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Prevent Injury Now, Avoid It Later

Think long term, stretch, stay balanced and you’ll be in the game long after others have dropped out.

Think long term, stretch, stay balanced and you’ll be in the game long after others have dropped out.

If you want to run without injury, suggests Jeff Abrams, M.D., AAOS, orthopaedic surgeon at University Medical Center, Princeton, stretching should be front and center in your workout, both before and after your run.

“Think symmetry,” he advises. “Whatever you do in front you have to do in back.”

RELATED — Running 101: Stretching For Runners

Repetitive Motion

“Many people try to pick up where they left off with physical activities and sports, whether they “left off” last season or five years ago,” says Selene Parekh, M.D. AAOS, associate professor of orthopaedic surgery at Duke University. Unless the layoff lasted only two or three weeks, you need to build back up in both intensity and duration, he adds. Performing the same activity in the same way can eventually lead not only to muscle imbalances, but to chronic injury.

RELATED: Adjusting Your Training For Missed Workouts


“Cross-training is important,” adds Parekh, “so that you hit muscle, tendon and bone in different ways.” As a runner you should be alternating hard and easy days, and incorporating strength training and plenty of stretching, or you will burn your body down.

Try alternating running with activities that use your body in different ways. Swimming takes away 90 percent of your body weight while still providing a good workout. Biking, kayaking, and exercise machines are great alternatives and use your muscles in different ways.

Foot Deformities

Got bunions? Most are the result of heredity, but as Dr. Parekh reminds us, they can also result from or be exacerbated by flat feet, or years wearing shoes that do not fit properly. Ninety percent of all foot surgery is performed on women and it is often because women tend to wear shoes that are too small. No matter what kind of feet you have, get fit for your shoes, make sure the toe box is roomy enough, and don’t put more than 300 miles on them.

“You can sometimes minimize the progression of the bunion by wearing shoes with an arch support,” says Parekh, and if your arches actually hurt, make sure you’ve got that support, or try orthotic insoles or an ankle brace.

Runners with high arches tend to overload the ball of the foot and tighten the Achilles, which overloads the front of the foot even more. Make sure to stretch the Achilles tendon before and after your run. Metatarsal pads of gel or felt will help minimize the pressure.

Common Injuries

“The number one injury across all sports is hamstring tightness, which leads to low back or knee pain,” according to Dr. Abrams. The tried and true advice from the American College of Sports Medicine (ACSM) still applies.“Warm up until you break a sweat,” stretching each muscle group two or three times, and stretch after your run for your cool-down. Flexibility declines with age so get in the habit now.

To avoid runner’s knee and other knee injuries, stretch the thigh muscles, glutes, hip adductors and the knee flexors and extensors.

Concerning the trend toward minimalist or barefoot running, “you need to transition slowly,” warns Parekh, “like over one to one-and-a-half years.” Getting our bodies accustomed to running with little to nothing on our feet takes a long time.

RELATED: Safely Transitioning To A Minimalist Shoe

Strength Training

To keep your body and muscles in balance, it’s of the utmost importance to strengthen your core, suggests Abrams. “Exercising the core muscles makes you physically stronger and better at your sport,” says Abrams. “Work on the abs to keep from making your back and spine take too much of the load, but work your back and shoulders too to keep in balance.”

Weight machines and free weights are excellent for building strength and helping to keep the body in balance. It’s important to keep strength-training exercises symmetrical, so that you work both the front and the back of your body, says Abrams.

Body weight exercises such as push-ups and pull-ups utilize your own body weight and require minimal equipment.

The Aging Factor

Muscle loss usually begins about age 40. Over time, muscles lose endurance and strength, become more susceptible to injury and need more time to recuperate, too. A sedentary person may lose 30 percent of their muscle mass over the next 20 years, which is considerable.

As an athlete ages, past injuries such as bursitis, a bad shoulder, knee pain, hip problems or foot issues need to be addressed. Abrams recommends periodization, where a runner cycles from emphasizes strength and endurance work during the off-season before transitioning to more intense workouts during competition season.


About The Author:

Sherry Hanson writes regularly on health, fitness and outdoor topics and is a 2013 winner of the AAOS MORE award for reporting excellence.