Prevention and Management

of running injuries: an educational resource

Injury Prevention

The most common injuries associated with running occur in the lower leg (¹), although hamstring and hip injuries are also common (²) and it is important to identify the factors that may lead to injury so that they can be avoided.

Overuse injuries are often caused by a combination of factors such as excessive mileage before the body has adapted to the rigours of the sport, suddenly changing the distance and/or intensity of training, too much hard training, and running on cambered roads(³). Building mileage and intensity slowly (by no more than 10% per week) reduces the risk of injury and avoiding cambered roads means less stress on knee and hip joints.

Wearing the wrong footwear is becoming increasingly common, particularly with online retailing. It is estimated that 85% of runners are wearing the wrong shoes – either too big, too small (the biggest cause of black toe nails) or the wrong type for their running style (⁴). Injury risk is easily reduced by visiting a specialist running shop where you can try on the shoes and test them before purchase. Video analysis of running style is offered in many specialist retailers as an aid to correct shoe selection.

Management

Pain is the body’s response to injury and should not be ignored: it is there to alert the athlete to injury so that appropriate action can be taken (⁵). Early intervention is essential: think P R I C E D (⁶). Protect the injured site by stopping running; Rest to allow healing to take place; Ice to reduce inflammation; Compression to reduce swelling; Elevate to remove fluid from the area; Diagnose by visiting a doctor or hospital.

Treatment of running related injuries may involve exercises to mobilise, stretch or strengthen the injury, or massage and electrical treatments to promote healing (⁵). Training programmes may be modified to allow an athlete to return to running in a shorter timeframe (⁷). Examples may include swimming, running in water, cycling or cross training to maintain cardiovascular fitness while allowing the injured part to recover fully (⁸). A gradual, structured rehabilitation programme with a staged return to racing will help to prevent the injury returning (⁸). Identifying and treating the underlying cause of the injury are also essential in the management of the injury so that it does not return. This may involve changing the training programme, changing footwear or treating a biomechanical cause (⁵).

References:

1. Clement, D.B. & Taunton, J.E. (1980).A guide to the prevention of running injuries. Canadian Family Physician, 26: 543-548.

2. Hoskins, W. Pollard, H. (2005). The management of hamstring injury – Part 1: issues in diagnosis. Manual Therapy, 10: 96-107.

3. O’Toole, M. Prevention and treatment of injuries to runners. Medicine and Science in Sports and Exercise, 24: S360-S363

4. Nichols, N. (2009). 85% of Us Are Wearing the Wrong Workout Shoes--Are You Among Them? Retrieved October 17^th 2009 from

http://www.dailyspark.com/blog.asp?post=85_wear_running_shoes_that_dont_fit_are_you_one_of_them

5. Petersen, L. & Renstrom, P. (2001). Sports injuries: their prevention and treatment. London: Martin Dunitz.

6. Porter, B. (2002). P.R.I.C.E.D retrieved 17^th October 2009 from http://www.brianporter.btinternet.co.uk/prod01.htm

7. Hreljac, A. (2004). Impact and overuse injuries in runners. Medicine and Science in Sports and Exercise, 36: 845-849

8. Hackney, R. G. (1994). Nature, prevention and management of injury in sport. British Medical Journal, 308: 1356-1359

Written by: Brian Porter, Sport and Injuries