Nobody wants to be injured. Let’s review a few ways in the coming days that runners typically hurt themselves and maybe you won’t have to join that club.
Chasing after specific mileages. Yes, for performance gains, you should have objective and defined goals. Certainly those can be related to mileage. But there’s more to healthy and successful running than miles per week. When a runner focuses too heavily on a certain mileage each week it doesn’t take into account many factors: the intensity of those miles, the terrain, the weather, the lack of sleep because you stayed up later than usual on a couple nights, the extra shift you picked up at work, your nutrition, and so on. You must account for all of the various types of stresses you have in order to stay healthy. Don’t be blinded by the numbers. Don’t get greedy. Improvement is a long and gradual process, and there is no equation or sum total of miles that leads to running nirvana. You can’t level up like it’s a video game after collecting mileage coins.
Being unwilling to diverge from your cookie-cutter workout plan. How many times have you heard “listen to your body?” If you are sick or noticing the start of a slight niggle of an injury, don’t try to stubborn your way through while hoping the luck gods take pity on you. Weigh your options. Do you have more to gain or lose by completing three more of the Runner’s World website-prescribed 400 meter repeats on an aching calf? How much fitness would you really gain from that day of junk miles? When you are thrown a curveball it doesn’t mean you can’t get in a workout. It doesn’t mean your race in two weeks is now an impossibility. If you remain willing and ready to modify your plan at any time, it isn’t so traumatic to do so. You can become an exercise ninja, ready and able to adapt at any instant. That might mean cross training. It might mean rescheduling a hard day for a couple days later. It might mean taking a full rest day. It might mean completely ditching the plan you found doing a Google search.
Doing the same thing over and over. Doing the same thing over and over. Doing the same thing over and over. Doing the same thing over and over. Isn’t that annoying? Guess what? Your body thinks it’s pretty annoying when you run the same pace and distances all the time on the same roads and same sidewalks. Is it that uncomfortable to do something different? Unlikely. But that protective part of your brain will tell you it is a problem to deviate. I don’t personally understand this - I hate running the exact same routes and intensities all the time - but I’m a weird trail runner and road runners don’t associate with us weirdos. The pavement pounders seem more reluctant to purposely and drastically switch things up. Yes, there is some good that comes from a consistent training stimulus because the frequent loads actually helps prevent injury. But that’s better off being an AEROBIC effort in most amateur runners, which means you have to run slowly. No, slower than that. (Thank you not-so-accurate online pace calculator for messing this up.) EVEN slower. More like trotting at times. Especially since we have these things called hills. What most runners do is train a bit too hard, too often, so it becomes a different stimulus. They sit just on the edge of discomfort, drifting past a high aerobic effort and into tempo pace, which is ANAEROBIC metabolism. That’s not something you should do for several runs in a week. You’ll get faster doing that, for a little while, but it’s not sustainable and eventually leads to every runner’s fear: a performance plateau. I’m giving you permission to not make every run hurt.
Ignoring overall athleticism and strengthening. I’m going to keep harping on this one until at least the year 2025. If you have no variability in your movement, you are asking for trouble to occur at some point. If you aren’t strength training and doing something to improve and explore the way your body moves as an overall athlete, running itself will not keep you healthy for very long. It might take a few years, but the problems will come. The muscles and nervous system demand frequent challenge, or they gradually begin to lose optimal function. You won’t detect it at first, but it’s no great mystery of physiology that we start to lose strength beyond the age of 30. Running doesn’t keep anyone strong or powerful. (Though it’s certainly better than doing nothing.) Performing strength work even once per week is a potent stimulus if you work hard.
Discounting the role of your routine posture and activities. I bet you thought about sitting up taller when you read the word POSTURE. Our daily lifestyle has more to do with getting injured than most people realize. One of the most common and detrimental issues I see in the clinic is that frequent sitting tightens the hip flexors on the front of the body. This keeps you from using the big gluteus maximus muscles that should produce a ton of force to propel a runner forward. So people begin to use the quads and hip flexors even more, the pendulum of the running stride shifts forward from its ideal location, and the cycle continues. It’s not as simple of a fix as just doing a couple hip strengthening items twice a week. The low back, neck, and thoracic regions are also areas that adapt negatively, thus shifting your body into an overall poor alignment. Mobility is lost. Strength is lost. Overall movement changes and there are eventual consequences.
Using the workout plan of a runner who is of a higher ability level. You know, because if they got better with this plan then surely you will get better and run just like them in a couple months. Nevermind that they have different genetics, better running technique, and 13 more years of running experience. Plus, they have full hip and ankle joint movement and muscle control that you lost 8 years ago thanks to your desk job. Yes, clearly all of the details are all the same. I always wonder how many people try to mimic the workouts of elite endurance athletes when they end up on a website somewhere. Just because the pro marathoner does back-to-back long runs doesn’t mean you should for your first marathon.
Listening to people who have no actual expertise but are ready to use you as their own personal guinea pig and offer plenty of untested advice for your training or injury recovery. I know this is often done in innocence, but that doesn’t make it any less concerning. Perhaps a more advanced athlete invites you to run with them and you decide to follow their workout or are too embarrassed to put forth any effort less than they are performing. The other athlete can mean no harm but may not really analyze the many possible scenarios that will impact your individual health. Them: “This is what my coach had me do.” You: “Oh my god, you have a coach, you must know what you are talking about.” People often do the same thing when they are injured. Them: “When I had plantar fasciitis the personal trainer told me to just do this stretch to my foot every day and not run and then it seemed like it got better in a couple months.” You: “I guess I should do that stretch everyday and not run.” Wait, you are taking secondhand advice about treating an injury from a personal trainer? I hope they have additional credentials!
