How To Holistically Prevent Running Injuries (Part 1)

Chances are you’ve been out for a run… and suddenly felt an ache somewhere.

Then, the freak-out happens: “NOOOOOOO! My training was going so well!” or “My (insert race) is coming up in a few weeks!”

Studies have shown that up to 79% of long-distance runners and 90% of marathon runners get sidelined with an injury.

Up to 2/3 sustain an injury that sidelines them for a week or longer.

So how can you avoid becoming a statistic?

The first thing you want to avoid is panicking! 

Sometimes it’s nothing, but other times – sure – it’s something.

But freaking out can often cause you to stiffen up, change your stride and lead to even more consequences.

So, instead, let’s relax, back up a few beats and see how you can prevent injuries and avoid a catastrophe to your running routine.

I’ll give you many things to try, but I emphasize that we’re all individuals. So, what works for one person may not be what works for you. 

The key is to find the gaps in your routine and adjust what’s needed.

This post is the first in a series on holistically preventing injuries through training adjustments, nutrition, sleep + recovery practices, mental health and outlook, and more.

What to do if you feel a running injury NOW

First, if you notice an ache that is not healing by your next workout, try conservative treatments at home.

This can include RICE (rest, ice, compression, and elevation) alongside extra recovery and TLC. 

Many times, aches and pains can be your body telling you it’s not recovering well enough. 

So adding in more days of recovery could help in this case. 

If these things don’t work, or it continues to come back, it’s best to see a doctor and get the best advice for healing.

I can’t emphasize this enough – get existing injuries treated by a professional. Many runners try to run through the pain, sometimes for weeks, afraid a doctor will tell them to quit running. 

They ask their friends or post online for advice. The problem is that something like “hip pain” can have multiple causes, so what helped one person may not help another. 

Continued delays can worsen the injury enough to make you stop running.

Try to find a doctor or sports doc who is familiar with runners. If you’re not sure – ask them directly.  

If you return to running and find that you are starting to get achy, let’s see what changes you can make.  

My method in coaching runners is to find your unique holistic “blueprint” to improve performance and prevent injuries so you can reach your goals and feel amazing in running and life.

So let’s start by looking at your training: what changes should you consider to stay uninjured this year? 

How to Train to Prevent Running Injuries

Numerous runners come to me for help who have suffered running injuries. Many times, repeatedly. Frequently, it’s due to training errors.

Some may think they had been doing things right because they read an article on “The Best Way to Train” or by doing what their friend (who never seems to get injured) does.

But then they still get injured.

Realize that everyone is different, so the factor (or multiple factors) that prevent injuries in one person may not be the same as what will work for you.

So, let’s dig in…

Make Running Changes Gradually  

I’ve mentioned before it’s excellent to be mindful of your run, but this doesn’t always mean during your run: it can also mean paying attention to how and where you do your training.

For example, many runners changed how they ran because of lifestyle changes caused by the pandemic. They stopped running with groups or changed the format of their runs: location, pace, or distance.

A study found that the more variables runners changed at once, the higher their chance of injury.

So, be mindful how many changes you make at once, including mileage, intensity, terrain, who you run with, or the times you run. It could impact your chances for injury!

Watch Your Mileage or Intensity Build-Up

Especially when coming back from an off-season or an injury or illness, you may want to return to where you were instantly. But immediately starting to run at your old pace or mileage could be setting yourself up to get injured.

The problem is that your body doesn’t tend to like big jumps or spikes in your training. It can take time for the muscles, joints, and tendons to adapt, as well as all your internal systems.

Injuries can also occur if you ramp your overall mileage too quickly to achieve a training volume you have not reached before. 

For example, running 50 miles per week and suddenly jumping up to 100 miles per week.

This is more common than it seems. It can be tempting to want the high mileage of elite athletes, post significant mileage on social media, or participate in running challenges that can cause you to jump your mileage suddenly.

Beginner runners, or any runner, can also fall prey to this by leaping into a generic training plan that isn’t at their level. Twenty miles per week may not sound like a significant amount of mileage to some, but it is a considerable increase for someone running 5-10 miles per week.

In this case, your muscles won’t have developed a “muscle memory” of running that mileage before, and it may take longer to recover and adapt, especially if you are a beginner, returning after substantial time off, or a master’s runner.

Start from where you are and build up slowly

The 10% rule is often adequate for limiting your weekly mileage increases.

If you’ve been running for a long time and are returning but haven’t been out of it too long, you may be able to increase more than 10% per week, but pull back if you feel any aches or pains.

