Running and Jogging Injuries
By Scott N. Stubbs, M.D.
This is the time of year I see an acute spike in the number of running related injuries in the office. Spring has come, summer is coming, and everyone wants to be outside getting in shape. The five-K, ten-K, half marathons and even marathons are becoming common community events during this time of year. While seasonal changes have a lot to do with the frequency of running, there are many other times when injury can occur.
In fact, there are four periods of time when runners are most vulnerable to injury:
- During the initial four to six months of running
- Upon returning to running after an injury
- When the quantity of running is increased (distance)
- When the quality of running is increased (speed)
Most running injuries are caused by recurring factors that runners can often prevent or avoid themselves. Training errors are the most common source of injury. These include lack of adequate stretching, rapid changes in mileage, an increase in hill training, interval training (increasing to faster speeds over shorter distance), and insufficient rest between training sessions. Most of these can be acceptable methods of training when a runner is properly prepared and conditioned. Most of us, however, impatiently push the limits faster than our body can often allow.
Another source of injury is equipment errors. A running shoe should fit comfortably and accommodate ones particular foot anatomy. When a shoe exceeds 500-600 miles, discarding them (at least from running) should be considered. The ideal surface on which to run is flat, smooth, resilient, and reasonably soft. Avoid concrete or rough road surfaces. If possible, use community trails that have been developed specifically for jogging and running. Hills should be avoided at first because of the increased stress placed on the knee and ankle.
Environmental factors are important to keep in mind as well. During warmer, humid weather (it is unfortunately upon us), increase fluid intake before and during runs. It is much easier to prevent dehydration than to correct it or play "catch up". It is often helpful to weigh yourself before and after runs to gage your level of hydration. Avoid running during extremes of hot and cold temperatures. When running at higher altitudes (not so much a problem here), the runner should gradually acclimate to the lower oxygen levels by slow steady increases in speed and distance.
Treatment of running injuries is almost always includes rest or modification of activity to allow healing and reduction of inflammation. This is often harder than is sounds because most runners are not "resters" by nature. A gradual return to running (10% increase in mileage per week) can be allowed after flexibility, strength, and endurance has returned. When severe pain, swelling, loss of motion, and/or other alterations in running form are present, immediate medical treatment is advised. "Running through the pain" is poor advice for any of these serious symptoms.
The goal of rehabilitation is to return the runner safely to the desired level of running. Remember, training errors constitute the most common cause of injuries. A well planned program prevents injury while benefiting the athlete.