How to avoid common running injuries

Don’t let injury derail your running. You can reduce your risk by following our top tips on staying healthy and injury-free, whatever your running goal.

Take it one step at a time

“Every runner has an injury threshold,” says Dr Irene Davis from the University of Delaware’s Running Injury Clinic. “It could be 10 miles a week, or 100, but once you exceed it, you get injured.”

Many experts agree that training errors are the main cause of self-inflicted running injuries. You need time to adapt to any changes in your training regime and any increase in mileage. Sports podiatrist Stephen Pribut suggests that you avoid the ‘terrible toos’ – doing too much, too soon, too fast.

The 10 per cent rule – only increasing your mileage by 10 per cent each week – is popular, but that may be too much if you are injury-prone so increasing by just three or five per cent could be the answer for you.

Listen to your body

Sometimes old advice is the best advice, and ‘listen to your body’ is a great example of tried-and-trusted guidance you’d do well to follow. “The biggest mistake people make is not listening to their body when they can feel an injury coming on,” says two-time Olympic marathon runner Liz Yelling. “Pushing on regardless ends up with lost time and enforced rest when immediate action could have got runners back on track quicker.

“If I get an injury I rest immediately and seek my physio's advice about the best action to take. This ensures I am doing the right thing from day one and I don't waste time treating it incorrectly. It is only when I know what is wrong through accurate diagnosis that I can make a call on how long I will need to rest.”

It’s not a good idea to keep running despite the pain. Adharanand Finn spent a year training in Kenya with elite runners before writing his book Running with the Kenyans. He says, “The best thing we can learn from Kenyans about preventing injuries is not to be afraid to skip a training session if you're tired. Their mantra is 'listen to your body'. Pushing things when you are over-tired is a common reason for injuries.”

Nip injuries in the bud by resting when you feel a twinge. At the first sign of pain that worsens during a run, or causes you to change your gait, take three days off before trying to ease back into it. If it doesn’t clear up, seek professional help.

Get shoes that fit

As Eamonn Martin, the last British man to win the London Marathon, says, “Training shoes are the most important item of kit.” There are plenty of shoes to choose from these days but it’s important to spend time working out which ones work best for you. While no shoes are guaranteed to solve injury problems, the right fit for you can help. Make sure to go to a speciality running store for expert advice.

Wayne Edwards, musculoskeletal podiatrist and director of operations of HFS Clinics, says, “The vast majority of running injuries are due to poor foot function and muscle balance. When choosing a pair of running shoes, ensure they fit properly and feel comfortable. It is a myth that you need to go up a shoe size to ensure this comfort; half a size is adequate.

“People have a wide variety of foot shapes. Low-arched mobile feet need more support from the shoe – those available for this are often grouped as stability or motion-control shoes. Average-arched feet can be accommodated in most neutral shoe designs. High-arched feet benefit from cushioning.” 

Don’t test your limits too often

Research shows a correlation between injuries and competing in races frequently. Physiotherapist Clint Verran warns against over-doing speed training and racing too often. “You might get five per cent faster, but your injury risk could climb by 25 per cent. That’s a bad risk-to-benefit ratio. Most runners can hit their goals without going harder than tempo pace,” he says.

Amby Burfoot, 1968 Boston Marathon winner and editor-at-large of Runner’s World magazine in the US, believes that you need to give yourself plenty of time to recover after every race – he recommends one day for each mile raced.

Stretch properly

You should always warm up before running, even if you’re eager to get going. Do some dynamic stretching before your runs for a safe, effective warm-up. Save static stretching (holding an elongated muscle in a fixed position for 30 seconds) for afterwards. Foam rolling tired muscles before or after runs can also help, as can icing and elevating any potential injury spots as soon as you feel them. Stretching has been debated in recent years but as Burfoot explains, “Runners are tight in predictable areas and therefore should increase flexibility in these areas. The muscle groups at the back of the legs – hamstrings and calf muscles – stand atop most lists of ‘best muscles for runners to stretch’.”

Reduce the impact of running

Experts agree that impact forces can reach two to three times your body weight with each step when you’re running so it’s no surprise that muscles and joints can easily become strained from all the shock they’re absorbing. Cross-training activities such as swimming, using a stationary bike, an elliptical cross-trainer or a rowing machine are a great low-impact way to improve muscle balance and help you to stay injury-free.

If you are injury-prone, avoid running on consecutive days. All runners are likely to benefit from at least one non-running day each week. If you have issues with runner’s knee, avoid the rowing machine, and if you’ve ever had shin splints or a stress fracture, you should probably steer clear of the elliptical cross-trainer.

Seek help

“The minute that you feel a slight niggle, speak to somebody,” says Paul Hobrough, a chartered physiotherapist at Physio & Therapy. “If you're thinking ‘In eight weeks' time I would like to enjoy running a race, be physically prepared and able to walk the week afterwards’, then what are you waiting for? It makes no sense trying to run it off. There is no heroism involved.”

Hobrough lists runner’s knee, patellofemoral pain syndrome and iliotibial band friction syndrome as the most common injuries that build up slowly over time. He insists coming in for help at an early stage is far better than coming in once the injury has forced you to stop running.

Pay attention to your diet

“Paying attention to the nutrients you are consuming is key for minimising injury,” says Mhairi Keil, performance nutritionist at the English Institute of Sport. "Correct nutrition will enhance muscular performance, optimise recovery, and support the immune system. Risk of injury is increased when muscles are fatigued, so pay attention to fuelling-up strategies and energy provision during long or intense runs.”

Once injured, nutrition is also key to the tissues recovering. “It is important to understand what the type of injury is as certain nutrients play a greater function depending on the tissue damaged,” say Keil. “For example, nutrients essential for bone repair include calcium, vitamin D, protein, magnesium and copper. Muscle injuries would focus more on high quality proteins and antioxidants, along with vitamin C and zinc for cell replication.

“Tendon damage can be more difficult to support from a nutritional perspective, however factors that can help to control or reduce excessive inflammation such as the antioxidants found in green tea, omega 3s, polyphenols found in red kidney beans and berries, and resveratrol found in red grapes can play a role."

Strengthen leg muscles

Your leg muscles are key if you’re to keep your body properly aligned while you’re out training. Biomechanist Dr Reed Ferber, head of the Running Injury Clinic at the University of Calgary, says it’s important to strengthen the hip muscles in particular.

“Strengthening the hips is optimal for effective rehabilitation, as opposed to treating the area where the pain is located (eg your knee),” says Ferber. “When you strengthen the hips – the abductors, adductors, and gluteus maximus – you increase your leg stability all the way down to the ankle." Ferber’s clinic has cured 92 per cent of knee injuries by working on the hips.

Ultramarathon runner and author Dean Karnazes says, “Work on building strength in the muscles of your legs by doing squats, lunges and using the cross-trainer in the gym. Having strong leg muscles will support your joints and tendons, which take a pounding when training. Being in good overall shape helps to support your stride and posture as the miles add up. Train hard one day then do a lighter training session the next to allow your body recovery.”