Running is one of the most popular forms of exercise, appreciated for its accessibility and effectiveness in promoting cardiovascular health, as well as mental health. However, it is also associated with a high risk of injuries, which can deter both novice and seasoned runners alike. The development of an ultimate injury prevention plan is essential for all runners, enabling them to enjoy their sport while minimizing the chances of injury.
As an avid runner averaging 100 miles per month, I’ve experienced my fair share of running-related aches and pains. While I can’t claim to have run all those miles injury-free, being proactive about body mobility, strength awareness, nutrition, and hydration has been key to my sustained performance.
Table of Contents
Common Running Injuries and How to Avoid Them
There is a laundry list of injuries that can occur from running, whether it be running a 5K race or training for a 100 mile ultramarathon. However, to keep your interest I will discuss the most common ones that I tend to see in the office.
Runner’s Knee (Patellofemoral Pain Syndrome)
Symptoms: pain around or behind the kneecap, often caused by overuse or improper mechanics.
Prevention: Maintain strong hip and thigh muscles to support proper biomechanics.
This is one of my favorites. Why do you ask? Because this type of patient is one often referred in by a medical physician who has treated the patient with medications, imaging, and maybe even physical therapy. Quite often these symptoms are due to biomechanical imbalances. Simple prevention tips, aside from having a full assessment performed in the office, is maintaining strength in the hip and thigh musculature.
Shin Splints (Medial Tibial Stress Syndrome)
Symptoms: Pain along the shinbone (aka the tibia), typically from overtraining or improper footwear.
Prevention: Transition gradually between different running surfaces and wear appropriate footwear.
Quite often I see shin splints when a runner or athlete suddenly changes to a different surface that he or she is running on. A perfect example is running on the treadmill during the cold winter months and immediately transitioning to the road, which is a much harder surface and less forgiving. This causes additional stress and not only the tibia but typically the tibialis posterior musculature as an inflammatory reaction.
Plantar Fasciitis
Symptoms: Heel pain, or pain on the bottom of the foot, caused by inflammation of the plantar fascia.
Prevention: Use supportive footwear, strengthen foot and ankle joints, and maintain proper arch support.
Plantar Fasciitis is common in all types of patients, not just runners. This condition is often caused by multiple factors including but not limited to improper footwear, loss of the longitudinal arch of the foot, poor balance, and poor strength or stability of the foot and ankle joints.
Achilles Tendinitis
Symptoms: Pain and stiffness in the Achilles tendon, which is in the back of the ankle, often from overuse or tight calf muscles.
Prevention: Stretch and strengthen the calf muscles (gastrocnemius and soleus) to reduce strain.
Personally, this is one of my common and ongoing running injuries. For me it is due to my ever increasing mileage week to week and month to month. For other patients it can be due to tightness in the gastroc soleus muscle complex, which make up the calf muscles. In both situations strengthening these muscles is key to not only preventing this symptom but also to help keep it from worsening and turning into more complex conditions such as a strain or tear.
Hamstring Strains
Symptoms: Hamstring strains are often described as pain in the back of the thigh, these are often caused by muscle imbalances or overstriding, or more specifically when going down a hill or sprinting.
Prevention: Focus on hamstring strength and functional training like sprint drills and plyometrics.
I often describe this type of injury to a patient using an image of a rubber band, where the muscle is the rubber band and we over stretch the muscle. A very common and easy way to avoid this type of hamstring injury is to maintain proper strength in the muscle as well as functional training, such as adding workouts into your weekly routine such as sprinting or plyometrics.
Stress Fractures
Symptoms: Pain begins during running and can progress to walking and daily activities, potentially persisting even at rest. It’s usually sharp and concentrated in one specific area.
Prevention: Gradually increase mileage, ensure proper nutrition for bone health, and avoid overtraining.
To keep it simple, stress fractures are small cracks in bones caused by repetitive impact and overuse. In the world of medical pathology there are two different types of stress fractures.
- Abnormal stress on normal bone, which is often caused by excessive running in the healthy male or female individual.
- Normal stress on abnormal bone, this can be described as a patient with severe osteoporosis sustaining some form of fracture due to normal everyday activities of daily living such as walking.
Train Smart to Avoid Running Injuries
When I see runners in my office (whether they come in for running-specific injuries or with any other complaints), I often talk to them about the “Four S” principles of injury prevention for runners.
- Speed
Gradually build your pace over time rather than making sudden increases, as sharp changes in speed can put excessive stress on your muscles and joints. - Surface
Vary the terrain you run on to reduce repetitive impact on the same areas of your body, and be cautious when transitioning to harder or uneven surfaces. - Sneakers
Choose the right running shoes for your foot type and replace them regularly to ensure proper support and cushioning, which helps prevent overuse injuries. - Strength
Incorporate strength training into your routine to improve muscle balance and stability, which supports better running mechanics and reduces injury risk.
If you follow these principles you will be able to avoid or minimize running injuries in your training.
Training Plan for Running Injury Prevention
Strength Training Plan for Runners
Incorporating strength training into a runner’s routine is vital for building muscle resilience and preventing injuries. Strength training focuses on enhancing the muscles, ligaments, and tendons that support running mechanics. Engaging in exercises that target the core, hips/glutes, and legs can improve stability and balance, leading to better running form.
