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How to avoid overuse injuries in runners

As we have already explored in the Running & Injury blog, one of the major reasons that runners get injured is because of training errors. Overuse injuries can happen if we don’t give our body adequate time to adapt to the demands of the activity and try to load it too quickly; or if there is insufficient recovery time between activities, meaning that the damaged tissue does not have time to heal. Normally it’s a combination of these things.

The GOLDEN RULES for reducing injury risk

  • Give your body time to adapt

  • Give your body time to recover

When running, we need to be mindful about frequency, duration and intensity. This allows us to consider whether we might be doing too much too soon (both in terms of speed and distance), if we are getting enough recovery between activities and whether our body is strong enough for the demand placed on it.

Progressive training is protective training

One of the classic approaches for building mileage is the 10% rule. Take the number of miles you ran in the last week and increase it by 10% for the current week. For instance, if you ran a total of 10 miles last week, it’s only an extra mile this week. This gentle progression approach has been around for many decades and is a good way of ensuring that we slowly adapt to the activity & build capacity, reducing the risk of injury. It feels like a very slow progression if you are looking to up your mileage but better to be patient, than find yourself an injured patient!

Another approach to reducing your risk of injury is the 80/20 rule. The approach has scientific backing and is particularly useful for ensuring both adaptation & recovery: 80% of your weekly training time is done at an easy effort level & 20% consists of harder running.

Often runners will try to push themselves on every run and end up doing all of their runs at the same intensity, but both moderate and high-intensity work cause the body too much stress. This not only increases the risk of injury but compromises recovery, as you go into your next run already fatigued.

Running at a slower easier pace puts less stress our muscles, bones and joints while still allowing for musculoskeletal adaptations. It also means we are able to recover more quickly between runs, both of which reduces our risk of injury. A further bonus of this training method, is that it can actually make you faster! A 2007 study found that athletes following the 80/20 rule had a 23% increase in 10k race pace!

The distinction between easy and hard is based on the point at which you switch from aerobic activity (using oxygen to fuel your muscles) to anaerobic (when there isn’t enough oxygen available for your muscles to use as fuel). The switch from easy to hard is based on heart rate and can vary for each runner, but the easiest way to ascertain your ‘easy effort’ level, is that it needs to be slow enough to maintain a conversation and this should form 80% of your running. The other 20% is at a moderate or hard pace that leaves you out of breath.

Rest & Recovery

Your body needs rest in order to adapt to training and to recover properly. Without enough rest and recovery, we risk injury and burn out. Rest & recovery days are essential to your training and as equally important as running days.

It is tempting to ‘go hard or go home’ when trying to get fitter or train for a specific event, but it is worth remembering that it is during rest & recovery that we give our soft tissue damage time to heal. Our muscles and tendons rebuild and become stronger & they adapt to the physical stresses we have put them through.

It's important to note that rest days and recovery days are different:

  • Rest days mean no running or exercising at all. Nothing, AT ALL. Make sure that you plan to take one day completely off each week.

  • Recovery days refer to easy exercise days and can aid recovery. Brisk walking, Pilates, swimming, easy cycling or strength training that focuses on lifting are all great activities that will boost blood flow & assist the recovery process by delivering fresh oxygen and nutrients to muscles. Experienced runners or runners who regularly run more than three days per week can use easy runs as active recovery days too.

Often overlooked as part of a recovery are the psychological factors, such as lack of sleep or stress at work which can delay healing or recovery by up to 60%.

Preventative Rehab

Also known as pre-rehabilitation or prehab, this is about taking the reactive strategies we use with patients in rehab and putting them into action in a proactive manner, to reduce risk of injury & improve overall physical health.

Typically, rehab will involve strengthening the muscles, joints etc that have been injured and prehab will involve the same, only as a strategy to PREVENT the injury rather than RESOLVE it.

Strength training is the vaccine to running injuries

It is really important to incorporate strength into your running schedule. Not only will it help you go further & faster, but it'll also strengthen areas of weakness which may otherwise lead to injury.

Strength training to improve performance & reduce risk of injury

Many runners neglect strength training for fear muscle bulk that leads to a reduction in speed but it is a total myth that strength training will slow you down. Multiple studies show strength training actually improves running performance & can reduce risk of overuse injury by almost 50%. Focus on heavy loads which will build strength and single leg exercises to iron out imbalances.

Get regular soft tissue treatment

Regular soft tissue treatment/sports massage as part of your training regime, is a great way of helping to reduce risk of injury & helps to maintain the health of the soft tissue.

Sports Massage

At Optimal Performance, whether you are injured or wanting to prevent injury, an assessment will look at your training, recovery, range of movement and any muscular imbalances.

Bespoke treatment includes massage therapy which offers the ability to monitor the condition of the tissues & the effects of training. By identifying & targeting areas of tissue damage it can help repair damaged tissues before they develop into injury. Mobilisation, massage & stretching all promote tissue healing and aid the remodelling phase of the damaged tissue, ensuring it does not become restricted, bound, tight or adhered to other structures. It can also help to reduce discomfort, tightness and improve flexibility & mobility.

We can also provide advice on warming up, cooling down, stretching, strength training & understanding pain, as well as prescribing rehab/prehab exercise plans to help you build strength & address any injuries, ‘niggles’, muscular imbalances & areas of weakness.

References & Further Reading

Esteve-Lanao, J.; Foster, C.; Seiler, S.; Lucia, A., Impact of training intensity distribution on performance in endurance athletes. Journal of Strength and Conditioning Research 2007, 21 (3), 943-949.


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