By:  Svetlana Marianer, Registered Physiotherapist, Practicing in downtown Toronto at The Orthopaedic Therapy Clinic. Whether you’re a novice, recreational or advanced competitive runner, there may have been a time where you’ve asked yourself “How can I run without injuring myself?” “What shoes should I wear?” “Is running outside better than the treadmill?” etc.  This article covers the essentials to help you better understand the “do’s” and “don’t” when it comes to the safety of your joints and the prevention of injury throughout your journey as a runner.

running injuries

MYTH #1: Running injuries are mainly caused by external or internal factors. Explanation

  • No matter how worn the shoe, how stiff the calf, or how weak the foot muscles, a runner only gets injured by RUNNING. Factors related to the gear, the running surfaces or the body itself can only worsen the already overloaded tissue which is primarily caused by the mechanical stress of running.
  • Injuries can be predicted by the amount of stress applied to the tissues. Studies show that the cause of nearly 80% of running injuries is directly related to an increase in training volume and/or intensity.
  • Studies show that increasing the amount of training by approximately 10% per week is the safest progression and the first step in preventing running injuries (as well as many other sport-related injuries). Furthermore, to strengthen the muscle, a minimal but relatively frequent stress is required for tissues to remodel and adapt. As well, it is also important to remember that extended periods of inactivity will tend to cause weakness, in which case the tissue de-conditions and becomes more fragile, leaving us more prone to injury.

MYTH #2: Shoe cushioning prevents injury Explanation:

  • Our feet are important. They inform us about the surface, absorb our body weight and adapt to the unevenness of the ground. The shoe provides essential protection from the cold and dangerous surfaces, but unfortunately “over-protects” our foot and in response sends our brains the wrong message throughout most of our daily activities.
  • Studies have shown that over the past thirty years, not only has the runner’s foot become lazier, but it’s ability to adapt to change (such as to different surfaces) has decreased. This change has paralleled the explosion in the technological development of the running shoe (more cushioning to reduce stress on the bones). In other words the increased thickness of the soles has resulted in our foot becoming less efficient at processing the information that the ground gives it, reducing our ability to quickly react to change i.e. uneven surfaces.
  • In terms of performance, the elevation of the slope of the shoe causes an unconscious first contact with the heel, which converts the runner into a heel-striker, as opposed to a forefoot striker. Due to this excess cushioning and “comfort”, the body senses an external protection and in turn, feels like it no longer needs to protect us from painful stimuli (such as the contact of the heel with the ground). Therefore, we end up landing on our heels, letting our joints absorb the high impact forces of the ground, hence substantially increasing the risk of injury.

MYTH #3: Hard surfaces increase the risk of injury, so only run on soft surfaces. Explanation:

  • Each type of surface provides us with diverse, yet necessary, feedback and produces different adaptation. For example, hard surfaces such as asphalt and concrete increase our ability to recognize and adapt to various impacts, while soft surfaces such as sand and grass help increase the body’s stabilization behavior. Both are equally important in order to train the runner’s foot to acquire the most efficient mechanical response.

Summary: Running injuries are primarily caused by an increase in training volume or intensity. To reduce your risk for injury it is important to use the “ten percent rule”. Build your weekly training mileage by no more than 10 percent per week. If you run 10 miles the first week, do just 11 miles the second week, 12 miles the third week, and so on. Lastly, keep in mind that if you are making any external changes (such as surface or shoes), they should be introduced gradually so that the body has time to adapt. If you are looking for running related advice, training or treatment, contact Svetlana Marianer Registered Physiotherapist, at The Orthopedic Clinic. Svetlana has completed several courses related to the prevention of running injuries, and as a dedicated runner, she has firsthand experience with the field. Disclaimer – This information is not meant to replace medical/health advice. Contact your health professional to ensure the diagnosis and treatment options are appropriate for your condition. References:  

Allen J. et al, The Runner’s World Big Book of Marathon and Half-Marathon Training. Sports and Recreation 2012.

https://books.google.ca/books?isbn=1609617088  – Brenner S.J. Overuse Injuries, Overtraining, and Burnout in Child and Adolescent Athletes.

The American Academy of Pediatrics 2007; Volume 119; issue 6. http://pediatrics.aappublications.org/content/119/6/1242      Chambon N. et al.

The effectiveness of motion control systems in preventing running-related injuries. Footwear Science 2015; Volume 7: S86-S87. http://www.tandfonline.com/doi/abs/10.1080/19424280.2015.1038623?journalCode=tfws20   Deneweth J.M et al.

Individual-specific determinants of successful adaptation to minimal and maximal running shoes. Footwear Science 2015; Volume 7: S97-S99. http://www.tandfonline.com/doi/abs/10.1080/19424280.2015.1038629?journalCode=tfws20#.V42PwvkrLIU

Dubois B. Effects of minimalist and traditional running shoes on injury rates: a pilot randomised controlled trial. Footwear Science 2015; Volume 7: pp 159-164. http://www.tandfonline.com/doi/full/10.1080/19424280.2015.1049300#.V42P6_krLIU   Fredericson M, Misra A.

Epidemiology and Aetiology of Marathon Running Injuries. Sports Med. 2007; Volume 37; Issue 4: pp 437-439. http://www.ncbi.nlm.nih.gov/pubmed/17465629 

Yeung E, Yeung S. A systematic review of interventions to prevent lower limb soft tissue running injuries. Br J Sports Med 2001;35:383–9.   http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1724431/