According to the study published in the Journal of Orthopaedic & Sports Physical Therapy, runners who participate in strength training programs experience a 30% decrease in overuse injuries. A well-rounded strength training program should be integrated into a runner’s weekly schedule, ideally two to three times per week. Patients often ask what my training regimen looks like. On the regular I hit Gold’s Gym in Smithtown twice a week for the sole purpose of incorporating strength training as well as recovery using the sauna.
To get started with strength training, focus on key muscle groups:
- Glutes & Hips: Essential for power and stability.
- Core: Supports proper running posture and balance.
- Legs: Builds strength for efficient strides.
- Upper Body: Improves arm drive and posture during long runs.
Essential Strength Exercises for Runners:
- Squats: Build lower body strength and improve hip stability.
- Lunges (forward, reverse, and lateral): Enhance balance, coordination, and single-leg strength.
- Deadlifts: Strengthen the posterior chain (glutes, hamstrings, lower back) to support powerful strides.
- Planks (front and side): Develop core stability to maintain good running form.
- Calf Raises: Strengthen the calves to support ankle stability and reduce the risk of Achilles injuries.
- Step-Ups: Mimic running mechanics, building unilateral leg strength and balance.
Practical Tips:
- Train 2–3 times per week, focusing on full-body workouts with lower-body and core emphasis.
- Prioritize proper form to prevent injuries.
- Progress gradually, starting with bodyweight exercises before adding resistance.
- Include dynamic warm-ups like leg swings, hip circles, and lunges before runs or workouts.
Flexibility and Mobility Training Plan for Runners
Flexibility and mobility are key to maintaining proper running form, preventing injuries, and enhancing overall performance. A well-rounded routine targets tight muscles and improves joint range of motion, allowing for smoother, more efficient strides while decreasing muscle stiffness. The effectiveness of flexibility and mobility training in preventing running injuries has been supported by several studies:
- Stretching and Injury Prevention: A review highlighted that both pre-exercise and chronic stretching can reduce musculotendinous injury incidence, particularly in running-based sports. (meridian.allenpress.com)
- Dynamic Warm-Ups and Injury Reduction: Research indicates that dynamic warm-up routines, which include active stretching and mobility drills, are effective in reducing muscle strain injuries and enhancing athletic performance. (pubmed.ncbi.nlm.nih.gov)
- Multicomponent Prehabilitation Programs: A study on trail runners found that integrating dynamic flexibility exercises, neuromotor strength and balance training, and plyometrics into a prehabilitation program significantly helps prevent musculoskeletal injuries by improving movement control and reducing fatigue-related risks. (pmc.ncbi.nlm.nih.gov)
Essential Mobility and Stretching Exercises for Runners:
- Hip Flexor Stretch: Loosens tight hips, common in runners due to repetitive motion.
- Hamstring Stretch: Increases flexibility to prevent hamstring strains.
- Quad Stretch: Relieves tightness from repetitive knee extension during running.
- Calf Stretch (Wall or Step): Improves ankle mobility and prevents Achilles issues.
- Dynamic Leg Swings: Activate hip flexors, hamstrings, and glutes before runs.
- Spinal Twists: Enhance thoracic mobility for better upper-body rotation.
Practical Tips:
- Dynamic Warm-Up Before Runs: Include leg swings, lunges with a twist, and hip circles to prepare muscles and joints.
- Static Stretching Post-Run: Hold stretches for 20–30 seconds to aid recovery and maintain flexibility.
- Foam Rolling: Use a foam roller on tight areas like calves, quads, and IT bands to release muscle tension.
- Pilates for Runners: Focuses on core strength, postural alignment, and controlled mobility. Pilates exercises like the Single-Leg Stretch, Leg Circles, and Shoulder Bridge improve hip stability, core control, and flexibility—key components for efficient running mechanics.
- Yoga for Runners: Enhances flexibility, balance, and mental focus. Poses like Downward Dog (stretches calves and hamstrings), Pigeon Pose (opens hips), and Low Lunge (releases hip flexors) help relieve muscle tightness and improve mobility.
- Consistency is Key: Aim for 10–15 minutes of flexibility work 3–4 times per week. Consider adding a weekly Pilates or yoga session to improve mobility and prevent injuries.
Importance of Athletic Evaluation
Personally, and professionally, I feel the examination or evaluation of an athlete is critical. Taking a patient through a full physical examination to include neurological testing, joint mobility, muscle testing, and functional testing is crucial to give the clinician a full understanding of what is going on with the patient. All too often clinicians and practitioners look only to the point of pain where the patient is complaining, however more times than not the pain that the patient is experiencing is often originating elsewhere.
Let me give a great example of a patient that recently came into the office. A 50-something year old male, active runner and local coach, complaining of right sided low back pain. The patient had been for workup with multiple physicians and sought the treatment from another chiropractor. After a thorough examination including functional assessment to include squatting, course stability assessment, low back strength, hip mobility, and hip strength it was concluded that the patient’s symptoms were stemming from the right hip joint, as well as mild weakness of the gluteus medius. Now, I am not patting myself on the back here (well maybe slightly) but myself, as well as the other practitioners at True Sport Care, always take the time to go through thorough evaluations to determine the root cause of the problem, and not just chasing pain. After designing a program focused on correcting muscular imbalances, the low back pain complaint was resolved.
Conclusion
Stay injury-free by following this guide and consulting a professional when needed. If you have any questions regarding what was discussed in this article, please feel free to contact the office or email us and we will be happy to discuss your concerns and address any potential calls that you may have.
