• Constant use (insufficient rest between stress workouts)
• Uneven terrain; failure to walk through rough terrain
• Prior damage
• Speedwork
• Too many races
• Doing something different
• Sudden increase of workload
• Not enough walk breaks during long runs
• Stretching can actually cause many injuries
It’s a physiological fact that the constant use of a muscle, tendon, or joint, without a break, will result in earlier fatigue and reduced work potential. Continuing to run or walk when the muscle is extremely fatigued increases the quantity of micro-tears dramatically and is a major cause of injury.
Pacing conservatively and inserting walk breaks early and often in long runs and stressful workouts will gain each runner a great deal of control over the fatigue process, while allowing muscles, tendons, feet, and joints to repair damage and maintain capacity. This lowers the chance of breakdown by significantly reducing the accumulating damage that leads to injury.
Note: This information is given as one runner to another and not meant to be medical advice. See a doctor for medical issues.
• Be sensitive to weak links, and let aggravations heal by strategic rest and treatment immediately when you experience a potential injury.
• Run long runs at least three minutes per mile slower than current marathon race pace (or from Magic Mile computation for a fast marathon).
• Take all walk breaks recommended on long runs based upon pace per mile.
• Avoid stretching weak links; stretching worsens or causes many injuries.
• Don’t try to change your running form significantly.
• Shoes: Get professional fitting advice from the experts in a good running store.
• Gradually break in a new shoe; don’t shift suddenly from a worn shoe to a new one.
• Run on stable terrain (e.g., track, road, or bike trail). Do your terrain training in small doses.
• Don’t do speedwork if you don’t have a time goal.
• Speedwork segments are paced according to the recommendations in this book.
• Run speedwork and long runs at the right pace for YOU and not that of faster runners.
• Gradually increase the speed and distance of workouts—no sudden increases.
• Take the full rest interval between speed segments recommended in this book.
• Run speedwork on a track or a paved surface.
• Prior damage, especially due to accident trauma, football, soccer, or skiing. It may not be possible for all of the damage to be repaired. In most cases, training adjustments can be made.
• Shoes are too worn.
• Terrain is too rough.
• Speed training and frequent racing increases stress on the weak links significantly. I have found individual training adjustments can often allow for continued training, but sometimes there needs to be a “vacation from speed” for a week or two.
• Stride length: Longer strides increase risk. A shorter stride may not slow you down if you will increase cadence or turnover. (See the section on the cadence drills.)
• Bounce off the ground: the higher the bounce, the more stress on feet, legs, and joints. The higher the bounce, the more shock to be absorbed upon landing. Stay low to the ground, touching lightly.
• Stretching: I have heard from thousands of runners who have been injured or had injuries worsened by stretching. In general, I do not recommend stretching. There are individuals who benefit from certain stretches, however. Be careful if you choose to stretch. Stretching is not generally found to be beneficial as a warm-up or cool-down activity and causes injuries when done at these times. Trying to “stretch out” fatigue-induced tightness often results in injury and prolonged recovery.
• Note: Those who have iliotibial band injury can often get relief from a few specific stretches that act as a quick fix to keep you running. Even when doing these, be careful. The foam roller treatment has been the mode that has reduced healing time for this injury. There is a picture on our website (www.JeffGalloway.com) that shows you how to use this.
• Continuing to work out when an injury has begun can dramatically increase the damage in a few minutes. It is always better to stop the exercise immediately if there is an indication that you have an injury and take two to three days off from running to get the healing started.
• Avoid certain exercises that worsen your weak links (different for the individual).
• The Toe Squincher: I recommend that all runners do this exercise every day to reduce and eliminate the chance of having a plantar fascia injury—or other foot problems. Point your foot down and contract the muscles in the forefoot/midfoot region. This strengthens the many little muscles in your feet that will provide extra support.
Note: Studies show that runners have healthier joints and fewer orthopedic complaints than non-runners.
Continuing to exercise when you feel that you might have an injury puts you at great risk for an extended pause from running. In most cases that I’ve monitored, when I suspect that there is an injury, it usually is an injury. Be sensitive to your weak links. When you notice any of the following symptoms, take at least a day or two off from running.
• Inflammation: Look for swelling, puffiness, or thickening.
• Loss of function: The area doesn’t work correctly or move normally.
• Pain: If the pain does not go away as you get warmed up and walk slowly, or the pain increases, STOP!
It is always better to err on the conservative side of injury repair. If you take an extra day off at the beginning of an injury you won’t lose any conditioning. But if you continue training with an injury, you may increase the healing time by a week or a month for each day you try to push through pain.
Some minor irritation may require just one day off from running. As the pain level increases, so does the need for more recovery days.
