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March 1, 2024
8 min read
Dr. Thomas Anderson, Running Specialist
Injury Prevention

Runner's Guide to Injury Prevention: Stay Healthy and Run Longer

Prevent common running injuries with proper training, strengthening exercises, and smart recovery strategies. Essential tips for runners of all levels.

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Running injuries sideline millions of runners each year. Studies show that 50-75% of runners experience an injury annually. The good news? Most running injuries are preventable with proper training, strengthening, and smart recovery strategies.

Most Common Running Injuries

1. Runner's Knee (Patellofemoral Pain Syndrome)

  • Pain around or behind kneecap
  • Worsens with stairs, hills, sitting
  • 22% of running injuries
  • Often from weak hips and glutes

2. Shin Splints

  • Pain along inner shin bone
  • Common in new runners
  • From increasing mileage too quickly
  • Often related to footwear

3. Achilles Tendinopathy

  • Pain in Achilles tendon
  • Worse in morning or after rest
  • From overtraining or tight calves
  • Can become chronic if ignored

4. Plantar Fasciitis

  • Heel pain, especially morning
  • From tight calves and improper footwear
  • Affects 10% of runners
  • Responds well to early treatment

5. IT Band Syndrome

  • Pain on outside of knee
  • Worsens during runs
  • From weak hip abductors
  • Common in distance runners

6. Stress Fractures

  • Localized bone pain
  • Doesn't improve with rest
  • From overtraining and poor nutrition
  • Requires extended break from running

The 10% Rule

Never increase your weekly mileage by more than 10% per week.

Why It Works:

  • Allows tissues to adapt
  • Reduces overuse injury risk
  • Sustainable progression
  • Prevents sudden overload

Application:

  • Track weekly mileage
  • Increase gradually
  • Include cutback weeks (reduce 20-30% every 3-4 weeks)
  • Be patient with progression

Essential Strength Training for Runners

Lower Body Strength (2-3x per week)

Single Leg Squats:

  • Builds leg strength
  • Improves running stability
  • Addresses imbalances
  • 3 sets of 10-12 each leg

Hip Bridges:

  • Strengthens glutes and hamstrings
  • Supports knee and hip health
  • Improves running power
  • 3 sets of 15-20 reps

Calf Raises:

  • Prevents Achilles issues
  • Both bent and straight knee versions
  • Off step for full range
  • 3 sets of 15-20 reps

Lunges (All Directions):

  • Forward, reverse, lateral
  • Functional strength
  • Balance component
  • 3 sets of 10 each leg

Core Stability (3-4x per week)

Planks:

  • Front and side planks
  • Hold 30-60 seconds
  • 3 sets
  • Essential for running economy

Dead Bugs:

  • Targets deep core
  • Prevents low back pain
  • 3 sets of 10 each side

Bird Dogs:

  • Balance and stability
  • Strengthens back
  • 3 sets of 10 each side

Hip Strength (Critical!)

Clamshells:

  • Strengthens hip external rotators
  • Prevents IT band syndrome
  • 3 sets of 15-20 each side

Side-Lying Leg Raises:

  • Hip abductor strength
  • Prevents knee pain
  • 3 sets of 15-20 each side

Monster Walks:

  • Band around ankles or knees
  • Activates gluteus medius
  • 2-3 sets of 10-15 steps each direction

Flexibility and Mobility

Dynamic Warm-Up (Before Running)

Leg Swings:

  • Forward/back and side to side
  • 10-15 each direction
  • Prepares hips for movement

Walking Lunges with Twist:

  • Warms multiple muscle groups
  • 10-12 each leg

High Knees and Butt Kicks:

  • Activates muscles
  • Increases heart rate
  • 20-30 seconds each

A-Skips and B-Skips:

  • Running-specific activation
  • Improves form and power

Static Stretching (After Running)

Hip Flexor Stretch:

  • Hold 30-60 seconds each side
  • Prevents lower back issues

Hamstring Stretch:

  • Multiple positions
  • Hold 30-60 seconds each side

Calf Stretch:

  • Both straight and bent knee
  • Hold 30-60 seconds each side

IT Band/TFL Stretch:

  • Standing cross-over stretch
  • Hold 30-60 seconds each side

Foam Rolling (Daily)

Target areas:

  • IT band
  • Quads
  • Hamstrings
  • Calves
  • Glutes

Spend 1-2 minutes per area.

Training Principles

Variety in Training

Mix Different Types of Runs:

  • Easy runs (80% of mileage)
  • Tempo runs
  • Interval training
  • Long runs
  • Recovery runs

Rest and Recovery

Rest Days:

  • At least 1-2 per week
  • Allow adaptation
  • Prevent overtraining
  • Mental break

Easy Days:

  • Conversation pace
  • Build aerobic base
  • Active recovery
  • Most important runs

Cross-Training:

  • Swimming
  • Cycling
  • Elliptical
  • Strength training
  • Reduces impact stress

Listen to Your Body

Good Pain vs. Bad Pain:

Acceptable (Usually):

  • General muscle soreness
  • Mild fatigue
  • Exercise-induced muscle burn

Warning Signs:

  • Sharp, localized pain
  • Pain that worsens during run
  • Pain affecting gait
  • Swelling
  • Pain at night

When to Take a Day Off:

  • Pain affecting form
  • Illness
  • Excessive fatigue
  • Multiple days of poor sleep
  • High stress periods

Proper Running Form

Key Elements

Posture:

  • Upright trunk
  • Slight forward lean from ankles
  • Shoulders relaxed
  • Head neutral

Foot Strike:

  • Debate exists (heel, midfoot, forefoot)
  • Land under body, not in front
  • Quick ground contact time
  • Light, quiet steps

Cadence:

  • Aim for 170-180 steps/minute
  • Reduces impact forces
  • Improves efficiency
  • Use metronome apps

Arm Swing:

  • 90-degree elbow angle
  • Forward and back motion
  • Relaxed hands
  • Drives leg turnover

Footwear and Equipment

Running Shoes

Replacement Schedule:

  • Every 300-500 miles
  • Varies by body weight and surface
  • Cushioning breaks down
  • Rotate between pairs

Shoe Selection:

  • Get professionally fitted
  • Consider gait analysis
  • Don't just go by looks
  • Allow toe room (thumb width)

Minimalist Transition:

  • Very gradual (months)
  • Start with short runs
  • Allow adaptation time
  • Not for everyone

Other Equipment

Socks:

  • Moisture-wicking
  • Proper fit (no bunching)
  • Consider compression

Clothing:

  • Moisture-wicking fabrics
  • Weather-appropriate
  • Avoid cotton

GPS Watch:

  • Track mileage accurately
  • Monitor pace
  • Heart rate data
  • Prevents overtraining

Surface Considerations

Running Surfaces

Trails:

  • Lower impact
  • Varying terrain (strengthens ankles)
  • Softer surface
  • More engaging

Roads:

  • Consistent surface
  • Hard impact
  • Watch for camber
  • Easy to measure distance

Track:

  • Consistent, measured
  • Softer than road
  • Repetitive turns (switch directions)
  • Good for speed work

Treadmill:

  • Controlled environment
  • Softer than pavement
  • Slightly different mechanics
  • Good for recovery runs

Variety is Best:

  • Mix surfaces
  • Reduces repetitive stress
  • Keeps training interesting
  • Builds different strengths

Nutrition for Injury Prevention

Overall Nutrition

Adequate Calories:

  • Fuel training demands
  • Support recovery
  • Prevent injury risk
  • Don't under-eat

Protein:

  • 1.2-1.6 g/kg body weight
  • Supports muscle repair
  • Post-run within 30-60 minutes
  • Distribute throughout day

Carbohydrates:

  • Primary fuel source
  • 5-7 g/kg for moderate training
  • 7-10 g/kg for high volume
  • Don't fear carbs!

Healthy Fats:

  • Anti-inflammatory
  • Hormone production
  • Joint health
  • Omega-3s especially important

Hydration

  • Drink to thirst
  • Urine color guide (pale yellow)
  • Electrolytes for long runs (>90 min)
  • Pre-hydrate before hot runs

Micronutrients

Iron:

  • Critical for endurance athletes
  • Get levels checked if fatigued
  • Include iron-rich foods
  • May need supplementation

Vitamin D:

  • Bone health
  • Immune function
  • Many runners deficient
  • Consider testing and supplementing

Calcium:

  • Bone strength
  • Prevents stress fractures
  • 1000-1200 mg daily
  • Food sources best

Recovery Strategies

Sleep

  • 7-9 hours nightly
  • Most important recovery tool
  • Affects injury risk
  • Prioritize quality

Active Recovery

  • Easy movement on rest days
  • Walking
  • Swimming
  • Yoga or Pilates
  • Light cycling

Massage Therapy

  • Regular sessions (every 2-4 weeks)
  • Addresses muscle tightness
  • Improves recovery
  • Prevents injury

Ice and Heat

Ice:

  • Acute injuries
  • After hard workouts
  • Reduces inflammation
  • 15-20 minutes

Heat:

  • Chronic tightness
  • Before stretching
  • Improves blood flow
  • 15-20 minutes

When to See a Professional

Warning Signs

  • Pain lasting >2 weeks
  • Pain affecting running form
  • Worsening symptoms
  • Unable to run without pain
  • Swelling that doesn't resolve
  • Night pain

Professional Options

Physiotherapist:

  • Biomechanical assessment
  • Treatment and rehabilitation
  • Running gait analysis
  • Strengthening programs

Sports Medicine Physician:

  • Diagnosis
  • Imaging if needed
  • Medical management
  • Return-to-running clearance

Registered Massage Therapist:

  • Soft tissue work
  • Recovery enhancement
  • Injury prevention
  • Maintenance care

Pedorthist:

  • Foot assessment
  • Custom orthotics
  • Footwear recommendations

Building a Sustainable Running Practice

Long-Term Success Factors

  1. Progressive Training: Gradual increases
  2. Consistent Strength Work: Non-negotiable
  3. Adequate Recovery: Built into schedule
  4. Proper Nutrition: Fuel your training
  5. Quality Sleep: Prioritize rest
  6. Listen to Your Body: Adjust as needed
  7. Professional Help: Early intervention
  8. Patience: Years, not months

Creating Your Prevention Plan

Weekly Schedule Example:

  • Monday: Easy run + strength
  • Tuesday: Workout (tempo/intervals) + core
  • Wednesday: Easy run or cross-train
  • Thursday: Easy run + strength
  • Friday: Rest or very easy run
  • Saturday: Long run
  • Sunday: Rest or cross-train + core

Adjust based on:

  • Experience level
  • Goals
  • Time available
  • Recovery needs

The Bottom Line

Running injury prevention requires a holistic approach:

  • Smart training progression
  • Consistent strength and mobility work
  • Proper recovery
  • Good nutrition and sleep
  • Quality footwear
  • Listening to your body

Don't wait for injury to focus on prevention. The runners who stay healthy long-term are those who prioritize these factors from day one.

Dealing with a running injury or want to prevent one? Our sports physiotherapy team at M.O. Therapy specializes in treating runners. We offer comprehensive running assessments, gait analysis, and personalized injury prevention programs.

Book your running assessment today. Whether you're training for a marathon or just starting your running journey, we'll help you stay healthy and achieve your goals.

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