At least once a week I receive a question from a fellow runner related to injury avoidance or how to speed up the recovery process for pre-existing running-related injuries. Admittedly, this isn’t surprising…considering the fact that most people can’t help but associate running every day (for +3 years) with extreme strain on the body. These assumptions are fair, but that doesn’t mean that consistent running will always equal injury – which I’m eager to dive into below.
First off, I’m not an accredited physiotherapist or professional. With that being said, I’m going to reiterate the disclaimer I provide at the outset of most of my posts: my writing is based on my experience and independent research. I hope this article functions as a jumping-off point for you to dig a bit deeper into your own research, see what resonates with you and, if need be, consult a professional. Now, let’s get right to the meat and potatoes of the article.
Over the last 3 years, I’ve exerted my body in unimaginable ways and have learned a thing or two in the process. I have experienced my fair share of injuries throughout my consecutive running journey; some minute, while others more serious. There was one instance when an injury left me unable to walk a few steps without feeling shooting pain up and down my legs. I lost some sleep over that injury, partially because of the pain (fml) but also because the thought of breaking my running streak invaded my mind. Long story short, I somehow managed to keep on keepin’ on.
It is certainly tough to prevent injuries and through a genetic lens, some people are more prone than others. After years of experimentation and listening to my body, I’ve been able to avoid debilitating injuries thus far and from the injuries I have sustained, I’ve been able to recover quickly.
In this post, I’ll outline a few strategies to minimize and avoid injuries by drawing on some common reasons runners get injured. We’ll also explore some ideas on how to recover from not only your conventional stiffness and soreness, but also more serious running-related injuries.
After exploring numerous online resources, journals, and articles on why people get injured or experience prolonged soreness, only three overarching themes emerged.
Overuse /Overtraining Syndrome
Overuse is one of the most common among runners, which is exactly as it sounds; you literally overexert your body, putting too much continued stress on your muscles without giving them ample time to recover.
Acute injuries are the ones that happen suddenly and unexpectedly. Tripping over a branch resuting in a sprained ankle, lacerations, or the absolute worst, breaking a bone would be classifed as acute injuries. These are indeed, quite random, and although not common for the everyday runner, they do happen.
The Wrong (or Old) Shoes
If I had a dime for the number of times I experienced knee pain due to old running shoes or wearing the wrong shoes for my foot type, I’d be a millionaire. If I also had a dime for every time someone used the reference “if I had a dime”, I’d also be a millionaire…and annoyed.
Whenever someone asks me to recommend a shoe, my answer basically auto-populates to this point: there is no universal type of shoe that will work for everyone on this planet. The type of running shoe you choose depends on the distance you’re running, your stride, the shape of your foot, your gait, your stack height preference, road running vs. trail running, etc., etc. I’m not going to provide a full laundry list of things to consider when selecting the right shoe (I’ll save this for another post), but I will leave you with this: using the wrong shoe – whether that’s design, style, width, type – or an old pair of shoes is a surefire way of injuring yourself. If your shoes are ill-fitted or have been worn down to the bone, you could experience knee pain, foot pain or shin splints. Watch out for these telltale signs.
However, if you do find a shoe make and model that works, try to stick with it. Bulk buy as many pairs as you can (as I do lol) so you don’t need to go through the long and tedious process of trying to find another shoe when the brand discontinues the model (which they will). As you can tell, this is my lived experience and yes…I am bitter.
It’s also important to point out that each pair of running shoes have a certain number of miles built in/recommended. Ask the staff, read reviews, and keep this number top of mind to track the mileage you’ve conquered in your shoes. Both the MapMyRun and Nike Run Club apps allow you to add in your gear and keep track of how many miles you’ve put into them. Once you get close to the threshold, it’s time to start looking for a new pair. For me, I can tell when I have a few weeks left. I start getting mild knee pain and know that it’s time to order a new set of trainers.
Make sure you take the time to find the right shoe that compliments your foot type and stride. Track your shoe mileage – when they’re getting close to the end of their life span or you’re starting to feel pings of pain, get back in the online shopping saddle and order a new pair.
Other Factors to Consider
I would be remiss if I didn’t mention that there are numerous other factors to consider when you’re trying to find the root of your injury, including poor nutrition, stability/balance issues, how your foot strikes the ground, randomly tripping over yourself and faceplanting on the pavement, among others. The three mentioned above, however, are typically the most common and can for the most part, be avoided.