• Get the okay from a doctor to continue training (find a doctor who wants you to run when you can).
• Stay below the threshold of further irritation.
• Work out every other day.
• Insert walk breaks and shuffle breaks into runs.
• Avoid faster running or gently ease back into faster running.
• Don’t stretch (unless you have certain stretches that work for you and don’t hurt you).
• Long run endurance can often be maintained by walking the distance of the long one when injured.
• Warm-up: Start very slowly, gradually accelerate, and ease into the workout.
• Run the first and the last repetition more slowly than the others. Don’t race the last repetition.
• Rest between repetitions. When you have a history of speed injuries, take more rest.
• Some runners are more prone to injury than others. It is better to take an extra day or two off if you sense the healing is not adequate for running.
• If you already have a weak link irritation, don’t do a speed workout or any workout that could make it worse.
• Many running injuries will heal while you continue to run, if you stay below the threshold of further irritation. Talk to your doctor about this issue to ensure that the healing has started and that you are not irritating the injury as you start back. Most injuries allow for walking the distance of the long runs. This will provide all of the endurance as from running the long run.
• Cross-training: Pick an activity that does not worsen the injury. Water running is the best for maintaining running conditioning. To hold current endurance, schedule a long water-run session that is the same number of water-running minutes you would spend running your current long run. Some runners have been able to maintain speed conditioning by doing a speed-running workout in the water once a week.
• Swimming and cycling are good for overall fitness but don’t have a lot of direct benefit to runners.
• Activities to avoid: Anything that irritates the injury.
• If you can walk, walk for at least an hour every other day.
• Check with your doctor to ensure that enough healing has occurred to begin running again.
• Stay below the threshold of irritation. You want to see progress, week by week, in reduction of pain.
• Stay in touch with your doctor and ask questions if you suspect that you are making the injury worse.
• Avoid exercising if you are favoring the injured area or limping. Running in an abnormal way can result in an even worse injury in another part your body.
• If you haven’t been running, start by walking. Build up to a 30-minute walk.
• Insert small segments of running into a walk (run 5-10 seconds, walk the rest of the minute). If there is no aggravation, you could increase five seconds on the running segment while decreasing five seconds on the walking segment—after using each new ratio for at least two workouts.
• Avoid anything that could further injure the problem area.
• First increase the duration of the long run by 5-10 minutes every other week. Keep the Run-Walk-Run ratio mostly walking for the first week before increasing.
While the body adapts and adjusts to the running motion, workouts or races that are long and strenuous can result in irregularities in our normal form. Since the body is not adapted to these “wobbles,” weak links can be irritated. Continued use and using an unaccustomed range of motion can lead to injury. Following are some of the common ones. For more information, see my book Running Injuries: Treatment and Prevention and a knowledgeable sports medicine doctor.
Troubleshooting form-related injuries
• Lower back: Caused by forward lean, over-stride, or too few walk breaks.
• Neck pain: Caused by forward lean or head placed too far forward or back.
• Hamstring pain: Caused by striding too long or stretching.
• Shin pain on front: Caused by too long of a stride length, especially on downhills or at end of run.
• Shin pain on inside: Caused by over pronation or uneven terrain.
• Achilles: Caused by stretching, speedwork, or over-pronating.
• Calf pain: Caused by stretching, speedwork, or inadequate number of walk breaks on long runs.
• Knee pain: Caused by too few walk breaks, over-pronation, speedwork, or extended stride.
The most efficient and gentle running form is a shuffle: The feet stay next to the ground, touching lightly with a relatively short stride. When running at the most relaxed range of the shuffling motion, the ankle mechanism does a great deal of the work and little effort is required from the calf muscle. But when the foot pushes harder and bounces more and the stride increases, there are often more aches, pains, and injuries.
Time goal runners need to run faster in some workouts. This means some increase in stride length, greater bounce, and foot pushing. By gradually increasing the intensity of speed training (with sufficient rest intervals and rest days between), feet and legs can adapt. But there is still a risk of injury. Be sensitive to your weak links and don’t keep running if there is the chance that you may have the beginnings of an injury.
Posture is an individual issue. Most of the runners I’ve worked with find that an upright posture (like a puppet on a string) is best in all ways. When runners use a forward lean, there is a tendency to develop lower back and neck pain. A small minority of runners run with a forward lean with no problems. In this case, one should run the way that is most natural to the runner.
• Feet: They should be low to the ground, using a light touch of the foot.
• Try not to bounce more than an inch off the ground.
• Let your feet move the way that is natural for them. If you tend to land on your heel and roll forward, do so.
• If you have motion control issues, a foot device can provide minor correction to bring you into alignment and avoid irritating a weak link. A supportive shoe is also needed.
