Running Rule No. 2: Avoid Injuries

There’s no need to be an athlete to appreciate the aggravation of an injury. Why and when our bodies break down is the question that may never have an answer, but maybe there’s a way to beat the system.


Injuries are generally defined as cumulative (overuse) or acute (traumatic). Football and soccer players most often suffer from acute injuries, having sustained the injury during a game. On the other hand, runners most often suffer from overuse injuries – caused by the constant repetition of the same movement.

Runner’s injuries have been attributed to a multitude of different causes, such as weight (over- being the operative missing word), minimalist shoes, over-cushioned shoes, rear foot-strike versus fore-strike, sedentariness (running 45 minutes a day and sitting on your bum the rest of the day), training errors, hard surfaces, anatomic abnormalities, not stretching, over-stretching….

However, the association between running injuries and factors such as warm-up and stretching, body height, mal-alignment, muscular imbalance, restricted range of motion, running frequency, level of performance, shoes and in-shoe orthoses, and running on one side of the road remains unclear or is backed by contradicting research findings.

Statements such as these make it abundantly clear we are anything but clear on what causes injuries.

My own pattern of training and injuries are interestingly odd as well. At times I have run 25 miles per week in constant pain and on the verge of injury, while other times I may run 70-mile weeks with absolutely no aches or pains.

During the last marathon training session, my calendar included two 20-mile runs. Unfortunately the weekend of the second such run also included a 24-mile backpacking trip with my classmates. To avoid dropping what I considered an integral portion of my training program, the 2nd 20-mile run was squeezed into the same 7-day period as the first 20-mile run, rendering myself a week of 90+ miles. It’s this kind of training decision we look back on and say “How stupid was that?”

Luckily, I survived that stupid decision…but why?

To build my case, let’s look at the list of several elite athletes’ injuries:

Nicolas Batum
Nicolas Batum

In 2009, Nicolas Batum of the Portland Trail Blazers suffered a shoulder injury, re-injured it during the summer, and tore it again when the season began – this time requiring surgery. Martell Webster (same team) had a stress fracture in his foot in 2008 and re-broke the same foot a year later.

Tiger Woods

Between 2002 and 2012, Tiger Woods sustained injuries to his left leg 9 times with a combination of ACL, MCL, tibia and Achilles’ tendon issues. It all began in earnest December 1994 when he had surgery on his left knee to remove two benign tumors and scar tissue.

Ryan Hall’s trouble began with plantar fascia problems, and then a hamstring injury forced him to drop out of the Olympic Marathon. That same hamstring injury also caused him to withdraw from the 2012 NYC Marathon. It was quad pain that caused him to ultimately withdraw from the Boston Marathon, and this past fall it was a hip injury – all on the same leg.

Paula Radcliffe
Paula Radcliffe

Paula Radcliffe’s running achievements appear larger than life now that we understand most of them came with what was effectively a broken left foot, courtesy of a stress fracture that never healed back in 1994.

Aches, pains and the highest risk of injury occur when coming back from a layoff….. what I call ‘re-entry’.

Over the years I have learned exactly where my aches and pains will show up: 1) on the top of the feet near the toes; 2) a small spot on the top of the right foot near the ankle; 3) sore shins;

Over the years I have also figured out exactly why these aches and pains show up: 1) Morton’s Toe, which makes the  metatarsals more prone to stress fractures; 2) possibly the car accident in 1985 that nearly crushed my right foot, or simply the way I’m made; 3) tight calf muscles.

None of these issues are an excuse not to exercise – they are simply the characteristics that make me who I am.  Left unchecked they will get worse. Left unhealed properly they will return even worse.

In case you haven’t heard, one of America’s premier talents in the marathon, Ryan Hall, has withdrawn from the 2013 ING New York City Marathon. Unfortunately for Hall, this is the third consecutive major marathon he’s pulled out of, and prior to that, he dropped out of the London Olympics due to a hamstring. Oct 28, 2013

Let’s Beat the System.

The body is a connected chain and will always compensate (often times unknowingly) when we have pain or weakness in a specific area, resulting in a never-ending cycle of injuries. If the injury is in the soft tissue such as when a muscle is torn, the tear, or rupture, is repaired with scar tissue. Untreated scar tissue is the major cause of re-injury, long after after you thought the injury had fully healed. There are ways to reduce the build-up of scar tissue at the time of the injury, and a deep sports massage will help reduce scar tissue that has already formed.

Understand your weaknesses and focus on them early.

I have learned my re-entry schedule must ramp up slowly or the weak body parts will be over-stressed. On the other hand, when I am in peak shape I can push the envelope a little. A slow ramp-up allows the metatarsals to become strong, massage helps the spot on the top of my right foot, and stretching the calves prevents the shins from becoming so sore that they are debilitating.

Your issues will be individual to you (remember N=1) making the fix equally individual.

If you’ve been diligent about a new exercise routine over the past few weeks, you are no doubt feeling a few aches and pains. You are not alone.

Acute injuries may be tough to avoid depending on your chosen sport, and sometimes our bodies will throw us a curve ball. For the every day aches, pains and looming danger, it is entirely possible to beat the system if you take the time to develop a real partnership with your body… and pay attention when it speaks.



Collateral and Re-Injury Prevention

Pulled Muscles, Scar Tissue, and Re-Inujury

This elite runner suffered from severe low blood sugar…..weaknesses are not always injuries.

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