how to stop getting running injuries

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I had one running injury after the next for five years, and then finally ran injury free for 10+ years. I shared how in this post — and what I learned after injuries popped back up last year.

Nearly all runners deal with injuries. But just because it’s common doesn’t make it any less frustrating and disheartening.

When I first start running races back in 2004, I dealt with constant running injuries. My most common and persistent injury was illiotibial band syndrome (aka IT band syndrome). It caused me to cancel my plans to run my first marathon in 2006, even after ramping up to 20 mile training runs.

The next year, I trained for a half marathon but had to walk for about 5 miles on race day because I was in so much pain, from my IT band flaring. And in another half marathon later that year, I hobbled across the finish line so badly that they had the first aid team coming at me immediately.

But then… I blissfully started enjoying years of injury-free running. From 2008 through 2019, I ran relatively injury free, other than some niggles here and there. I was able to train consistently without major injuries. And that consistency allowed me to improve my speed, endurance and break all my PRs. Today, I’m sharing what helped me run injury free for so long and what I think caused a return of injuries in 2019.

How I stopped getting constant running injuries

1. Mobility work

My first injury-free training cycle came in 2008, six months after I starting consistently practicing yoga. I was amazed. In 2007 I had run multiple races with severe pain (despite a prescription for prednisone to help with the injury) and was under the care of an ortho. And yet, despite his treatments, I was still running injured. I started yoga and the IT band issues went away.

Yoga helped strengthen my weak glutes and hips, and also helped me get in regular stretching, which I was NOT good about doing, even as my mileage ramped up. While I now know to find a sports-specific ortho and ideally a physical therapist who is also a runner, yoga addressed a root issue that I didn’t know I had and my doctor didn’t address.

For my 10 year stretch of injury-free running, I was doing yoga 1-2x a week. In the last 1-2 years, my yoga practice has been much less frequent. But, I am much more consistent with warming up, stretching, foam rolling and getting sports massages. I bought a Hypervolt massage tool last year and that was incredibly helpful for loosening tight muscles and releasing knots leading up to the 2019 Boston Marathon.

I shared more more details on my pre-run warmup, stretching and recovery routines in my running course, which is open for enrollment for another week!

2. Proactively addressing small issues before they become big issues

As a newer runner, if something felt off or started to hurt, I pushed through the pain. I felt like I HAD to log the miles on my training plan or I would fail come race day. Now I know that the best runner on race day is a healthy runner. If I show up to a start line injured, there is no way I can run my best.

So, as soon as something starts to feel off, I take steps to address it. These are the top three things that helped me run marathons the past three years, increasing my mileage and training intensity each year. (And, I set PRs in each. First at the Wrightsville Beach Marathon. Then at the 2018 Boston Marathon and again at the 2019 Boston Marathon.)

Physical Therapy and Dry Needling

When I was training for my second marathon (and attempting to get my first Boston Qualifying time), I started having IT band issues again, in addition to glute pain. My training buddy Kate kept telling me that I HAD to try dry needling. Finally I got desperate and gave in, even though I was squeamish of needles. Dry needling and physical therapy have transformed my training and are a regular part of my training. Addressing issues early on has helped prevent so many niggles from turning into bigger problems that require big chunks of time off.

Sports Massage

These are not relaxing massages. These are intense and very uncomfortable. But regular massage helps dramatically, especially whenever my weekly mileage starts to jump over 40 miles a week.

Strength Training

I never consistently strength trained until I started CrossFit. Granted, yoga was a form of strength training to be sure, but as my yoga habit waned (story for another day), I added CrossFit into my schedule. That created some issues with balancing training load, BUT CrossFit made me much more comfortable in the gym. I added muscle, which helped me run more powerfully, helped prevent injuries from muscle weakness, and I showed up to races a LOT stronger. While I don’t do CrossFit anymore, I have continued to strength train 2-3x a week. Last year, that meant going to the gym and doing my own strength workouts. This year, since our gym is closed due to COVID, my strength training involves mostly bodyweight workouts or workouts with 8 lb dumb bells since that’s all I have at home!

3. Not running through pain

When I was training for my first marathon, I was very hard on my body and mind.  If I had to walk part of my 18 mile run because of pain, oh well. I needed the mileage! If it hurt, I tried to ignore it and keep running. I needed to run for X minutes or X miles, no less! Besides, no pain, no gain right?? Wrong. Now, yes, I feel discomfort all the time when running these days. (Heck, especially these days since I’m 8 months pregnant!) But I’ve learned over the years of training for over 50 races that there is a big difference between discomfort and pain.

No, every run doesn’t always feel good, especially when training for a big goal. It’s uncomfortable to run faster or longer than your body is used to but that’s sometimes required to make improvements. But I never run through tears from pain or pain that causes me to change my gait. If I’m feeling true pain, I stop running. (And if I forget my own advice — which you’ll read below — I typically end up with an injury.)