10% increases can be too much for some due to their makeup. Add more recovery and increase at a slower pace if this is you.

You may need to use smaller weekly increases if you come back from something like Covid-19. Be sure to tune into your breathing and fatigue levels overall and adjust where needed. And, be sure to check in with your doctor.

Watch the proportion of your overall weekly mileage

Your long run and its ratio to other mileage and activities can depend on your race distance. Depending on the athlete and race length, those training for ultramarathons may have longer (but potentially slower) long runs than runners training for marathons.

Still, typically the lower the percentage of your weekly miles that your long run makes up can lead to a lower potential for injury.

It can also depend on how many faster miles you have in your training plan, as the quicker pace can be a stressor on your body.

Add speed work gradually

It’s OK to want to add in strides, and fartlek runs, interval sessions, threshold runs, or repeats of more intense work. However, adding in too many of these sessions per week, especially too soon, can increase your risk of injury.

The body can reject sudden jumps in intense training like large jumps in volume. It can also be essential to get the body used to easier speedwork so that the neuromuscular system can adapt: the muscles and nerves can develop the ability to fire faster as they adjust to speedier runs.

You may want to start with adding in 4-6 sets of strides, which are 20-30 second pickups and fartlek runs, which contain variable speed in free-flowing intervals.

Then progress on to more intense work. Depending on your race and ability to recover, you may want to limit your speed sessions to 1-2 per week.

Another key is to make sure you are training at the correct intensities. Many runners mistakenly think that to run fast, you need to run at your fastest all the time, and this causes them to make the previously mentioned mistake and run too fast too frequently, increasing injury risk.

But also, running too fast too much can cause a runner to lose the feel for what an easy run is, and this can cause them to run their recovery workouts too fast or even not have them at all.

Continually repeating the same training pace is also known as “training monotony,” which is a rating that indicates a lack of hard/easy variation in your training. Training in this way can increase your risk of injury and overtraining.

It also causes distance runners to miss out on the foundation of their distance running performance: easier-paced running that develops your aerobic energy system.  

Save competing for actual races

Running in a group can have tremendous benefits, but a drawback can also be that more competitive runners can also run too fast too often.

They can fall into the trap of wanting to “win the workout” by racing their friends and end up similarly running too fast too often. Not only can it increase injury risk due to too much intense training with less recovery, but it can also lead to burnout.

For this reason, I heard a related quote at one of my coaching certifications years ago: “People who win workouts don’t win races.”

Speaking of races, if you plan to do a race as a training run – say running a half-marathon as part of a long run but at marathon pace – try to keep it that way. 

Running races too often and uncontrollably racing during “training races” can be another big challenge for runners, and this mistake has led to the undoing of their ultimate goal at their target race.

Increased intensity can also happen in a park or even on a treadmill when runners frequently become too competitive with strangers who may be running nearby to try to be the faster runner. It seems harmless until it happens too often.

It can also happen if you forget about pacing during interval workouts and just run all your intervals as fast as possible.

Remember that training paces work to train different aspects of your abilities as a runner. And that pushing hard in this way all the time can increase your risk of injury.

Be Consistent

One of the keys to being a successful runner is to be a consistent runner, and being inconsistent can also lead to injury.

A few years ago, a friend made a video on what he thought made the best runner, and he put having the proper training volume over consistency.

In a later discussion, I mentioned that I’d prefer to train a consistent runner who may put in slightly too few miles than an inconsistent runner who put in the correct number of miles.

Let’s look at an example.

Runner A has 30 miles scheduled in a week, and they end up running 7, 3, 6, 2, and 10 miles. They ran their schedule but had to cut one of the runs slightly short due to getting called into work. So, they got 28 of the 30 miles done that week.

Runner B has the exact 30 miles scheduled and runs 7, 3, then misses the rest of their runs. So, they try to make it up by busting out a 20-miler on the weekend, ending with 30 miles.

Runner A was consistent even though they had a couple of miles less. Their mind and body get used to their running routine, and there are no sudden jumps in mileage.

Runner B was more inconsistent and suddenly had a massive jump in mileage.

Runner B is going to have the higher injury risk!

Plus, I often say, “How you do one thing, you do everything.” 

So if you are consistent with your running, you are more likely to be steadier with your nutrition, fueling, sleep, etc.

So even if your run distance may be less than perfect for that day, it can be worth it to keep up your routine to keep your training going, and it can reduce your risk of injury.

