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Photo: The North Face®/ Tim Kemple

How to Avoid Running Injuries

The number one question I get as an ultra runner, besides “Where you go to the bathroom during a 100-mile race?” (in the woods, as nature intended—hopefully out of view, but not always), is “How can you run so many miles without getting injured?” People are usually skeptical when I tell them that I’ve never—knock on wood—had any major injuries and have perfectly functioning knees despite running up to 100 miles per week. I wish I had a pithy one-liner as a response to their doubts, but alas, I’m not clever enough to come up with anything. In reality, there are a myriad of ways to prevent running injuries. Here are a few tips and tricks I’ve picked up along the way.

Mix it up

The proverb “variety is the spice of life” applies here. Running on the same surface in the same direction all the time is like wearing a groove into your body. I try to avoid running on paved roads because it seems harder on my body than trails. If trails aren’t an option, try to run on the side of the road on the softer surface.

Or take the opportunity to cross-train. Cross-training to me means optimizing your environment and counterbalancing the effects of running. I don’t run in the winter because I’d rather be skiing. Cross-country and backcountry skiing are great ways to stay fit while working out different muscle groups, incorporating more core and upper body.

Yoga or any form of stretching helps reduce the compacting associated with jarring activities like running. Some good yoga poses for runners include:

  • The ubiquitous Downward Dog: helps lengthen tight leg muscles and strengthen arms
  • Pigeon or any hip opener: running locks up my hips tighter than Fort Knox, Pigeon helps undo this
  • Revolved Triangle Pose: a balancing and stretching pose, also a spinal twist
  • Warrior II: groin-stretcher and glute-strengthener

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Rory deep into her Warrior II pose.

Focus on Technique

A huge appeal of running is its simplicity. It’s one of the few sports that doesn’t need to be taught—it’s innate. Maybe this is why most runners don’t focus a lot on technique. But there’s more to running than just putting one foot in front of the other, and the biggest improvement in my running came after I analyzed my form and made adjustments. And I think these technique corrections have also contributed to my relative freedom from many of the aches and pains common to distance runners. Here are some things to avoid:

Heel striking

This puts a lot of stress on knees and leads to over-striding. There isn’t a unanimous consensus on the best foot placement, but most experts agree heel-striking is less efficient and more jarring than mid-foot striking.

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The runner on the right demonstrates a low-impact strike while the runner on the left is striking with his heels.

Sitting in the backseat

Or as my friend descriptively puts it, “popping a squat on the royal throne.” This puts too much emphasis on the quads and doesn’t properly utilize the most powerful muscles, the glutes. Correct this by tilting your hips forward without arching the lower back, and standing up taller. I think of my core (abdomen) as being attached to a string that’s pulling it forward along the trail, and my legs are pendulums that swing freely with minimal effort.

Poor upper body posture (aka “Quasimodo running”)

I used to look like the Hunchback of Notre Dame, shoulders high and tight, back rounded, slouchy. Keeping shoulders low and loose and a tall torso (not over-arched) helps lungs expand.

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Rory executes proper upper body form while out training.

Over-striding

Long-distance running doesn’t require the knee-lift and exaggerated stride that shorter distances do. A shorter stride with quicker cadence is the more sustainable, efficient way to run farther.  Your feet should land directly under your body, not way out in front. Over-striding stresses the hamstrings and leads to heel-striking.

Good form can prevent many problems, but remember: accidents do happen. At least a couple times a year I take a digger. Usually it’s related to doing the shuffle (not picking my feet up high enough) or spacing out and not concentrating on the trail. If I’m stubbing my toe frequently, it’s a sign that I need to pay more attention to my feet. If you find that you’re rolling your ankles more, losing balance, stubbing your toes, etc., slow down, take shorter, quicker steps, and try to focus on your center of gravity. I do this by taking even breaths and envisioning my legs as swinging like pendulums from my core.

Training Run Supplies

Since I train 99% of the time by myself, I’m like a Scout when I go out for a long run in the mountains or other isolated areas—I’m prepared. For an all-day adventure I carry a pack with space for a few essential first aid supplies, enough to clean up a scrape or repair blisters. All of this fits in a very small 3 x 5-inch baggie.

advmedicalfirstaidAdventure running first aid kit:
  • 1 lancet for blisters
  • Alcohol swabs
  • A few pieces of precut moleskin
  • 2 blister-specific heel-shaped Band-aids
  • Benadryl tablets for my dog (for rattlesnake bites or allergic reactions)
  • 1 small tube of petroleum jelly (chafing is my biggest pet peeve)
  • Leukotape sports tape (wrapped around a tube of chapstick, so I’m not taking the entire roll with me). This stuff is fantastic. I use it to tape my feet to prevent blisters; it stays on even if feet are wet
  • Several single-use packets of antibiotic ointment
Some other extras to consider:
  • Tylenol
  • Sunscreen
  • More blister bandages
  • Benzoin vial – this sticky gum resin makes Band-aids or tape adhere way better to skin
  • Upset stomach remedies, such as Zantac, Tums, ginger chews, etc.
  • Disposable shower cap (free ones from hotels work) – good for keeping the heat in and your head dry in an emergency and weighs nada.

If you’re going on an all-day adventure, especially in a new-to-you area, consider carrying a lightweight headlamp in your pack with an extra set of batteries.

Blisters—Public Enemy #1

I probably don’t need to tell you that blisters need to be avoided at all costs. First of all, find a shoe that fits, and break it in gradually—avoid anything longer than a couple hours initially. Keeping your feet dry is also helpful. This is really hard for me, because I love running in soaking wet shoes. However, after losing eight toenails due to wet feet, I’ve stopped. You might want to consider shoes with Gore-Tex or some other waterproofing if you frequently run in wet weather.

Another tip is to pre-tape; I don’t know if anyone else does this, but before a long run or race I tape my heels and a couple of hot spots on my feet with Leukotape. I did this for a 106-mile race in the Alps; the result was no blisters, and the tape stayed on the entire time. Also, some runners like to put anti-chafe powder in their socks or body glide directly on their skin to prevent blisters.

Warming Up—Is it Necessary?

I know warming up and stretching are supposed to be key for preventing injuries, but I never warm up before a 50- or 100-mile race. That’s what the first 5 miles (or more, in my case) are for! For interval training sessions, a 20-minute warm-up is good to loosen up the muscles before sprinting. I never stretch before I run or even after a warm-up unless there is something really nagging me, like tight hips. Most runners I know never stretch and seem to do just fine. I do, however, stretch for 10 minutes after a run as part of my cool-down; I use this, and yoga, as a way to work out the kinks and undo the muscle contraction caused by running for hours on end.

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2Comments

Here's what the community has to say.

Edward G.

Edward G.

I'm in my early forties and am starting to hear the call of lower impact running. I've tried Rory's suggestions on form/strike, and I think I'm doing ok on flat and uphill with a mid-foot strike. But I can't figure out how to do this running downhill so it's not even more jarring than heel-striking. Suggestions?

(0)

MtnRnr Wanabe

MtnRnr Wanabe

Props for highlighting first aid! I think its an under represented topic but pretty important if you plan on spending 3+ hours running in the mountains or trails in general.

(1)