Specific (and Annoying) Types of Running Injuries
I’m not going to get into too much detail in the types here, but it’s worth pointing out that the most common types of injuries include runner’s knee, plantar fasciitis, achilles tendonitis, stress factures. Iliotibial band (ITB) syndrome, and our favourite, shin splints. Each of these have specific causes and treatment options. For further reading, here’s a good article titled, Preventing Running Injuries.
How to Avoid Injury
Let’s get candid, there isn’t really a way to completely avoid injury. We can all get injured in weird and unprecedented ways. I’m sure you know at least one person that has sustained an extremely bizarre injury out of the blue. There are, however, some preventative measures you can take to try to minimize the chance of injury.
When I announced the #RUN70 Consecutive Running Challenge on social media I received a cacophony of mixed reactions. Many were supportive and provided encouraging messages, while others were more cynical; believing that my body wasn’t capable of running 70 consecutive half marathons in a row.
My mind was in a state of ambivalence. On one hand, I just completed a challenge running 10 kilometers per day for 30 days which gave me the confidence to up my mileage and made me believe that completing #RUN70 was plausible. On the other hand, I’ve never run consecutive half marathons; not even two in a row. Ever. How would I be able to pull this off? Maybe these people were right and I will destroy my body while becoming a public failure.
The first few weeks of the challenge I let the negative self-talk and comments get to my head. I started experiencing soreness I’ve never felt before on my runs, including a strange sting at the bottom of my foot, knee pain, and even shin splints. During the entirety of my runs, I kept dwelling on the injuries, which seemed to amplify the throbbing pain I was experiencing.
I bought a foam roller and started focusing my energy on recovery after the runs. I told myself that I would do everything in my power to give my body the R&R it needed post-run in order to ease into the next day’s half marathon. I spent at least 30 minutes using the foam roller, stretching, and icing my joints. I wouldn’t walk more than a kilometer a day, and if I needed to, I would move my run to later in the day to give me a bit more rest time. About 3 weeks into the challenge, I felt more acclimatized to the distance – it seemed to have worked!
Which leads me to my next point…
The Body is Very Adaptive
Before the 10k per day challenge, I ran an average of 5-7 kilometers per day, 6 days a week. In retrospect, I was slowly building up my mileage over time. Doubling the daily distance from 10k to 21.1k was indeed a shock to the system, but after dealing with some mental roadblocks and the initial physical discomforts, I gained confidence and felt my body loosen up.
One of the key lessons I’ve learned over the years is how adaptive the body is. My body has adjusted to running every day. That doesn’t mean I don’t experience soreness or haven’t sustained any injuries; it just means that my legs know we’re running every day whether they feel like it or not – they are prepared.
I’ve been running for 12 years now with a slow build-up of mileage over time. Consistency is key here and has been the catalyst in saving me from a debilitating injury. It’s important to note that if you are new to the running game, your chances of sustaining an injury are a wee bit higher. One study concluded that,
Novice runners are at significantly higher risk of injury 17.8 (95 % CI 16.7–19.1) than recreational runners, who sustained 7.7 (95 % CI 6.9–8.7) running-related injuries per 1000 h of running.
However, as long as you’re not pushing yourself too hard and being cognizant of the fact that perhaps running 5 kilometers twice per week then jumping to 10 kilometers 6 days per a week, isn’t a great idea, then we’re good.
Know Your Limits and Build Up Your Mileage
If you’re keeping up a consecutive or consistent routine, you can’t push yourself too hard every single day or you will most likely fall prey to a bad injury. Learn to listen to your body. For me, that means doing slow and steady-state cardio, bringing down my mileage and/or bringing down my pace. Otherwise, I would burn out.
The body needs time to adapt. Tackling an extreme distance or overexerting your pace are the main reasons for sustaining an injury and a cause for the previously mentioned overuse injury. I’m a bit hypocritical when I suggest this, but experts recommend the 10% rule when it comes to building up your mileage. The rule explains that each week you should increase your mileage by 10%. For example, if you’re running 70k or 43 miles/week, the following week you can up that to 77k or 48 miles per week.
