform better, improving your posture will improve the efficiency of your movements, allowing you to train more effectively and will go a long way in helping to reduce your injury risk potential.

 

 3) Improve Tissue Quality

The tissue I’m speaking of is your muscle and fascia. We all know what muscle is, but not very many runners can define fascia and understand the importance of keeping it healthy. According to Thomas Myers, Author of Anatomy Trains, “Muscles are the engine of movement, fascia is the medium of movement.” “Think of fascia as the inner skin of the body”-says Guy Voyer, World Renowned Osteopath. “Fascia is the 3D cobweb that holds everything together”-Thomas Myers.

Muscle and fascia don’t just get short, they also gets dense. Dense tissue means there are adhesions, knots or trigger points in the connective tissue beneath the skin. These adhesions cause soreness, restrict fluid movement throughout the body and can cause pain. By applying pressure using tools such as; foam rollers, massages sticks and balls, you will be softening and lengthening the fascia, breaking down scar tissue, improving flexibility and joint range of motion and allowing your body to recover more quickly.

Endurance athletes tend to avoid the self-care strategies of foam rolling and stretching and instead opt to do that same run again and again. But most endurance athlete’s bodies are a mess of trigger points and overuse injuries are just waiting to rear their ugly head. Regular soft-tissue work followed by regular stretching would be time much better spent than logging more and more miles. Every injured runner I have rehabilitated had poor tissue quality. One of the most important things you can do to reduce your injury risk potential as a runner is to regularly perform myo-fascial release-DO IT DAILY…

 

 4) Pre-Run Stretching

Whenever I’ve asked a runner if they stretch before they run they look at me as if I’m speaking in a foreign tongue. And when I do get someone who says they stretch they are usually using a less than optimal method. The best way to stretch before activity is with ‘active-stretching’. In active-stretching you are stretching multiple muscle groups over multiple joints in movement patterns for short periods of time, just a few seconds. Active stretching also lengthens fascial trains and helps to improve joint range of motion as well as preparing the nervous system for activity. In contrast, static stretching isolates individual muscles and holds that muscle for an extended period of time. When the stretch is released, the nervous system will not know how to integrate the new length into movement patterns.

The reality is that static stretching is a poor way to warm up before exercise, and an active stretch routine is superior. I have created a series of 5 stretches in my Ready to Run program that once learned, takes only 5 minutes to perform. Do these regularly and you are a step further way from injury.

 

 5) Add Strength Training

Runners look forward to strength training about as much as the average person enjoys going to the dentist. But running in and of itself requires high levels of muscular strength in order to avoid running related injuries.

Obviously we don’t want to train runners for big bulging muscles. But with the careful manipulation of loading parameters (the exercises, sets, reps, rep speed, load and rest periods) we can adjust the body’s response so that strength training can increase muscular strength and power without increasing size. This is done by applying heavy loads to clean movement patterns. This type of strength training helps to improve how messages are carried from the brain to the muscles, so more fibers contract with greater force.

Strength training myth: Runner’s should only use light weights. Wrong! No one gets strong doing high reps of ‘light’ weights…. We actually need to be performing a lower number of reps with high loads in order to gain strength, power and train your neuromuscular system, allowing you to better control your body.

I always say, “get strong before you go long.” You can use lighter weights in movement patterns while training for an event but it’s not appropriate to do all of the time, which brings me to my next topic.. Periodization..

 

 

 6) Periodize Your Training

Any runner who has followed a program to train for a half or full marathon has followed a plan strength and conditioning professionals call periodization. Periodization simply means a method of exercise progression that allows an athlete to peak at the necessary time, usually at the point of competition. Most periodization plans for runners are a combination of linear and undulating. Linear periodization is a system that gradually adds volume over time. Undulating periodization usually consists of threes weeks of increased volume followed by an unload week or decrease in volume (miles).

Training for a half or whole marathon is as grueling mentally as it is physically and completion of an event of this magnitude should be followed by a period of rest-sufficient enough to allow your body and mind to recover from the intense training. Once you have recovered it is time to implement of an off-season strength training and running program. But many runners are locked into the same running routine and follow a half marathon or marathon event with another just like before the sweat dries. This is not only a recipe for reduced performance but it will bring you one step closer to an orthopedic surgeons knife.

I recommend creating and off-season (time away from all that endurance training), to work on your physical weaknesses, using a progressive resistance training program with an emphasis on addressing your deficits in hip and core strength. Getting strong prior to beginning an endurance training program will take your running to the next level and dramatically decrease your injury risk potential.

“Before each training cycle, I add one thing to focus on that will benefit my running, like doing strength training. This helps me to improve without risking injury.”-Clara Grandt-2011 Boston Marathon in 2:29:52 at age 24! 

