These are the most common running injuries and how to avoid them:
Plantar Fasciitis
Primary risk factors:
Rapid increase in intensity or uphill running followed by sleeping on your stomach or tightly tucked sheets. This causes nocturnal contracture (shortening) of the plantar fascia.
Preventions:
Build volume before intensity
Sleep with your ankles in a neutral non-toe pointing position
Obtain a tibial night splint from a sports medicine professional
Secondary risk factors:
Hyper flexible running shoes (racing flats) or work shoes
Excessive mileage on your shoes
Overpronation (flattened arches)
Preventions:
Train at moderate distances in a moderate weight shoe, and race in a flexible, fast racing shoe.
Obtain an orthotics consultation from a professional sensitive to the needs of a runner. (A 4oz orthotic in a 10oz shoe adds up.)
Wear quality rigid supportive shoes like Danskos to work on concrete floor
Tertiary risk factors:
Weak intrinsic muscles of the feet com
Preventions:
Perform toe gripping and toe walking activities to bring these muscles endurance up to speed with the rest of your program.
Patellar Tendonitis
Primary risk factors:
Rapid increase in intensity.
Downhill running, or pseudo-downhill running (over striding)
Preventions:
Build volume before intensity before initiating downhill running.
Lean forward on the flats and downhill running.
Land with your foot level with the ground rather than leaning backwards with toes up trying to decelerate one self.
Oscillate side to side on steep downhill running to disperse deceleration forces into your IT bands rather than patellar tendons.
When looking down at your patella (kneecap) as you run, your sternum should be on top of your kneecaps and your kneecaps on top of your second toe. Poor alignment from either flat feet causing toe out or weak groin adductors or hip abductors cause excessive side to side tension on patellar tendon.
Increase back swing of upper extremity opposite of the symptomatic lower extremity to aid in forward propulsion and decrease deceleration forces.
Secondary risk factors:
Inflammation exceeds healing rate causing patella to become distended with fluid
Preventions:
Ice daily with non-moist ice bag directly on patella with compression
Iliotibial Band Syndrome
Primary risk factors:
Same as patellar tendonitis risk factors
Over supination or high arches, or excessive outward bowing on knees are inherent to ITB
Preventions:
Same treatment approaches as patellar tendonitis except add hip abductor endurance activities on symptomatic side to minimize inherent Trendelenberg gait (hip drop) on side opposite symptoms at heel strike.
Running on loose sand and dirt surfaces also surprisingly increases incidence of ITB due to the natural behavior of pausing during heel strike to establish firm surface to push off.
Hamstring Strains
Primary risk factors:
Overstriding (not leaning forward at heel strike)
Performing speed work on hamstrings that are already suffering from delayed-onset muscle soreness/hypertonic
Weak adductor and gluteus maximus causing hamstring overemphasis
Preventions:
Fix or identify over striding
Never do speed work on hypertonic hamstrings
Limit hamstring weight training the day before a track workout
Ice hamstrings after every workout to decrease natural hamstring tone
Perform adductor/gluteus maximus facilitation activities as demonstrated by a sports medicine professional
Trochanteric Bursitis/Gluteus Medius Tendonitis
Primary risk factors:
Rapid increase in intensity and steep climbing in the preseason before tendon thickness is adequate
Over striding
Excessive hip drop opposite symptomatic hip at heel strike
Poor hip abductor group endurance
Preventions:
Volume before intensity i.e. Stairmaster walking before skyrocketing up Green Mountain, carrying 20lb child in a backpack on level surfaces before attempting straight up a mountain
Shorten stride and lean forward
Increase opposite arm back swing to increase forward propulsion without overloading same side abductors
Hip abductor/side-kicking endurance program
Ice hips daily before they become symptomatic
Shin Splints
Primary risk factors:
Intensity before volume
Overstriding/not leaning forward/landing with a level foot at heel strike.
Poor endurance of anterior tibialis muscles
Overly rigid or flexible shoes
Running in the same direction every day around a track
Running downhill with unusual weight on your back
Preventions:
Perform volume before intensity
Obtain a video gait analysis (VGA) to identify/correct overstriding
Perform anterior tibialis endurance exercises
Obtain a shoe prescription and switch shoes every 300 miles
Alternate directions around a track
Ice daily with compression to decrease compartmental pressure at the shins
Stress Fractures in the Feet
Primary risk factors:
Relative excess volume combined with premature intensity.
Hyper flexible training shoes.
Toe running/landing on mid to forefoot during heel strike.
Rapid increase in downhill running.
Rapid transition from trail running to pavement running
Preventions:
Build volume before intensity and listen to your body.
Know weekly mileage threshold at which you experience stress phenomena.
Train in a moderate weight training shoe and race with a flexible flat if needed.
If you come from a booted sport background like hockey and are new to distance running, take a year to build up to the marathon distance as you likely don’t have the bone density yet necessary to train marathon distance on hard pavement.