I increased my mileage from 70k per week to 147k per week (a 100% increase LOL). BUT I am the first one to admit that I am an anomaly and I have good genetics when it comes to injuries. Some may still get injured with this modest increase, but the above rule is used as a suggested guideline for the general population.
Genetics & Luck
The fact is that some of us are more injury-prone than others. Genetics and Wile E. Coyote luck can come into play here and it is unfortunate and unfair, but it’s the truth. I have runners in the family; my two uncles were avid runners, which puts me at a genetic advantage.
We all know those injury-prone people. You know the type – the friend who trips and falls face-first into a wall for no apparent reason.
If you are amongst the unlucky ones who get shin splints, plantar fasciitis or knee pain, doing a 3-5% week-over-week mileage build-up is typically recommended. This isn’t a fool-proof plan, but this ‘rule of thumb’ might be helpful. Again, listen to your body, understand your limits, and I’m going to circle back to this again, change your shoes REGULARLY.
Work on Strength Training, BUT not too much…
This is a tough one because I’m the first to admit that I don’t do too much leg strength training. Luckily, my physique doesn’t quite resemble stick legged Humpty Dumpty, but give it time. I work out my upper body 4x per week, my core 2x per week, and legs, well…maybe 1x per week? I rarely do a full leg strength days as it really offsets my running for days after. To avoid this, I’ll split up my leg training into two days. Doing 2-3 exercises for each session (usually mixed in with core) and that’s it. With squats and lunges, I pay particular attention to my form because it’s easy to diverge from the proper technique for these exercises and I’ll end up fucking up my knees. No thanks.
Strength also helps with body alignment; a very important element for running. An article in Runner’s World titled The 10 Laws of Injury Prevention suggests focusing on exercises to strengthen the hips:
Strengthening the hips is optimal for effective rehabilitation, as opposed to treating the area where the pain is located (e.g., your knee). When you strengthen the hips—the abductors, adductors, and gluteus maximus—you increase your leg stability all the way down to the ankle.
The key here is to not build bulging muscles, but rather work on strength to keep the body symmetrical and balanced. When we’re off-balance, that’s when we can start encountering issues. Remember to work on some lower body strength training, but don’t overdo it.
Dealing with Muscle Soreness and Injury
So you’ve taken every preventative measure in the book but you still end up sustaining an injury. First thought: this is some straight bullshit. Second, less reactional thought: how do I recover as quickly as possible? Can I still continue to exercise while healing? If you go to a professional, they will advise you to stop running for weeks or months – depending on the severity.
Last spring, I suffered from a third-grade hip flexor strain. Albeit, I don’t know the causation of the injury, I do have a hunch as to why it happened: a combination of overuse and a shock to the body. Please excuse me while I digress for a moment. From October – April in 2018/2019 I ran exclusively indoors on the treadmill. I vehemently detest running outdoors in the frigid Canadian winters. The Toronto Marathon was coming up in May, it was now mid-April and I needed to start training with some long runs outdoors. So, what did I do? Embraced my full idiocy and ran a half marathon on my first outdoor run! As I’m sure you guessed, I pulled something in my hip and struggled to run the following days leading up to the race. I had shooting pains in my groin region and with the Toronto Marathon only a few days away, I oscillated between running it or dropping out.
I ended up running it and miraculously experienced no pain, and somehow (don’t ask me how) even accomplished a personal best. The next day, feeling overly confident, I decided that I would run a 10k along the waterfront and play ball hockey in the evening. Mid-way through my game, I felt something in my groin pull in a very unnatural way. The next day I could barely walk. The preceding day it only got worse – I could barely manage my daily runs without unbearable pain around the hip area. I knew that my last resort was to visit a physiotherapist, who told me I had a third-grade hip flexor strain and that I needed to stop running for at least 2-3 weeks. He gave me some rehabilitation exercises and off I went. On the way I home I remember thinking that if it keeps getting worse, I’ll need to stop my streak and recover. Naturally, I didn’t want to, as I was only months away from hitting my 1,000 consecutive day goal, but the possibility of losing my ability to run forever wasn’t worth it. Taking my physiotherapist’s advice, I proceeded with performing the exercises, icing the sore spots, and pulling out my foam roller. I started noticing minor minimizations of pain day after day. I built up my mileage slowly and surely, continuing my streak in a way that felt manageable for me.
