Spring is finally in the air! Birds are singing, snow is melting, mud is EVERYWHERE, and you, like many of us fairweather runners, are starting to get the itch to hit the pavement, trail, or track. If you're like me, then the begging of warm weather also brings on a little trepidation. In previous years I've found that starting running has left me with annoying, disruptive foot pain and, within a month, I have to stop or severely cut back on running in favour of other activities much to the disappointment of my seventy-five-pound lab, Moose. If this sounds familiar, you're not alone. Research estimates that upwards of 50% of runners are injured each year, and in over half of those cases it leads to stopping running altogether. For those, like me, that try again next spring, recurrence rates of the same injury are upwards of 70%.
Boiled down, that means that if you started running today, there's a 50% chance you'll get hurt this season, there's a 50% chance that that injury will stop you from running this season, and a 70% chance that it will happen again next year if you don't do anything about it.
As one of the most accessible forms of exercise out there, these running injury statistics are pretty startling, especially during a time where physical health is more important than ever, and access to gyms has been at an all-time low.
The vast majority (50-75%) of injuries that occur with running are overuse injuries: meaning they happen simply due to repetition of the same action over and over again (rather than rolling an ankle on a curb, which would be an acute injury). These injuries are pretty simple when it comes down to it: they happen as a result of mismatched capacity and demand. Capacity is how much load your tissues can handle (this is affected by your strength, the surface you're running on, your form, and your equipment) and this will increase or decrease over time based on what you're doing. For example, if you worked out all winter, or ran all winter, your capacity is going to be higher than someone that runs in the summer and hibernates in front of Netflix all winter. Demand is the amount of work you're doing (affected by distance, speed, terrain, frequency of runs, and amount of recovery between sessions).
The amazing thing about overuse injuries? You can control MOST of the factors that contribute to them! In this article, I hope to give you four practical strategies that have been shown to reduce the risk of overuse injury and help you stay active early and often this summer. Read on to EMPOWER your running this year!
Ease Back In
It sounds simple, and I'm sure it's advice that you've heard over and over again, but slowly increasing your mileage is one of the easiest things you can do to mitigate injury in the early part of running season, particularly if you took most of the winter off. This is the "demand" portion of overuse injuries. There's a number of factors here that you can control, and my advice to all of my runners is to only tinker with one at a time, because if you increase demand in multiple places at once, you may find yourself on the wrong side of your capacity.
Duration or Distance
This is generally the first thing that comes to mind when it comes to easing in: how long are you running for? If you haven't run all winter then heading out for an hour might be biting off more than you can chew (even if you could do that last summer!). Generally, my advice is to start with a run-walk (which we'll talk about in intensity) for 15-30 minutes, plus warm-up and cooldown time. If you're a new runner, start with 15 minutes and fill the other 15 with brisk walking, if you're a more experienced runner, try the 30 minutes of run-walk and see how you feel.
How do we measure success here? You don't have pain during your run, immediately after your run, or the next morning. When you're starting out for the season, I aim to complete 2-3 successful runs at the same duration before increasing, after which you can increase by 10% each week until you reach the duration or distance that you're aiming for.
Intensity is another variable that you can control easily as you restart running for the season. Intensity is essentially how hard you work during a session on average and in bouts. If we rated intensity out of ten, ten being as hard as you could possibly run, zero being standing still, we can get a ballpark measurement of intensity. Another easy way to measure intensity is using split times that any running app or watch will give you. Personally, I'm a fan of the rating system, and I'm going to show you why:
Look at intensity within a session in two different scenarios: 5/10 intensity for thirty minutes straight, compared to a run-walk of 6/10 intensity for three minutes, and 2/10 intensity for two minutes repeated for thirty minutes. Which run has a higher intensity overall? If you said the 5/10 intensity for thirty minutes, you're right! Even though the peak intensity of the run-walk is higher, the average over the course of the half-hour is higher in the first scenario. So what does this mean for you? Using a run-walk early on in your running season allows you to lower the intensity and potentially protect yourself from injury.
When using a run-walk format, I like to have my runners complete 2-3 successful runs at a given run-walk interval in the early part of their return to running before increasing the work interval (running) or decreasing the rest interval (walking). I typically do this in increments of 30 seconds, but as long as the runs are staying successful (see the criteria under "duration"), progress is allowed at the runner's own pace.
Another easy point to make on intensity is to look at it on average over the week. If you rate your runs on that same ten-point scale each day based on how hard you feel you worked, the AVERAGE of all your runs in the week should be between 7-8/10. That means you may have a 10/10 run one day, but it should be balanced with a 5-6/10 run another day, and your third run of the week could be a 7/10 difficulty. Too many 10/10 runs will put you consistently over your capacity and result in injury, while too many 5/10 runs will slow your progress if you're working towards a goal, so get in the habit of rating your runs!
Where do you love to run the most? For me, it's trails, whether that's through the woods or the rail trails around town, but every terrain has its advantages and disadvantages. It's important to ease into whatever terrain you're going to use for training depending on what your goals are.
Road training is best for our speed demons. Roads are flat, spacious, and are usually a consistent surface (just watch out for potholes!). You're the least likely to roll an ankle on a flat road, but because the surface is so hard, it's also the least forgiving when it comes to absorbing force. Concrete and pavement don't bend when you land on them, which means your body has to absorb all the force it places down on the ground. This isn't an inherently bad thing, but if you're the kind of runner that makes hard contact, it might pose a problem over time.
