Over many years of coaching junior and masters runners I have seen the same recurrent injuries year after year that sideline runners for weeks to months. 65-75% of runners are injured annually (Hanlon, 1987). Think about that for a second, 3/4 of runners are sidelined with injury each year. Through my experience most of these injuries are preventable with a well-designed training program that integrates core stability, mobility, strength, and sound training principles with technical development.

Taunton et al. (2002) compiled a list of common overuse injuries suffered by runners:

● Patellofemoral pain syndrome

● iliotibial band syndrome

● plantar fasciitis

- the above accounted for 32% of all running injuries

● meniscal injuries

● patellar tendinopathy

● Achilles tendonitis

● Shin splints

● knee/hip pain

● stress fractures

Most of the injuries mentioned have a few commonalities in their root cause. Once such commonality is over striding. Over striding while running refers to the athlete reaching or placing the foot too far out in front of the body (center of gravity) causing the foot to slam down into the ground. The result is an inefficient running stride, characterized by larger than optimal breaking forces applied to the lower body. The reasons for over striding can vary from person to person but are typically driven by mobility, stability and strength imbalance factors Souza (2016), Milner (2006), and Noren et al. (2014), (2012) Where the breaking point (injury) occurs is largely a function of individual makeup and training idiosyncrasies.

As a physiologist I have spent most of my career developing methods to prevent injury. In doing so, a fundamental understanding of the mechanisms of injury are requisite to the design of an effective training program focused on injury prevention and performance. As previously noted, most injuries are caused by fundamental imbalances of optimal mobility and stability. The dysfunctional interplay between these two essential elements of locomotion can lead to a laundry list of issues to include:

-Increased impact forces (due to overstriding)

-Altered/compensated muscle firing patterns which put additional stresses/activity on adjacent muscle groups

-Restricted range of motion of joints specifically ankle, hip and spine

-Inability to have proper body position

-Inability to balance and have dynamic stability

-Inability to transfer and manage forces generated by our muscles

“A potential driver of poor running kinematics are a lack of, or simply inefficient reflexive core stability strategies. This issue fundamentally prevents an expression of the full range of motion of the lower body. To understand this concept, an assumption is made that the human body is inherently designed to covet stability over mobility.

When the reflexes that drive the stabilizing muscles of joints crucial to locomotion - in this case we are talking about the central core - have become slow or neurally pruned (due to lack of use or previous injury) the body seems to compensate by using prime movers to stabilize the involved joint(s).

Since these muscles can not be movers and stabilizers at the same moment in time, the body will default to stability over mobility and a loss of range of motion can be noted.

Hence sub-optimal reflexive control of the core leads to compensatory movement and stability strategies in an attempt to provide the articulating limbs with a solid base of operation. The net result to the end user of said strategy is one of restricted range of motion or in a worst case scenario - pain and injury.” (Shropshire, 2020)

Poor mechanics due to mobility deficiency or poor running technique in turn results in over-striding which dramatically increases the impact forces while running. All this extra pounding will result in stress related injuries such as shin splints, plantar fasciitis, and joint injuries. Injuries related to mobility and core strength deficiencies tend to be iliotibial band syndrome and gluteal medius injuries.

So how do you prevent these injuries? Start with an Original Strength or FMS evaluation, then have your stride mechanics assessed. Once you know what deficits you have, address them, start an corrective exercise program to improve your mobility and stability imbalances. Then improve your mechanics with stride development drills.

To get the most out of your training is not black magic. It requires consistent, systematic, training and specific, individualized goals. The training of athletes is a very individualized process since each athlete has different natural abilities, adaptation rates, and base levels of training. What works for your friend may and usually does not work for you. Training using standardized programs often found in magazines and websites will elicit average to sub-average results since they are often based upon a single runner’s or coach’s experience. Training has to be individualized and systematically modified over a long period of time. Training paradigms differ dramatically for beginner, developing and elite athletes. This article is targeted primarily for the beginning to developing runner. For starters the most important step requires some introspection, to think about your goals and individual talents. Be realistic. A key ingredient to success and training longevity is to initially focus on developing natural abilities. After developing some training consistency is a better time to train your weaknesses.

To first determine what type of training is best for you think about when you race and train how you feel at different paces and distances? Do you have a slow turnover rate and when you try to run fast it does it not happen? Then speed work is something you need. When you push a little harder do you start to have erratic breathing, especially after your first mile or so? Then more interval work is needed. Can you run at a good pace for a mile or so then fall off pace? Then speed endurance interval training is needed. For most endurance oriented runners the most difficult ability to develop is running velocity. Often athletes get caught in the rut of running the same speed…pretty hard, all of the time. This does two things, first it causes you to peak and plateau after about 6 weeks, and secondly it does not stimulate the improvement in either endurance or speed. In order to improve consistently a systematic training plan is a necessity.

The key to having a systematic plan is Periodization. Periodization is a systematic means of increasing and varying training elements and loads (see fig 1.)

Fig. 1 Yearly Training Periodization Structure

Each period is a step, towards a consistently higher and higher level of performance. Each training year is sub-divided into progressively smaller segments, macro cycles-(Prepatory, Pre- competition, and Competition) each has specific goals and structure and are broken down into even smaller segments of a month called micro-cycles(see fig. 2).

Fig. 2 Micro-cycle structure

The wonderful thing is exercise physiologists have studied this a great deal and developed guidelines from which to build a program.

Some general rules are:

1. Training volume increases should be done consistently and structured such that volume increases are gradual 5-10% increase per month otherwise overtraining can result.

2. Intensity levels can increase 3-6% over a four-week period.

3. You can only focus on training 1-2 new abilities (ex. speed, strength, endurance) over a micro cycle otherwise your body will become confused and not adapt as efficiently.

4. In order to develop an ability (ex. speed) you need to train it at least twice per week.

5. Don’t train the same ability two days in a row. (your body needs to regenerate from this stress, otherwise it does not supercompensate)

6. When you go slow go very slow when you go fast, go very fast. The in-between stuff does not teach your body much.

7. Train to Race don’t Race to Train.

How to start planning….. If you are a beginning runner a reasonable amount of time spent training is < 200 hours per year ( average citizen racer 200-300, more advanced 300-400, national level 400-500) This does not mean that if you want to be national level you start training at this volume! I made that mistake in my teens as a competitive cyclist, I think I made two 450 mile weeks before I realized it did not work. For the beginning runner you can start by subdividing these hours into 4 hours per week for prepatory stage, 4-5 hours per week for pre-competition stage then 2.5-3 hours per week for competition stage.

What percentage of your training should be endurance, interval (anaerobic threshold), and speed training? This is where knowing yourself and having well set goals is important. Generally in your prepatory phase of training the ratios are: Endurance-75%, Strength 5-10% interval-15-20%, speed-5%

in your pre-competition phase the ratios are: Endurance-50-60%, interval-30%, strength 5-10%, speed-10-20%, Competition phase: Endurance-50%, interval-15-20%, strength-5%, speed-10-15%, race/pace-15-20% .

So what does all this mean for the developing runner? Do your highest intensity speed or tempo work in the beginning of the week when you are well recovered. Follow it with an easy run on the following day for recovery. Then a day of combination speed/interval workout, follow that with another easy endurance run, then either a race or interval workout over the weekend.

RUNNING INJURY PREVENTION

Getting the most out of your Running Training-An introduction to making consistent gains in your running program

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