If I feel pain, I stop a run early or take a couple extra days off. It’s always better to listen to your body and take time off for a shorter period of time than to deal with a longer, forced time off due to injury.

Remember that it’s okay to adjust your training. Having a running coach helped with this a lot. But even before then, when I self coached for years, I learned to listen to my body and if something wasn’t feeling quite right, I’d adapt my plan to give my body an extra day off or an extra recovery day. I’d shorten my long run or reduce the number of prescribed repeats on an interval day. I’d postpone a tempo day or switch an easy run to an elliptical day. I don’t follow a training plan EXACTLY as written simply because it was written down like I used to. I let my body and common sense have a say in the matter as well.

4. Crosstraining

I used to believe that a workout wasn’t a “real” workout unless it involved running. And to be honest, that’s still a mindset I struggle with since I just love running so much. But, I quickly learned last year when I was running 60-70 miles a week that cross-training was essential. It allowed me to train on days that my body was feeling less than stellar and allowed me to keep working on my cardiovascular endurance. It reduces impact from the repetitive motion of running, strengthens other muscles and helps prevent burnout.

In January, Tommy and I gifted each other a Peloton and that’s been incredibly helpful for cross-training as I recovered from my first major injury in years. (We especially got lucky since we ordered it before the increased demand when gyms closed due to Covid.) One of the keys to cross-training is to find something you truly enjoy so it enhances your overall training, both mentally and physically. This post has more details about why cross-training is so important and the best types of cross-training workouts.

5. Fueling appropriately

So often athletes focus on increasing their mileage or intensity, but neglect to give the same amount of thought and effort to improving their fueling. The more you train, the more you need to eat. It’s that simple. And, it’s important to make sure you’re getting the right kind of nutrition, particularly carbs. This post talks about the importance of carbs and this post talks about what I eat in a day while marathon training. I also have a lesson in my running course about what to eat before, during and after a run.

There is research that also shows that endurance athletes are prone likely to have injuries if they are underfueled. So, if you keep having injuries and you can’t seem to pinpoint why, it may be worth working with a registered dietitian who specializes in sports performance to identify any gaps in your eating habits. InsideTracker is another great resource for analyzing your bloodwork and diet.

 

Learning from my injuries

Okay, so what about the string of injuries I had last year? First plantar fasciitis, then a torn ankle tendon. In retrospect, I can more easily identify what likely caused those injuries.

Plantar Fasciitis 

With plantar fasciitis, I ramped up my mileage pretty quickly and then didn’t take enough time off after a BIG training block. I went right from the 2019 Boston Marathon in April, into training for the BolderBoulder 10K in May and then the American Fork Half Marathon in June. I promised myself I’d run the 10K and half marathon easy… but I didn’t.

Then I came home from the half marathon and literally the next day, went to running camp. I eventually recovered from from plantar fasciitis, but man, it was frustrating. It still flares occasionally but I’m much more proactive with treatments.

Posterior tibial tendon tear

With this, I simply didn’t pay attention to pain vs. discomfort. It started when I rolled my ankle while trail running. I didn’t think much of it since it didn’t hurt to run and kept running for another 8 miles that day. The next week, things still felt fine so I just kept running. But about a month later my ankle was really bugging me, and by then, I’d forgotten about rolling my ankle.

I thought  I just needed more time to warm up since I was “getting older” but I ignored the fact that the pain changed my gait and it got worse throughout my run. I kept running and running through pain for months, until finally, I literally couldn’t and had to walk home from a run. Eventually, an MRI showed a torn tendon, but that wasn’t diagnosed for 6 months after my pain started. And at that point, the damage was likely much worse than what rolling my ankle likely caused.

More tips to avoid overuse injuries and recurring injuries.
  • Stay consistent in your workout routines. Taking large chunks of time off and then diving right back in as if you hadn’t is a recipe for disaster.
  • Evaluate your training plan and timeline. Make sure you don’t try to build up your mileage or intensity too quickly! (I have a lesson in Get Your Run On about how to choose the right training plan for you.)
  • Evaluate and adjust your goals, if necessary. Giving yourself realistic racing or timing goals can help you avoid unnecessary injuries or strains. And if you’re recovering from an injury, remember that your endurance and speed will take some time to come back.
  • Know your injury history and what your weak spots are. As I’ve gotten into my early to mid 30s, it seems I’m prone to lower limb issues, e.g. plantar fasciitis, ankle instability, etc.

I hope this post helps you avoid running injuries! If you do get a running injury, evaluate what happened and be smart about how you return to running after an injury or time off.

Ready to run?

Let me help! I’ve been running for almost 20 years, and have run over 50 races from 5Ks to marathons.

I’ve learned a lot along the way and would love to help you too!

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