• Legs: Maintain a gentle stride that allows your leg muscles to stay relaxed. In general, it’s better to have a shorter stride and focus on quicker turnover if you want to speed up.
• Water-running can help in reducing flips and turns of the feet and legs, which sometimes cause injuries, aches, and pains. Using a flotation device, run in the deep end of a pool so your feet do not touch the bottom. Even one session of 15 minutes, once a week, can be beneficial.
At some point, most people who take long trail runs will experience at least an occasional cramp. These muscle contractions usually occur in the feet or the calf muscles and may come during a run or walk, or they may hit at random afterward. Very commonly, they will occur at night when you are sitting around at your desk or watching TV. When severe cramps occur during a run, you will have to stop or slow down significantly.
The most common cause of muscle cramping is overexerting the muscle, especially during the first mile or so. A slower warm-up often helps, as does a slower pace at the beginning of a workout. Running too hard on hilly terrain is also a cause. Medications, especially statin drugs, often cause cramping during exercise. If this is a possible cause, talk to your doctor; there may be a medication that allows you to run cramp-free. An over-the-counter salt tablet called Succeed! has been very effective in reducing cramping when it was related to sodium depletion. Cramping is common in the very long, long weekends and ultra marathon races.
Cramps vary in severity. Most are mild, but some can grab so hard that they shut down the muscles and hurt when they seize up. Light massage can relax the muscle and allow it to get back to work. Stretching usually increases the damage from the cramp, tearing the muscle fibers, according to my experience.
Most cramps are due to overuse—doing more than in the recent past or continuing to put yourself at your limit, especially in warm weather. Look at the pace and distance of your runs and workouts in your training journal to see if you have been running too far, too fast, or both. Remember to adjust long run pace for heat: 20-30 seconds a mile slower for each 5 °F of temperature increase above 60 °F—or, respectively, 20 seconds/kilometer slower for every 2 °C of temperature increase above 14 °C.
• Continuous running increases cramping. Taking walk breaks more often can reduce or eliminate them. Numerous runners who used to cramp on long runs when they ran continuously stopped cramping when they increased the frequency of the walks and decreased the length of the run segment.
• During hot weather, a good electrolyte beverage (consumed during the day, during the 24 hours after a long or hard run and during the four-hour rest periods on long weekends) can help to replace the fluids and electrolytes that your body loses in sweating. Accelerade has been the most effective drink in my experience. Drink about six to eight ounces every two to four hours throughout the day.
• Take a longer and more gentle warm-up.
• Shorten your run segment or take walk breaks more often.
• Slow down your walk and walk more.
• Take a longer warm-up during speed sessions.
• Look at any other exercise that could be causing the cramps.
• Take a buffered salt tablet during your long workouts (follow the directions on the label).
• Don’t push off as hard or bounce as high off the ground.
• Shorten your stride length.
• During speed workouts on hot days, walk more during the rest interval.
• Walk up hills.
Plantar fascia and foot injuries: The toe squincher
This strengthens the many muscles in the foot, promoting a strong push-off, reducing foot fatigue, and reducing foot damage. Point your foot down and contract the muscles of the foot, which will cause the toes to curl in. Keep the contraction until the foot cramps. This can be done when wearing shoes or not, 15-20 times a day.
Back and shoulder soreness and pain: Arm running/the crunch
Holding dumbbells (hand-held weights) in each hand, go through a slightly exaggerated motion you would use when running for a set of 10 reps (one left and one right equals one repetition). Pick a weight that is heavy enough so that you feel you have strengthened the shoulder and neck muscles, but not so much that you struggle to finish the last two repetitions.
This is the best treatment I’ve found for speeding the healing of the IT band. Use a cylinder of dense foam (illustrated on www.JeffGalloway.com). Lie down on your side, where the IT pain is felt. Rest your bodyweight on the roller and move your body (pressing down on the roller) with your hands so that you’re rolling from below the pain site to just above it. Roll for five minutes before the run, five minutes after the run, and five minutes before bed at night (probably the most effective).
Ice massage for achilles and other tendons next to the skin
Freeze a paper cup or Styrofoam cup of water. Peel off the outer layer at the top so it’s just a chunk of ice. Rub the ice constantly over the tendon for 15 minutes. The area should be numb after the treatment.
Night treatments may help more than others.
Experts tell me that most of the healing occurs overnight. If you perform one of these treatments before you go to bed, you may speed up the healing process.
If you are sensitive to your weak links, take the appropriate walk breaks and rest days, stop training when there could be an injury, and treat a damaged body part, you may avoid all serious injuries. This will bestow the greatest reward from running: enjoyment of every run.