I’m not suggesting you run on an injury because it is stupid. I am very stubborn and that has indeed worked both in my favor and against me. The reason I’m telling you this tale is to give you an idea of the process I went through when I sustained an injury during my streak. I did keep running, but I was hyper-aware of how my body was feeling and followed the three-step recovery protocol that has served me so well all these years:
1. Foam Rollin’
My foam roller has been my savior. Not only does it feel AMAZING on sore muscles, but it is very effective in helping deal with pain caused by delayed onset muscle soreness (DOMS). The benefits of rolling out muscles include a better range of motion, flexibility and a full range of other benefits that come with a deep tissue massage, but for a much lower price tag. A lacrosse ball is another great purchase to really pinpoint those trigger points. Invest in both and use them regularly.
I’ll be the first to admit that I rarely stretch. I have the tightest hips and cannot even touch my toes. HOWEVER, if I’m sore then I will force myself to stretch for 5-10 minutes after my run while my muscles are still warm or I will stop mid-run and do some stretching. Stretching regularly when your muscles are warmed up can help decrease the chance of injury while also speeding up recovery of existing injuries. Here’s a link to The 10 Most Effective Stretches for Runners to incorporate in your post-run routine.
There’s a bit of controversy surrounding icing or using cryptotherapy for overuse injuries. It has been proven to help with inflammation injuries (ie. ankle sprains), but not so much with overuse (sore knees, shin splints etc.). I don’t make icing a regular habit, but if I do feel like I have some inflammation post-run, I’ll 100% ice the inflamed spot. Icing can also help increase blood flow to the designated area and reduce pain. Whether it actually expedites the recovery process, well most sources point to maybe. If you do ice, it’s recommended to ice for around 20 minutes; any more than that and you could experience frostbite (which I stupidly endured by keeping a pack on my hip for 30 minutes and forgetting about it). I make these mistakes selflessly for you guys…Seriously though, learn from my stupidity and don’t make the same mistake I did.
This is the type of recovery that I’m all for. In John Romaniello’s article Active Recovery: How to Limit Delayed Onset Muscle Soreness (DOMS) he mentions that if you’re “experiencing muscle soreness after a heavy training session or hard run” then it’s better to be “active to facilitate recovery.”
If you’re feeling really sore the next day, instead of taking a full rest day, some light and steady-state cardio or light strength training targeting the sore spots can actually help with recovery. For me, it’s usually after a big race (marathon or ultramarathon) or after a leg session where I’ll experience sore calves, glutes or quads.
Active recovery can help increase blood flow to the torn muscles and expedite the recovery process. The key here is to perform light exercises that hone in on your sore body part. It seems to be quite a weird contradiction because we’ve been conditioned that with soreness, our bodies are indicating rest. If done properly, however, it has been proven to help expedite the healing process. Just make sure, you don’t overdo it. The effort should be light, such as running. Roman suggests doing yoga or another class to help after a leg day.
If you have a severe injury, as I experienced, it’s important to visit a physiotherapist to aid in your recovery. The physiotherapist I visited told me I shouldn’t run and of course, I didn’t listen. But there are injuries that are extremely severe and shouldn’t be taken lightly. Use your own discretion if you’re on a streak of your own or experiencing any type of pain. Listen to your body and remember to adjust accordingly. If the injury keeps worsening then perhaps it’s time to stop (as I told myself after my physio visit). If your injury is on the mend then go slow, activate an easy pace, take lots of breaks, and follow the recovery protocol to help you get back to your normal self. Oh, and one more thing…CHANGE YOUR SHOES IF THEY’RE OLD.
An annoying (and vague) conclusion is that injuries can happen anywhere at any time to anyone. If you do get injured it’s important not to chastise yourself for the mistakes you made, but rather understand and acknowledge that the more you exercise the more adaptive your body can become. Shifting gears from minimal or no exercise to working out every day can put your body in a state of shock and can cause overuse injuries.
Running on different terrains can also help with prevent some of the more common injuries (ie. pavement running can be super taxing on the joints. Try running through trails/soft ground or the treadmill.)
My hope with this post is that you can learn from some of the techniques I’ve used to avoid injury while also expediting your recovery process.
Wishing you all a healthy, injury-free fitness journey!