Overuse Injury Prevention Guidelines for Runners/Walkers

What are overuse injuries and how do they occur in runners/walkers?

Overuse injuries may develop from continuous, repetitive trauma to a tissue, or basically doing too much too soon.  Runners and walkers are predisposed to these types of injuries due to the repetitive nature of the activity. Some of the most common mistakes made are increasing mileage/volume too quickly, wearing an ill-fitting or worn out pair of shoes, or not varying the surface you work out on. With the right knowledge and preparation, all these factors can be easily addressed prior to starting your running or walking fitness journey to ensure you can keep moving and stay injury-free.

What are some common overuse injuries?

Although injury symptoms and types can vary from person to person, these are some of the most common ones you may experience if you start to feel pain during your training program:

Iliotibial Band Syndrome (ITB Syndrome)- pain on the outer portion of the knee, sometimes causing a snapping or rubbing sensation while running; caused by the iliotibial band on the outer leg rubbing on the lower part of the femur, just above the knee joint.

Runner’s Knee (patellofemoral pain syndrome)- a generalized term for any pain at the front of the knee; a common source of this pain is from your patella (kneecap) not moving correctly while running.

Patellar Tendonitis- pain and inflammation just below the knee joint, where your patella attaches to the lower leg bone. This may also be aggravated by going up and down stairs or get tight after sitting for long periods of time.

Achilles Tendonitis- pain, inflammation and tightness in the back part of the lower leg near the heel. Pushing off with your foot or going upstairs will be bothersome when not running.

Plantar Fasciitis- tightness and pain found on the bottom of the foot, typically starting back at the heel and progressing forward through the arch/midfoot. Typically symptomatic when the foot is put on a stretch.

Shin Splints (Medial Tibial Stress Syndrome)- Sharp, sometimes throbbing pains through the middle lower leg during activity. This injury will sometimes develop in both legs simultaneously.

Stress Fractures- Sharp, throbbing, focal pain in any bony area with the most common areas being the lower legs, heel and mid foot areas. This is often a result of untreated shin splints or sharp, focal pains that have been ignored for too long. You will most likely experience the pain throughout all daily activities.

How can I help prevent these injuries from occurring?

There are several preventative steps runners can take to stay injury-free and moving forward. Some simple tips to consider include:

Take a break from running/training! Although this may be the hardest tip to follow, usually it’s the simplest fix when you start to feel those annoying pains setting in. Typically a few days to a week of rest can help the body heal itself before you hit the road again.

Add at least 1 day of cross training into your weekly schedule. Our muscles and joints are designed to be active in many different ways, so varying the types of activities you do will help the body rest from running without losing any cardiovascular benefits.

o   Another tip to consider would be to implement a walk-run pattern into your running program. Adding short bouts of walking at regular intervals during runs has helped many runners stay injury-free and maintain cardiovascular fitness.

Follow the 10% rule when increasing mileage.  Many runners focus on increasing their miles when they sign up for a road or trail race.  Weekly mileage should only be increased by 10% each week; this helps your body adapt to an increased stress (more mileage) without putting it at risk for overuse and injury. Following a well-structured 12 to 16 week training plan created by your coach or a reputable running source will usually help you maintain a steady increase in weekly mileage to make you ready for race day.

Get professionally fitted for proper running or walking shoes. There are many run specialty stores that will walk you through the steps of finding the perfect running shoe for your foot type and running form. Wearing the right shoe can help improve your biomechanics (how you run/walk), therefore helping your muscles and joints work more efficiently and helping prevent injuries from occurring.

Replace your shoes every 300-500 miles. Depending on how you run and how often you run, most running shoes need replaced every 300-500 miles in order to provide maximum comfort and stability for your foot type. When the bottom soles of your shoes start to look worn and smooth, it may be time to replace.

Vary the surfaces you run on. Some people prefer trails over roads or roads over treadmills, but running on a variety of surfaces is best for our bodies. Sidewalks/roads and treadmills are the easiest to access, but they’re also the hardest on our bodies. When you can, try to add in a trail or track run at least once a week to give your body some variation on a softer surface. Also try running on different sides of the road (when it’s safe) to even out the stresses on your body.

Listen to your body!!! It will tell you when it is tired. Our bodies know when we are doing too much or it has had enough, we just need to learn to listen to the signals it sends.  If your legs are feeling heavy or you are feeling slowed down and fatigued during workouts, it may be time to stop the workout for the day. You may need to take a day of rest and do an easy run when you start back up. If the same signs persist, then you may need a longer period of rest or it may be time to see a physician or sports medicine professional.

When should I seek medical attention?

It may be time to seek a medical evaluation and guidance from a physician or sports medicine professional if:

pain does not decrease with 2-3 days rest from running/activity

you feel pain throughout the rest of the day with daily activities (going up/down stairs, walking, sitting into or standing up from a chair, etc.)

you notice a limp while walking or avoid using the painful leg

              Source: Whitney Snyder, MS, AT, CES

               Athletic Trainer, Orthopedic ONE

Orthopedic ONE is the largest private orthopedic surgery practice in the state of Ohio and represents a group of 60 of the region's top orthopedic experts with one mission: To make each and every patient our number ONE priority. Our team of physicians, therapists and trainers provide orthopedic, injury prevention and rehabilitation services to some of the most elite professional organizations in central Ohio, as well as collegiate, high school and club programs. Our goal is to keep athletes out of our office and back to doing the activities they love.

We invite you to learn more by visiting www.orthopedicONE.com