For the purpose of this article, we'll define trail running as a run through the woods along a beaten trail, not a gravel path. This is the most inconsistent of all the surfaces, meaning you regularly have to account for rocks, roots, wet leaves and sticks lying on the ground. This makes you significantly more likely to sustain an acute injury, but the constant adjustment of footing and position means you're actually much less likely to have a repetitive injury. However, the trade-off is that trail running is often much slower than road running and is more intense at slower paces.
Track running, for the purpose of this article, will also include gravel trails (like our rail trails here in town). These surfaces tend to be fairly consistent (with the exception of the odd potholes or washout) and are much softer than running on pavement. A gravel track tends to absorb force, which decreases the tissue loads on landing but doesn't give it back, meaning you have to push off harder to generate the same amount of speed. Whereas a rubberized track both absorbs force and gives it back, meaning you don't have to push off as hard for the same amount of speed. Both scenarios have advantages and disadvantages based on your current or previous injuries, which one of our physiotherapists would happily explain to you at length, but suffice it to say that for the novice runner, these make a safe starting surface.
A go-to for many people over the cold winter months, treadmills are useful tools for keeping active. The surface is flat and consistent and it absorbs and releases force to make running easier than on pavement or a gravel track. Because treadmills are generally self-propelled, meaning the carpet moves under you without you having to push it, it makes it easier to run at higher paces for longer durations. Make sure you take these factors into account when going from indoor running to outdoor running.
Flats Versus Hills
This one isn't as easy as flats are easy, hills are hard. While that's partially true, all of these have a role in your running program. Generally speaking, flats will always be the easiest place to start, become consistent on, and experience success before progressing to hills. Notably, hills can be good or bad based on injuries you're experiencing. Chronic hamstring or Achilles injuries? You might want to pace yourself on the uphill. Pain under your kneecap or on the front of your knee? Speedy downhills may be a problem for you.
The final component of easing in is a counterintuitive one: taking time off. When restarting running, you might be tempted to think that more is better, and that will get you towards your goals faster. The reality is that better is actually better. Better training with better recovery at better intervals. To get your timing right, you have to listen to your body. That means if you have successful runs (no pain during, immediately after, or the next day), you can run more frequently, but if you have unsuccessful runs, which typically starts out as having pain after a run or the following day, give yourself more of a break between. Start out with 2-3 days between runs, and after every 2-3 successful runs you can decrease the days between.
Add Some Strength
We're going to expand on this more in another blog post, but suffice it to say that adding in 1-2 short resistance training sessions per week focused on running-specific exercises can drastically reduce your injury rate. Typically, this means rotational core training, and lots of single-leg strengthening that will benefit the hip, knee, foot and ankle. We often start these as a portion of our rehabilitation for a running injury and have runners continue to work on a shortened list a few times a week to maintain their strength gains.
Where easing in has everything to do with controlling demand, adding strength has everything to do with increasing your tissue's capacity to tolerate running load. Remember: overuse injuries occur because of a mismatch between tissue capacity and exercise demand, and while controlling demand is a fast and effective way to reduce injury risk, increasing capacity is by far the best long-term solution to improve your running performance.
Get A Running Assessment
Have you ever heard that two heads are better than one? Four eyes better than two? And one running assessment is better than none? Ok, maybe not the last part, but have you ever HAD a running assessment?
At CONNECT these are a staple for any runner we work with. Typically, we'll begin with a walking warm up after we've already done our hands-on treatment and progress towards your normal training pace. We'll take videos at 240fps from either side and the back so that we can look at every aspect of your stride; from strike and take off, to vertical displacement, rotation, arm swing, and joint angles. We synthesize this into a report that YOU can understand, and we use it to make exercise or technique recommendations.
These running assessments give us a critical snapshot of what's going on when it comes to things that could be contributing to your current or past injuries, and ways that we can help you improve your performance, which leads me into my next point:
Get A Tune Up
Treat every spring as an opportunity to get better, faster, and fitter than last year. That means taking care of last year's injury so that it doesn't become this year's roadblock. The therapists at CONNECT are experts at treating running injuries old or new, and finding ways to optimize your running so that you can make this season a personal best!
Whether it's Registered Massage Therapy and breathing with Jamie, functional acupuncture, adjustment and kettlebell training with Dr. Nick, core and pelvic health with Stephanie, or hands-on therapy and performance strengthening with Cody, Sarah or Clare, the CONNECT team has exactly what you need to succeed this year.
Now that you have all the tools you need to build your perfect transition back to running, get out there! Know that it will take 4-6 weeks to gain back 80% of what you finished with last fall, so be patient with yourself, but get a head start so that by the time the weather is perfect, so are you!
We can't WAIT to see people taking advantage of all the beautiful weather that is sure to be coming our way after what has undoubtedly felt like the longest winter in recent memory. We hope you enjoyed this article, and remember, the CONNECT team is here for all of your running and performance needs!
Clare Donaldson is a Registered Physiotherapist, new mom, Crossfit enthusiast, poor but passionate hockey player, and genuine lover of all things physiotherapy. She is especially interested in keeping moms of all ages strong and healthy throughout their lives. When she's not at CONNECT, you can find Clare hiking with her dog, Moose, or spending time with her young family. To find Clare at CONNECT, click here