Running. It’s fun. It’s convenient. It’s easy. But sometimes, it hurts. While running is a great cardiovascular activity (and stress reliever!), there’s more to running than just running to remain pain-free and to increase the longevity of running careers. Below are suggestions to incorporate into weekly running routines to prevent injury or to address those nagging aches and pains to hips, knees, ankles, or feet.
Runner’s Guide to HEALTHY RUNNING
Running. It’s fun. It’s convenient. It’s easy. But sometimes, it hurts. While running is a great cardiovascular activity (and stress reliever!), there’s more to running than just running to remain pain- free and to increase the longevity of running careers. Below are suggestions to incorporate into weekly running routines to prevent injury or to address those nagging aches and pains to hips, knees, ankles, or feet. Having the necessary mobility of muscles and joints allows us to function through our body’s full range of motion to move (and RUN!) more efficiently decreasing undue stress to our muscles and joints. Limited mobility also affects running technique leading to potential compensations that could also lead to injury. So what’s the best way to improve mobility? Static stretching? Foam roller? Both? There are pro’s and con’s to both, but the bottom line is both techniques will improve flexibility/mobility of muscles and joints. Static stretching feels good and is quick; however, it does not decrease risk of injury or reduce post-workout muscle soreness. Foam rollers can target specific areas of tension within the muscle, increase mobility, and decrease post-running soreness allowing for quicker recovery. The best areas to typically address prior to running include: glutes, hamstrings, quadriceps, and calves, avoiding rolling over any bony areas. Focus on tender spots or “knots” within the muscle 30-60 seconds per muscle group before and after running, totaling four to eight minutes pre-and post-running. Don’t have a foam roller? The use of a lacrosse ball, tennis ball, massage stick, or rolling pin can perform the same function. As tempting as it is to pop out of bed, tie up your running shoes, and run, a dynamic warm-up is key for injury prevention. Dynamic warm-ups increase your body’s core temperature and increase blood flow to your muscles better preparing your body for running and exercise. Dynamic warm-ups also prepare the muscles in a more specific way that they’re used while running. Examples of dynamic warm-ups include: Inch worms, leg swings, Frankenstein’s, butt kickers, high knees, or walking lunges. Follow your foam roller program with a 5-10-minute light dynamic warm-up to get your heart rate up and your muscles primed for your run! Wait, strength training? Like lifting weights? YES! Resistance training not only builds strength, but it also makes muscles more efficient while running – meaning, muscles are using less energy over the same distance during your run. Muscles that are more efficient (and using less energy) become more resilient to injury allowing for less stress to ankle, knee, and hip joints, which equals more pain-free running! Stronger muscles also improve power that gives the extra push at the end of race to help enhance overall performance leading to potential PRs. Strength Mobility/Soft Tissue Work Dynamic Warm-Up
Focusing on functional movements while strength training (such as squats, deadlifts, and lunges) utilizes multiple muscle groups per exercise that better carries over to running performance/injury prevention than isolated strengthening exercises. Performing one-legged variations of squats and deadlifts will also help improve overall balance and stability while running. After all, running is essentially jumping from one leg to the other! These exercises also help to increase gluteal (buttock) and hamstring (back thigh muscles) strength; muscle groups that are notoriously weak in runners and the general population at large. Our gluteals and hamstrings help propel our bodies forward while running, and weakness in these muscle groups often lead to compensations by overusing the hip flexors and quadriceps (front thigh muscles) causing the all-too-common hip and knee pain in runners. Despite many runners shying away from appropriate strength training to avoid taking time from training schedules, performing strengthening exercises 1-2 days per week can effectively build strength without significantly affecting training routines. As the weather gets colder in the offseason and training tends to decrease, increasing the weekly frequency of strength training to 2-3x/week will better prepare your body when resuming training as the weather warms and outdoor running season returns. As with running form, strength training with appropriate form/technique is vital to maximize the benefits of strength training and to avoid compensations that could lead injury. Contacting a certified strength and conditioning specialist or a physical therapist will help to ensure these exercises are performed appropriately and safely. The “core”. What exactly is “the core” and why is it important for me to run? The core is a general term referring to the muscles that help to stabilize our back, pelvis, and hips. While running with the alternating pattern of the arms and legs, a strong core will limit having too much rotation throughout the midsection of the body allowing runners to maintain an efficient running technique for longer. Being able to run with an appropriate technique over a longer period of time not only decreases the risk for injury, but it also helps to improve performance! Many runners perform sit-ups or back extensions as a form of “core stability” exercises; however, these exercises only isolate specific muscle groups and can actually be more detrimental to low back health. A more integrated approach to core stability using multiple muscle groups throughout the abdominals, low back, and hip muscles is a more effective routine with regards to performance and injury prevention. These muscles help to maintain posture, as well as transfer energy to the legs, leading to less stress to the hips, knees, and ankles and more pain-free running. Four of the basic core stability exercises include the plank, side plank, bridges, and bird dogs. When performing these exercises, it is important to maintain the back’s natural curve without overly arching or overly rounding the back. Begin by doing one to two repetitions of these exercises holding for 20-30 seconds every other day and gradually increase to perform daily and with increase hold times. By “bracing” your core (as though you were about to be hit in the stomach) ensures the muscles of the low back, hips, and abdominals are all engaged simultaneously. Lastly, but most importantly, being able to continue to breathe while executing these core stability exercises engages our diaphragm (the muscle Core Stability
that fills our lungs with air) that provides further core stability while also mimicking breathing patterns while running. Much like running, core stability requires little (if any) equipment and can easily be done anywhere before or after a run. Building core endurance needs to be a cornerstone in any running training program for less fatigue and improved form while running to decrease the risk of injury. Many running injuries are the result of overuse and lack of rest and recovery days. Repetitively stressing our muscles, tendons, joints, and ligaments without appropriate, adequate rest will inevitably result in tissue breakdown and injury. Taking a rest day every seven to 14 days allows for tissue and metabolic regeneration leading to increased energy stores and stronger muscles, bones, and tendons that improve their resiliency to injury. Rest days may include focusing only on soft tissue mobility, taking a light walk, cross-training (cycling, swimming), participating in yoga, or another light activity to avoid overuse. Stresses resulting in overtraining will be entirely different from beginner runners to the experienced, but the signs of overtraining remain the same. Signs include pain, excessive fatigue, decreased energy, depressions, lack of appetite, excessive weight loss, irritability, sleep difficulties, increased colds/illnesses, and increased incidence of injuries. While taking a rest day may feel like time away from training (detraining effects typically don’t occur until after two weeks rest), a day’s rest a week is always better than being sidelined for six weeks with an injury! Recovery The primary risk factor for any injury is a history of a prior injury. A physical therapy evaluation focuses on movement analysis to identify potential movement patterns, as well as mobility, strength, or stability deficits that could lead to injury. Whether seeking physical therapy for an active injury or for injury prevention, first time runners to veterans can benefit from movement analysis to receive an individualized plan to help supplement training. Physical therapy offers manual therapy, exercise prescription, and education to address any mobility, strength, or stability deficits to return runners to pain-free running. Running is a great form of exercise with tremendous health benefits, but can at times lead to injury. Taking the time to focus on soft tissue work, strength, and core stability with adequate rest and recovery will help to keep those hips, knees, ankles, and feet pain-free and increase your performance! To speak with one of our physical therapists about staying injury free or managing an injury, please call us at one of our 4 convenient locations. Physical Therapy
Cherry Hill 856.874.1166
Sewell 856.582.3400
Haddonfield 856.616.8000
Garnet Valley, PA 484.800.8186
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