Stay on Top of the Road
By, Joe Esposito, MSPT, CSCS at Moore
Although it may not seem like a complex exercise, running is a multi-faceted movement involving many moving parts. These parts make up a chain which starts from the ground up. If one link in this chain is out of sync, it can ruin the entire system. The following guide is designed to help you prevent injury and ultimately maximize your running performance.
Footwear
Runners should wear appropriate shoes based upon their foot type. Although many sporting goods stores are unable to fit you on an individual basis, many specialty running shops are trained to do just that. We like Runner's Roost in Darien and New Balance New Canaan. For some runners, a shoe in itself may not fulfill their needs. Some of these athletes may require orthotic inserts. This can usually be accomplished through an over the counter product. On occasion, however, a few may require a custom orthotic. In this instance, an individual’s foot is casted and a custom orthotic is created. Although this option can be expensive, it offers the truest fit. Another important fact is that running shoes should be replaced every 350-500 miles.
Stretching
Although runners dedicate many hours a week to running, most do not take a few minutes before or after to stretch. And the ones that do aren’t necessarily stretching correctly. Ideally, active or dynamic stretching is performed prior to activity. This helps warm up the body by increasing blood flow and loosens up muscles to prepare them to work properly. Static stretching (i.e. holding a stretch for a period of time) should be performed after running. Research has shown that the ideal time to hold a stretch is 30 seconds. This type of stretching after activity not only helps you maintain and improve your flexibility, but it also reduces muscle soreness.
Active or Dynamic Stretch Static Stretch
Training/Program Design
Many injuries are caused due to errors in training and the design of their program. A general training principle whether it is running, weight lifting, or other exercise, is that one should not increase volume by greater than 10 percent per week. Runners must also take into consideration the pace of their run as well, as this has a direct impact on response to exercise. Incline is another factor that runners need to consider. Athletes should take a minimum of one day off per week, although two is preferred for recreational levels. Many athletes progress at too fast of a rate or increase multiple factors at once. Thus, they become susceptible to injuries and a condition called overtraining syndrome.
Surfaces
It is important that one takes into consideration the terrain that they are running on. The safest way to run on a road is on the left hand side as you are able to see oncoming traffic. However, many roads are crowned to aid in drainage. This crowned surface creates a height difference between one’s right and left side. Even if this difference is only a fraction of an inch, its impact can be felt after the thousands of strides one takes for every mile that they run. Other challenging surfaces include trails and the beach. Running up and down inclines are more challenging for runners as well and this should be taken into consideration.
Solution: Change the side of the road that you run on when it is safe to do so (i.e. less traveled roads). Try to minimize or avoid altogether uneven surfaces. This is especially true when recovering from an injury or for beginning runners. These groups should run on even surfaces such as a local track or flat roadways instead.
Injuries
Runners are susceptible to a variety of injuries starting in the foot and working their way up to the hip and low back. Most of them can be classified as an overuse or repetitive stress syndrome and involve an inflammatory component. The following is a list of the more common injuries experienced by runners.
Plantar Fasciitis
Inflammation of the tough, fibrous band of tissue (fascia) connecting your heel bone to the base of your toes is called plantar fascitis. It is common in people who have recently increased their level of weight bearing activities such as standing, walking, or running. People with flat feet or very high arches are at an increased risk for developing this condition. Tight calf muscles can also put you at a higher risk. Symptoms are usually felt in the morning with the first few steps a person takes, as well as when they are barefoot or wear unsupportive footwear. Pain can be felt in the heel, arch, or “balls of your feet”. For a more in depth look at Plantaar Fasciitis, read Lindsay Richard's article...
Area of pain with Plantar Fasciitis
Posterior Tibialis Tendonitis
Injury to the posterior tibialis tendon can occur due to similar causes as plantar fascitis. The primary role of the posterior tibialis muscle is to help support the arch on the inner part of your foot. When your foot is not supported correctly due to improper footwear or other training errors, the tendon that connects this muscle to the underside of your foot can become inflamed as it is overworked. Pain is usually felt near the bone (medial malleolus) that sticks out on the inner half of the ankle.
Achilles Tendonitis
Inflammation of the large tendon that connects your calf muscles to your heel bone is called Achilles tendonitis. Tight calf muscles can also contribute to the onset of this injury. A sudden and forceful movement, such as jogging across the street suddenly between traffic or slipping can also lead to this condition. Excessive running up inclines can also contribute to this condition as doing so places a higher amount of stress on the calf muscles and the Achilles tendon.
Runner’s Knee
Knee pain is another common injury experienced by runners. Many times, it is due to poor strength and flexibility of the hip musculature. This can cause the knee cap (patella) to not move properly in the groove of the thigh bone (femur). Thus, the cartilage on the underside of the patella can become inflamed, and in chronic cases, soften and wear away. Improper footwear or injury in the lower leg can also contribute to Runner’s knee.
***If you are experiencing any of these symptoms, you should be evaluated by a physical therapist or physician. Do not continue to train or try to run through it. Doing so can lead to the injury worsening and cause your recovery timeframe to lengthen.
Conclusion
Although these injuries can be treated at a high rate of success with physical therapy, it is important for the health care provider to analyze the aforementioned factors to maximize recovery. If the cause of the injury is not truly established and addressed, outcomes will not be ideal. Full recovery may not be achieved or the injury may recur in the future. These guidelines should help minimize your risk of injury as well as maximize your performance on the road, trail, track, or wherever your path may lead you .
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