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Running with injuries: Listen to your body, not your log.


I recently read an article published in Running Times discussing injury patterns amongst elite athletes. The bottom line was that if you run and push yourself to improve times and be more competitive, then injury is expected. Really? Should a conversation about marathon training always contain the following – plantar fasciitis, IT band syndrome, piriformis syndrome, hamstring strain, shin splints, knee pain, condromalacia, neuroma, and so on? No wonder why so many people tend to think runners are “crazy”! And have you ever heard someone say, “I’m not built to run”, or “I can only do the elliptical because its easier on my knees”? There’s actually a study published demonstrating an increase in force to the knees in while using an elliptical.

Running is natural.
It is a gradual progression from walking where both feet are on the ground together to a single legged activity of nothing more then jumping, or as Mark Cucuzzella, MD describes “engaging the spring”. If its so natural, then why are injury rates as high as 70% a year amongst recreational runners? That’s a question that many physicians, coaches, and exercise physiologists have been trying to answer for years. It becomes a very difficult process to study because of the extreme variables that exist amongst runners. Consider that elite runners train 80-110 miles a week many times running twice a day. When you try to compare causes for their injuries to a recreational runners who does maybe 20-30 miles a week, there are no relationships that could be considered credible. In other words it would be very easily disputed and not published. Other variables include ones body type, their foot structure, shoe selection, orthotics, intensity, form and fitness level to name a few.

What is my approach to this complex problem?
Don’t make it so complex. Start slow. Gradually increase mileage according to the 10% rule each week. Walk/running is great for starting out. A hear rate monitor will also bring you to reality with how fast you should be going. Learn to midfoot or forefoot strike much like you would if you were to run in place. My $1.99 text offers high quality video demonstrating this. (I’m not a salesmen so don’t take this as a pitch! Much of what is in that book text wise can be found on my blog. It does offer a simple read with video explanation for those using an iPad though.) Secondly, when choosing footwear, it should allow your foot to be mobile and feel the ground. I’ve been quoted as saying, “a shoe should allow you to run, not enable you to run”. There is no true data to suggest runners should be wearing motion control shoes to prevent injury. A shoe is like the shirt on your back when it comes to preventing injury. Most importantly, listen to your body, not the log. If the log has you going 3 miles and you feel awesome, you may be able to to 5 or 6 that day. Conversely if you are exhausted, missed sleep, and have a big day, you may need to skip the run. Something I tell many runners when training for a marathon, or even half marathon, log slow, slow miles. We know that from following your heart rate fitness will improve regardless of your pace. When you push you pace to try to become faster, this is a recipe for disaster. You may feel good for one mile, but your body will be compensating for each step of every mile that follows increasing risk for injury. Something else to consider is that you become a better runner by running more. A 3 day a week running program isn’t always best to avoid injury, especially when training for a marathon. The body isn’t being prepped for the long runs. Gradually building to increase your days and miles slowly will reduce the likelihood of becoming injury by adequately conditioning the body. Preceding and following a long weekend run with slow easy runs is much better then taking a day off before and after. Remember slow and easy is the key. If you feel too fatigued you’re either going too fast, or you do need rest. Even if you walk a bit of these runs it’s ok.

So sometimes the best program to follow is the one you create. Until you have developed into a runner that is seasoned enough to run injury free, don’t add speed workouts. Build the endurance engine and your speed will follow all while becoming injury free. How many miles a week? As many as you want as long as you build by the rule of 10%. Should you run 7 days a week? I prefer 6 but if you’re going easy 7 could be fine. Don’t get cut up with what’s on paper! A final thought. Running should be fun. If its not, then you’re probably doing it wrong.

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