Transitioning to Running Injury Free

Ross McKinnon, Physiotherapist.  Kelowna Manual Therapy Centre

Many athletes will be transitioning to running over the next few weeks as the snow disappears and the weather warms up.  Runners can help reduce the incidence of overuse injury by following a few guidelines.

Training Load Management 

Overuse injuries occur as there is more stress and strain on the body than it can handle. This is termed the training load, or load for short.   In other words, the body’s musculoskeletal system’s ability to adapt to load is exceeded.   This excessive load can be any combination of increased volume, increased intensity and/or too little rest in between running sessions.  Runners should gradually increasing their running volume and or intensity. 

A general rule is to increase the training load by 10% per session.  A runner would need to make an educated guess on how long the first run should be if they have stopped for an extended period.  A conservative plan would be to start back at 25% of the average run from the previous season, this would be an ideal place to start if there have been previous injuries or they haven’t been running.  Runners that haven’t had previous injuries could start back running at a higher percentage.  Starting off, it would be beneficial not to run on back to back training days. 

Runners should also follow the ’24 hour rule’.  An increase in pain longer than 24 hours after training would be a warning sign of excessive load.  If the pain does not settle within 24 hours then the runner needs to reduce the training load.  Working through post exercise muscular soreness, though mildly uncomfortable, is okay and has been proven to have no negative effect.  More concerning would be tendon pain, joint pain or muscular pain that would be described as sharp or stabbing. 

By following those two training guidelines runners can expect to get stronger and faster while remaining injury free.  The key is to gradually increase running and be patient with progressing the distance and intensity.

Work on Running Technique

• Increase running cadence (180-220 steps per minute) to decrease ‘over striding’.  Increasing cadence ensures that the foot cannot be place too far ahead of the body. A high cadence also minimizes the ‘braking’ i.e. sheer forces at foot contact with the ground. 
• Run ‘softly’, minimizing foot impact sounds.  One drill would involve running in socks without shoes on a rubber track to help ‘feel’ how to minimize impact.
• Minimize vertical oscillation, i.e excessive up and down motion.
• Lean slightly forward snd lean from the ankles.
• Foot strike should not be too far ahead of the body (control length of stride).  Heel strike vs forefoot strike is debatable. Runners should do what is natural but focus on a soft landing with a high cadence as mentioned above.
• If you trail run, practice downhill running to minimize loading and reduce the chance of injury. (Salomon TV: How to downhill Run https://www.youtube.com/watch?v=YLScRlispoo)

 General

• Start with running on softer surfaces like trails rather than roads to minimize impact.  Gradually work up to hill running.  Initially a quick walk uphill is required especially on the steep hills.  Be careful on steep uphills as landing on your heel will put extra compression on the achilles tendon.
• Runners should consider purchasing new shoes at the start of the season and begin to rotate shoes, alternating pairs with each running session.  This has been backed by research showing a 39% reduction in running injuries by rotating through 2 or more pairs of shoes.
• Some running over the winter is beneficial to maintain running capacity for the body to handle the ‘stress and strain’ of spring running.  It will make transitioning to spring running much easier.
• If an athlete continues to complain of pain or soreness it would be best for the athlete to consult with a local physiotherapist for advice and treatment.