BY DAVE MCCONNELL
During this time, when gyms and fitness centers are closed, running has become a popular form of exercise for both men and women of all ages. It is beneficial to their health, requires no training, and can be accomplished without equipment. Unfortunately, something so natural comes with a high rate of injury, as high as 37% yearly for the typical runner. Health care providers have tried to identify an accurate set of risk factors for running injuries, but with little success. Most say that age, gender, height, weight, and running experience are not related to running injuries, with the exception of more stress fractures in female runners (sorry, ladies). Several studies have investigated differences in anatomic alignment between injury-free runners and those prone to overuse injuries, also without concrete conclusions on why injuries occur in some and not others. And then some researchers consider all running injuries as “overuse” or training error problems resulting from too many miles, too fast a pace, running on the wrong surface, or injuries resulting from improper training. All these arguments deserve some attention.
First, let’s define “overuse injury.” An overuse injury is an injury of the musculoskeletal system resulting from the combined fatigue effect over a period of time beyond the capabilities of a specific anatomical structure that has been stressed. When repetitive forces, such as the impact experienced during running, are applied repeatedly to a muscle, tendon, or bone, injury can occur if sufficient rest between stresses does not occur. Specifically, a running overuse injury can be defined as a musculoskeletal ailment attributed to running that causes a restriction of running speed, distance, duration, or frequency for at least one week.
Half of running injuries occur in the knee. The most common knee complaints in runners are patella pain (pain in the knee cap), iliotibial band friction syndrome (pain on the side of the knee), and meniscal injuries (pain under the knee joint). Achilles tendinitis and shin splints account for 40% of running injuries. The fact that 90% of running injuries occur at or below the knee suggests a pattern that can be identified and predictive of overuse injuries if researchers keep looking.
Training variables that are linked to running injury include running distance, training intensity (speed), rapid increases in weekly running distance or intensity, and stretching habits. Increasing running distance or speed too aggressively can lead to structural damage (inflammation, strain, sprain, tearing) if some other variable of the workout is not adjusted. If the distance is increased, then speed or amount of incline could be decreased to avoid injury. Gradual increases make sense! Some studies relate stretching prior to running with injury prevention, especially stretching hamstring muscles. Achilles stretching is also a good idea, especially for older runners.
One variable that can be influenced by the runner is hip strength. Studies have found that weakness in the gluteus medius muscle (the muscle that moves your leg out to the side) can increase stress on the leg while running, and is found in runners with iliotibial band syndrome.
A 6-week strengthening program for the gluteus medius resulted in a significant improvement in strength and resolution of pain while running for those with iliotibial band syndrome. This is a factor that runners can influence through a cross-training program that includes strength training, not just running in isolation.
Do you run the risk of running injury? It is hard to say, but listen to your body and be smart about running progression; stretch before and after running; and, if possible, implement a strengthening program for weak hip muscles. These are simple exercises that can be done without weights by simply doing 30-50 leg lifts to the side and back (keep the leg straight) several times a week. There are many benefits from running, but it can also put us out of commission and even lead to surgical procedures. The best advice is to be smart, be safe, listen to your body, and have fun!