Not having fun. If it’s not fun, you’ll eventually burn out, which is the ultimate injury. Training variation can keep things fresh and interesting. Strength and plyometric training will help your running, so don’t shy away from it if you enjoy that type of exercise. If you are the competitive road racing type, maybe you need to train for an adventure race, triathlon, mountain bike race, or trail running race. Try Crossfit (but don’t get hurt) or play rec league soccer. Or even leave running altogether for a few months, not that I ever would encourage someone to do such a thing. Sometimes people do appreciate their running more and can actually improve performance and decrease injuries when they have been away from running for awhile. If you aren’t having fun, what is the point? To make yourself routinely miserable? Find something you actually enjoy and keeps you healthy.
Thinking an injury is gone just because an initial pain has subsided. Your nervous system is super smart. It can decrease the amount certain muscles work when moving and use an alternative strategy if doing so leads to less pain. It can shift the demand to other muscles to still get the movement done with the same total force output. Most people won’t have any awareness of this change in muscle activity. The initial area of injury may never flare up again, but many times when another pain arrives, the real problem isn’t where the newest pain is occurring. For example, low back or gluteus maximus pain leading to an Achilles tendon pain months to years later. This inhibition of muscle activity is clearly not ideal if those muscles were working just fine prior to the initial injury. Traditionally people (clinicians included) mistakenly try to rehab the area of current pain when they ought to be emphasizing something else. Prior injury matters.
Not taking any easy days. Running is supposed to be hard! Running is supposed to hurt! I’m going to do high intensity intervals every time I run! And that’s four days every week right now but I’m going to work my way up to five days! What...the...heck? Why? Can we talk about how much I’m not impressed by Instagram photos of people “crushing it” multiple times each week? I get that there’s a satisfaction in showing off your hard work. But no one with any real longevity in endurance sport trains this way (because it’s unsustainable). Anaerobic efforts, like intervals and tempo work, are super helpful to improve fitness, technique, and speed - but are not necessary for every workout. Easy, slow distance miles just don’t give the sexy social impression that interval work creates. If you want to run for only five, maybe ten years, then go ahead, do crazy intervals for every run. To summarize a phrase from fellow PT Christopher Johnson: runners run at 80% effort 80% of the time which leads to an injury occurrence of up to 80%. Strive to stay in the 20%! Use a heart rate monitor, power meter, or monitor your breathing to truly keep tabs on your intensity. Pace is a poor measure of intensity for many runners but that’s what people rely on because it’s simple.
Not recognizing the importance of recovery time and being proactive in your recovery techniques. Yes, I know you are busy. But do you want to run a handful of years or do you want to run for decades? Each day you should have a goal, and that goal doesn’t always have to be increasing speed, fitness, or strength. Recovery time can be broken into active and passive methods. Easy running days should be active recovery days, meaning they aren’t intended to gain you fitness but they are intended to make you feel loosened up and healthy. It’s still exercise. You should be able to finish an easy aerobic run and say “I could easily do that again.” On the passive side, learn a couple techniques to directly work on your muscle, tendon, and fascial tissues. Get yourself a lacrosse ball and a massage stick and use them at least three times a week on your major leg muscle groups to break up those funky tender and hard spots you have inevitably created in your legs. If you aren’t familiar with any muscle self-treatment techniques, check out “The Roll Model” by Jill Miller or “Becoming a Supple Leopard” by Kelly Starrett for ideas. Recovery time requires planning, just like the workouts. We create the muscle fiber adaptations to training gradually, while you aren’t training, so if you don’t allow enough time for that, when are the adaptations supposed to happen?
Not being proactive about your recovery from an injury. Instead of actually completing what’s required to recover from an injury, some athletes prefer to do nothing. It’s the wait-and-see approach. Our bodies want to heal, so rest typically decreases pain in the short-term. But it doesn’t address the root of the problem for recurring and long-lasting overuse injuries. Unfortunately, this is a common practice among injured athletes, who routinely take a couple days of rest before trying to resume their typical training without any modification. If the pain just started a couple days prior and is getting better quickly because you did your due diligence, that’s one thing. But it’s an entirely different scenario when you’ve had persistent pain for a couple weeks, a month, maybe longer. Clearly rest isn’t the solution at that point. Some people avoid proper treatment because they are afraid of getting worse or delaying what little progress they’ve made if they attempt something new (like seeing a PT, massage therapist, or chiro). Or maybe a negative experience treating a prior injury leads to reluctance in discovering the best ways to treat a current injury. Some are fearful that nothing can be done to help their injury and they would be wasting their time to try other tactics. More often than not, doing nothing doesn’t get you very far. While adequate rest is oftentimes an integral part of the recovery process, it should never be considered the sole means to addressing an injury.
Relying on medications to control symptoms. Medications, whether it be pills or injections, are not a viable long-term solution to a mechanical overuse injury problem. As athletes, when we get injured, we naturally look for the quickest solution that would allow us to return to training without pain. And because you are working hard in training, there’s little energy or time left to devote to active injury recovery techniques. While NSAIDs and corticosteroid injections have their place in orthopedic medicine, they rarely, if ever, provide a long-term relief of symptoms or resolution of an overuse injury. And let’s not forget the well documented side effects that these medications have when used with frequency.