7) Know Your Limits

Christopher McDougall, author of Born to Run, said, “talk to a runner, I guarantee that within 30 seconds the conversation will turn to injury.” With all of running’s great physiological benefits; stronger bones, stronger muscles, and improved cardiovascular health–it’s important not to overlook the negative impact running can have on your body. With each step we take, your body is subject to the shock of impact of three times your body weight. This can take it’s toll on someone who is not ‘born to run’ and may aggravate trouble spots or weak links and lead to injury. This is where many runners are their own worst enemy. Most common running injuries are due to a combination of physical asymmetries coupled with overuse. So one of the best ways to reduce your injury risk potential is to limit how much stress you place on your body by only running one race event in any given week. Yet, there are organized events that encourage runners to run multiple races within the same weekend, putting their bodies at greater risk of injury, just to earn a different medal or special T-shirt.

Every runner has an injury threshold, the point at which any additional stress on the system, whether it’s in volume (miles run) or intensity (speed work or races) will get you injured. There probably aren’t any Tarahumara Indians reading this. Just a lot of regular runners like me and you. Unfortunately we all are not as injury resistant as the great Dean Karnazes! Don’t get me wrong, I love a good race as much as any runner and run about 20 every year, but running multiple events in the same day or same weekend isn’t just Goofy, it’s stupid. 

8) Get Enough Sleep

We are sleep deprived as society. Fatigue is the most common reason for visiting physicians worldwide. Today our caveman immune systems get overstimulated every single day. We have artificial light available to us 24/7 and many of you reading this are attached to your computer screens, T.V.’s, tablets and smart phones way too late in the day. This light stimulates the release of cortisol in the body, an awakening hormone, and puts our bodies on alert and often disrupts our ability to fall and stay asleep.

Research shows that people who regularly get fewer than six hours sleep have a less healthy immune systems and higher levels of inflammation. How much sleep do we need? Well, individual needs vary, but most health professionals agree that we should be getting between 7 – 9 hours per night. However, it’s not just how many hours you get but when you get them that’s key.

The body does it’s physical repair from 10 p.m. to 2 a.m. and it’s psychological repair from 2 a.m. to 6 a.m. So the later you go to sleep, the less time your body has to recover from the stresses of your day to day routine and your training. This long-term circadian stress often leads to a depressed immune system, chronic fatigue, reduced performance and illness or injury. The solution, set a regular sleep schedule, and stick to it, even during the weekends, to establish a healthy sleeping pattern. Getting the right amount of sleep between workouts and before races will help you get the most out of your body and reduce your injury risk potential. 

9) Recovery & Regeneration

The majority of runners I know take an all-or-nothing approach to their training. They’re either running or they’re not, more often they’re running. The problem with that formula is that it fails to facilitate the most important aspect of training: the repair of muscles and cells. Continual exposure to endurance training puts your body in a constant state of borderline overtraining and creates an inflammatory response in body. To get the results you want from your body and to best reduce your injury risk potential you need quality work as well as quality rest.

Just as we take vacations to regenerate our body, mind and spirit from the everyday-we need to take time off from all that hard training. If not managed, the inflammatory response in the body from overtraining will cause unnecessary damage to tissues and cells.

R & R can take many forms. Active recovery methods include: foam rolling and stretching. Passive recovery includes: sitting in a cold plunge or hot tub or getting a massage. Hands-on body work should be part of every runners regeneration program as it helps to breaks down scar tissue and helps to restore flexibility as well as speed recovery. Add at least one recover y & regeneration day into every week of training and build in recovery weeks every three to four weeks to avoid burnout. 

10) Get the Right Shoe

Don’t expect shoes to correct an injury resulting from training error or muscular imbalance. Running shoes are not designed to cure running injuries. Most running related injuries are caused by “you, not the shoe.” But the right shoe for you is as much a part of the formula for staying injury free as anything else I’ve discussed. Your goal is to make sure you get the shoe that fits and functions best on your feet. There’s no single best shoe for every runner. There are different categories of shoes to fit different runners individual biomechanics and running needs.

That being said, not having the right shoe for you can definitely increase your injury risk potential. I can say with certainty that most runners that complain of ‘tissue issues’ have no idea what category of shoe they’ve been wearing (whether or not is a neutral shoe or stability shoe) or how long they’ve been wearing it. The wrong or worn shoe can actually aggravate existing problems you may experiencing in your feet, leg, knees or hips. And most running shoes need to be replaced between 300-500 miles.

It’s imperative to have someone with experience in analyzing gait watch you run so they can see how your body interacts with the shoe and the ground and you can see how they feel. Don’t pick out a shoe based solely on color, style or brand.

Things I consider when helping a customer pick out a shoe: injury history, arch type (normal, high, or flat), biomechanics, age, running experience, running surface, weekly mileage, and runner’s goals.

Brett’s Bottom Line:

Using the ten principles I’ve outline above the average runner can dramatically reduce his/her injury risk potential and not just ‘survive’ running but ‘thrive’ as a runner. It’s far easier to prevent and injury rather than treat one. Injuries arise in runners because most simply try to add fitness or performance to a body out of balance. Using these principles can help reduce the impact running has on the body and will help you stay on the roads and out of rehab.

Brett is a fitness consultant, holistic lifestyle coach, runner and creator of Ready to Run, a comprehensive conditioning program specifically designed for runners and triathletes. He can be reached at: www.integratedtrainingsystems.com