Preventing running injuries – Part 1

It is estimated that worldwide around 1.6 billion people take part in running for exercise or competition. Around 10.5 million of those are in the UK alone running for various reasons such as health, fitness, recreation, social wellbeing or training.

However, running injuries can happen to any runner, and it’s estimated that 79% of will get injured in any given year. It takes just a few steps to prevent the development of a serious injury and a few moments to understand the cause and education in preventative plans.

Running injuries

The most common place for running injuries are from the hips down, although most runners will report issues from the knees down – if you’re reading, and you are a frequent runner, it is very likely you’ve experience one of the injuries below. But fatigue, poor technique, the wrong footwear, change in running surface or a fall can also lead to injuries from the waist up.

The below two graphics show the front (anterior) and back (posterior) most common running injuries.

Anterior running injuries
Posterior running injuries

The many causes of injuries

There are many things that can cause running injuries and often are combined, increasing the risk of injury:

  • Poor footwear
  • Non-specific training methods
  • Previous history of injury
  • Abnormal running mechanics.

Particularly for males there is a high tendency to run excessive distances, which also predispose the runner to injury. A high arched foot (cavus foot) muscle weakness and leg length difference also appear to be factors for predisposition to injuries.

A tremendous amount of body weight is placed on the heel and ball of the foot combined with much higher impact forces due to sufferers with cavus foot decreased shock absorbency and flexibility. Injuries that are more prevalent with cavus foot include stress fractures and a higher risk of PFP. An asymmetric gait caused by leg length difference, which can be anything from as little as 0.05cm up to 4cm, is associated with injuries such as stress fracture of the lower leg, Iliotibial band syndrome and lower back or hip pain. However a major factor associated with lower extremity injuries is due to muscle weakness that causes imbalances and if not corrected can lead to particular areas of the body being placed under undue stress, this in turn can also lead to injury.

A few examples of how weak or inhibited muscles can lead to specific injuries:

  • Tight gastrocnemius (calf) muscles combined with weak tibialis anterior (shin muscles) can lead to stress fractures of the tibia and shin splints.
  • Inhibited or weak gluteal muscles can cause ITB injury.
  • As with leg length difference, muscle weakness causes the weak muscles to fight the tight muscles. This results in fatigue setting in, and combined with inadequate biomechanics generally leads to joint integrity being compromised, which further leads to the onset of injury.

Choosing the appropriate footwear

The attempts to reduce injury for runners through specific based on shoe design is based on material development, technological advancement in shock absorbency and active control of the impact area. But it seems runners are swayed more by brand, colours and looks than terrain suitability and fit.

The interaction between your feet and the shoe and the shoe and the running surface should be the key aspects of shoe design and choice. Manufacturers have embraced that to decrease injury the shoe has to be fitted top the foot and gait and modern shows have various features that help with foot functions. Reducing injury is further achieved by understanding the terrain that the runner will be running on predominantly, examples of shoe specific design would be extra cushioned shoes for greater shock absorbency supinators or cavus feet and elevated insteps for overpronators.

Barefoot running is also becoming more popular and the lower impact midfoot and forefoot strike and shorter stride is thought to reduce the risk of injury even further. But the transition from traditional running to this more natural running must be done gradually, managed properly and on appropriate terrain to reduce risk of injury.

Part 1 | 2