Preventing injuries while running may seem difficult even at the best of times, especially if you are putting in heavy mileage, adjusting to new shoes or just running on new terrain.

Recent studies estimate that between 19% and 79% of runners sustain an overuse injury in a 1 year period.  Recurrence of injuries is also common.  20 – 70% of injuries will come back.  The most common injuries are knees, feet, hips and pelvis.  In my clinical practice, beginner runners or runners that have not followed a true prevention program are the ones that come in with these types of problems.  The more experienced or elite runners come in with other types of injuries, (i.e. back), if they come in at all.  The more experienced you are, the more savvy you are at prevention.

Most people know your general prevention strategies for running injury free.  Increase mileage slowly, don’t just run -you must cross train, maintain your flexibility etc.  These are pretty standard in running circles.

But savvy runners go beyond the basics because not knowing what is going on in your body is akin to running a marathon without proper training.

Anyone practicing a sport will often wait until they get injured before they seek help.  Having a strategy for preventing injury should be paramount in every runner’s arsenal.  Just because you can move in a way that is pain free, that does not mean it is functional and can’t cause pain or dysfunction in another body part.  That is where a good physical therapist comes in.  This is what the smart runner knows.

I believe that education about your own body goes a long way in prevention. Physical therapists can advise runners on proper form, training methods, strategies for preventing injuries, and work with you to develop a plan, tailored to your specific needs, for successful running. Physical therapists can also evaluate, diagnose and treat runners who have sustained a running-related injury.

To illustrate this, I will cite a few patient examples.  I will keep this fairly simple so as to make this easily understandable for anyone who is not a physical therapist.  Patient with a history of stress fracture to his left foot he sustained while training for a marathon.  The patient is young, fairly healthy and has no other related injuries. He has not run for a year and his foot has not gotten better.   One would think that the rest would help the healing process if the foot were the main problem.  During the evaluation, I notice that while he stands on one leg and when he takes a step forward, he shifts he weight over his opposite foot, thus creating a sub-optimal weight transfer onto his other leg.  After finishing the clinical evaluation, his ultimate problem was that he sustained a shift in his rib cage after his stress fracture (probably just to transfer his weight from his painful foot) .  Ultimately, he was unable to compensate for this which is why he did not get better with rest.  In the end,  I had to treat his rib cage as well as his foot.   If only his foot were treated, he would return to the clinic with the same problem and a recurrence of the running injury.

He is now running pain free.

Patient comes in with a history of right knee pain that occurs early on in her run. She had some knee pain as a child but it went away after a period of time.  She started a running program to get into shape and runs on a treadmill and outside if the weather is nice.  Mileage is about 5-10 miles a week.

One has to remember that running is a one legged activity, so it is really important in the evaluation to look at how the person stands and loads their limb on one leg.  In her particular case, she had poor mechanics at her foot which affected her knee. When her foot was treated, her knee got better.

It is absolutely necessary that runners undergo a full body evaluation that is pertinent to their running program whether they are in pain or not.  Because as you see in the above cases, dysfunction in other parts of the body are what really caused their injuries.

Recurrence of injuries is a big problem with runners and getting to the core of the problem early and seeing a physical therapist should be at the top of the list.

The bottom line is, preventing these injuries BEFORE they happen should be your ultimate goal.  Getting an injury 5 weeks into a training program will set you back .  Don’t try and run through it-that will only make it worse.  Why not educate yourself about your body and how perhaps a muscle imbalance or joint dysfunction elsewhere may eventually lead to increased injury risk.  Whatever area of dysfunction is found, a physical therapist can put you on a corrective exercise, flexibility or a performance based training program to lower your risk of injury.

Erica Meloe, PT, OCS, COMT, MBA, MA

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