Issue 22 • March 2014

Running Injuries and Prevention

With race season here, there’s more mileage, more speed work, fewer days off, and all too often more injuries. An injury during training can be frustrating or even worse, force you to forfeit a race. Don’t fret! There’s a lot you can do to stay injury free while setting new PR’s all season long.

What’s going to get me?

First, you need to know the risk before you talk about prevention. According to survey studies, up to 90% of runners will report some level of “injury” in any given year and as many as 30% of injuries occur during races. The most common injuries occur in the lower extremities i.e.: hips, knees, ankles and feet. There’s heavy debate but limited evidence on what exactly causes all these injuries. With that in mind, here are a few common sense guidelines to keep you healthy and on target for your next 26.2.

What can I do?

Follow the 10% rule. It may be cliché, but the ol’ 10% rule is your friend. Don’t increase volume, intensity or frequency of running by more than 10% per week. You may be tempted to up mileage or intensity because you are just feeling like a hero or because you are making up for a few lazy days, but don’t get sucked in. Stick with the 10% rule and avoid injury.

Train “proximally” to succeed “distally”. Running is all about the kinetic chain. Your feet may hit the ground first, but it’s the hips and thighs that call the shots. A growing body of evidence suggests that injury risk is closely associated with abdominal and core strength. So get to know the classic moves. Positions, like plank, clam shell, reverse clam shell, monster and crab walks should be daily exercises. Despite their crazy names they can help keep the most stubborn running complaints at bay.

Is pain really “gain”? We all know someone who “runs through the pain”. But when is it safe, and when is it CRAZY? Pain in your lungs, a nice burn in your quads, a little occasional ache in your calves….all good. However, joint pain (ankles, knees, hips) that lasts for hours or days after a run, or pain with swelling, or pain with every time your foot hits the ground…not cool. Those pains could be anything from a stress fracture to an OCD (a cartilage defect) to a nagging IT band syndrome. If you try a few days off with appropriate RICE (rest, ice compression, elevation) and the pain persists, get an evaluation by a doc’ who knows the sport and wants to keep you running.

Don’t let a competitive spirit or crowd enthusiasm dull your body’s plea for TLC. Being proactive will keep you running longer, farther and with less pain. If you’ve already got pain, find out what’s going on and make some modifications. IMPORTANTLY, stretch with each run to help your body keep keeping on. We want to see you on the other side of the finish line!

Top Running Injuries

  • Achilles Tendonitis
  • Iliotibial Band Syndrome
  • Plantar Fasciitis
  • Medial Tibial Stress Syndrome
  • Patello-Femoral Dysfunction
  • Stress Fracture
  • Piriformis Syndrome
  • Posterior Tibialis Tendonitis

Top Running Stretches

  • Hip Flexor & Hip Rotation
  • Standing Hip Flexor
  • Inner Thigh
  • Lying IT-Band
  • Pigeon Pose
  • Pretzel Pose
  • Runner’s Twist
  • Triangle Pose

Tiffany Esser CPT is a certified personal trainer, group fitness instructor, pre/post natal exercise specialist, and an avid triathlete. She is the co-founder of and co-creator of

Stephan Esser MD, USPTA is a Non-operative Sports and Spine physician at Heekin Orthopedics in Jacksonville, FL. He was a former #1 in the US in Men’s Open USTA Doubles Tennis and treats recreational and elite athletes in his practice. He can be reached at

Tiffany Esser

Tiffany Esser

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