If you miss a workout, keep going

There may be situations where you can shift things around if it’s a key run. You’ll need to look at your upcoming balance of workouts to see if this looks realistic for you. 

But, adding the missed miles later can lead to the dreaded spikes in your training if you add in more than the planned miles on other days.

Or, even though you are trying to be more consistent by “making it up later,” trying to make up missed days can lead to irregular training patterns. So you could have several days of not running at all and then multiple days of running bunched together.

These bunched-up days can also be more challenging to recover from adequately before your subsequent workouts, affecting your performance going into the following week. Your body may respond with pain or even an injury.

It’s better to be slightly undertrained and uninjured at the starting line versus limping or not even making it to the race. 

If you have one week of training that is somewhat off, keep going. You don’t have to be perfect to have a good result.

But with multiple weeks of inconsistency, you may want to reevaluate your goal to avoid injury risk.

Be Careful When Changing Surfaces and Elevation

It’s all running – right? Well, that’s sort of true. 

But changing surfaces and elevation too quickly can also lead to an injury. 

Remember gradual adaptation? The same can apply here.

If you run only on roads and want to run trails, incorporate off-road terrain gradually. The difference in surfaces and muscles that you use can be enough to throw you off and cause a fall. You may also want to hike or walk-run the trail your first time through.

Similarly, be aware of the changing seasons. If you haven’t run on snow or ice in a long time (or at all), be careful as well. You’ll need more strength and balance, and it can take time to adjust to uneven, slick surfaces.

If you need to, shorten the distance of your runs in the snow until your body adapts. You may also want to run later in the day when it tends to be warmer, you are more visible, and snow crews have had a chance to clear off roads and sidewalks.

Or if you’ve been on a treadmill (or even a Peloton bike or other winter sport) all winter, slowly integrate running on the hard surface of roads as the weather gets better.

Although your cardiovascular system may be fit, suddenly running a lot on hard concrete and asphalt can cause shin splints or plantar fasciitis.

While it’s acceptable and even necessary to integrate hills into your training, again, don’t go from 0% hills to 100% in one week. 

You may sign up for a hilly race or an ultra with a lot of elevation change and suddenly feel pressured to run a lot of hills. 

But instead of just starting to run all hilly routes, try to add one or two hillier runs per week and see how you respond and build up from there.

Races with heavy downhill segments such as the Boston Marathon, Pike’s Peak, or lapped ultramarathons may require you to replicate more downhill running in your training to prepare.

These types of workouts can be very tiring (especially on your quadriceps, the large muscles in the front of your thighs), so they should also be limited in scope. 

Make sure to give yourself ample recovery in the days following them to heal and regain overall coordination.

Warm-up, Cool Down and Work Flexibility and Mobility

Yes, many of us know we are supposed to do this, but we don’t.

In a time-crunched world,  it’s easy to get up from sitting all day (or from sleeping in the morning) and immediately start running.

But if you want to run like a well-oiled machine, include a short warm-up. It doesn’t have to be extensive, but even five minutes of walk-jogging with a few dynamic stretches are better than nothing.  

And the same for your cool down. Do about five minutes of walking to and stretch any tight areas before getting in your car and driving home.

Although warming up and cooling down help prepare your body for aerobic activity and regulate blood flow, studies on whether these activities (as well as stretching) prevent injury are mixed. Because we are all individuals, you need to find what works for you.

Stretching helps improve your range of motion and flexibility around a joint. 

This type of activity can be helpful if you have a previous injury that remains stiff after healing, such as a twisted ankle or calf strain.

If you sit in a chair all day and have trouble reaching over and touching your toes, some flexibility and mobility work may work better for you than someone already doing yoga a few times a week. 

Try it and see how it makes you feel in running and your daily life.

Listen to your body

Overall, listen to your body. If you feel tired during a particular workout, if not sick or injured, it can be beneficial to start the activity and see how it goes. 

The feeling will often lift in the first few minutes, and you’ll be able to continue as usual.

But if the fatigue doesn’t improve throughout your workout, don’t be afraid to pull back. As driven endurance athletes, our tendency can be to do the training perfectly or not at all. 

However, disregarding our internal signals can lead us to push too hard and lose coordination or succumb to an injury that you could avoid by being mindful of the signs your body is giving.

So don’t be afraid to pull back your training for the day, recover, and if it continues, reevaluate your training plans if need be.

Ok, that’s all for now! 

Look out for Part 2 about how your NUTRITION can lead to less risk of injury (and better performance!)