Running doesn't have to mean injuries. Here's how to avoid them.

Don't want to be sidelined from your favorite sport? These physical therapists share their tips for staying the course with fewer injuries and less pain.
Image: Stretching before running
Simple principles like the frequency of running, how often you run easy versus hard, and how you approach recovery all play a key role in reducing injuries. Rocky89 / Getty Images
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By Amanda Loudin

Running, on appearance, seems like an incredibly simple and straightforward activity — one foot in front of the other, right? Statistics vary, but as many as 60 percent of runners wind up injured in a given year. If you love the sport and hate ending up on the sidelines, there are steps you can take to build a more bullet-proof runner’s body.

We checked in with three of the sport’s top physical therapists for their top tips on staying injury free. Chris Johnston, of Seattle’s Zeren PT & Performance; Jay Dicharry, director of REP Lab in Bend, Oregon, and author of "Anatomy for Runners and Running Rewired", and Robert Gillanders, of Maryland’s Point Performance Team, all weighed in with their best advice.

How to avoid pain while running

To begin with, Johnston recommends runners accept that some pain is probably normal — to a point. “Getting runners fixated on ‘pain-free’ running is a disservice,” he says. “As runners, we are going to deal with aches and pains so it really boils down to decision making in the context of muddy water.”

With that in mind, Johnston has guidelines he wants runners to follow with their training. “Focus on building volume before layering in any focused hill or speedwork,” he says. “The tissues in the lower extremity need to go through a conditioning process that can’t be rushed.”

Johnston also emphasizes that runners should try to turn their feet over faster to help reduce the load on the lower legs. He refers to a 2011 study that shows a five percent increase in step rate at a constant running speed will lead to a 20 percent reduction in energy absorbed at the knee, thus lowering the odds of injury to this area.

Simple principles like the frequency of running, how often you run easy versus hard, and how you approach recovery all play a key role, too. “Overdoing it is classic among runners,” says Gillanders. “Instead, runners should aim to avoid junk (unnecessary) miles and replace them with cross training or active recovery.”

4 things to focus on when you're not running

While training principles are important, it’s often what you do when you’re not running that leads to the most gains in injury prevention, says Gillanders. “Runners want to run, but the components of efficient running include range of motion, core strength, and stability,” he says. “These are not things you build from just running.”

Dicharry agrees. “We know running is going to overwhelm your tissues, so you need to prepare for your sport,” he says. “You need to take responsibility to ensure your engine and chassis show up ready to run.”

1. Watch your posture

Areas that runners might not consider but should include posture. “Posture is so much more than your mother telling you to stop slouching,” says Dicharry. “Runners who run in the ‘back seat,’ a highly arched back or slump forward when they get tired, wind up increasing the stresses on their body.”

To improve here, concentrate on your posture throughout the day — practice makes perfect. “The fix is to drop the rib cage down in front until the weight you feel is evenly split between your heels and forefoot,” says Dicharry. Then spread your shoulder blades down flat along your back without moving your spine. Yes, this will feel different, but with time can feel more familiar.”

Incorporate this posture while brushing your teeth, walking down the hall at work, and while running, says Dicharry. Start with three seconds at a time to begin with, eventually increasing until it becomes second nature.

Overdoing it is classic among runners. Instead, runners should aim to avoid junk (unnecessary) miles and replace them with cross training or active recovery.

Robert Gillanders, physical therapist

2. Strengthen your backside

You also need to work your backside — or posterior chain — to improve the strength and engagement of your hamstrings, glutes, and calf muscles. “The glute max, in particular, is the powerhouse that steers your legs, maintains posture, and drives your forward,” says Dicharry.

In his books, Dicharry recommends a variety of exercises to improve in this general area. Exercises like bridges (side lying included), clamshells, the ‘rotisserie chicken,’ and strength moves like Romanian deadlifts and Bulgarian split squats are all among his go-to-moves.

3. Focus on your feet

Dicharry says that another common area of neglect in runners is foot strength. “Shoes don’t improve stability, you do,” he points out. “Your feet are worthy of attention to steer your legs straight and help bulletproof you against shin splints and plantar fasciitis.”

Key here is learning how to use your big toe and arch muscles to control your foot. Dicharry recommends “toe yoga” to make improvements. As Gillanders puts it, “You need efficient range of motion from your foot to your hip if you want to run without injury.”

4. Re-evaluate your training routines from time to time

Keep in mind that as you age, your running and strengthening routines should change, too. “Strength training in the form of heavy, slow resistance is important for the sake of tendon stiffness in masters’ athletes,” Johnston points out.

Gillanders reminds that every few years, you should re-evaluate your approach to running. “A long history of training the same way year after year tends to catch up with us and our bodies reorganize over time,” he says. “At a certain point, you need to check in on your strength, flexibility, mobility and balance and make adjustments as needed.”

Staying injury free doesn’t have to be complicated, but it does take some back-end work. “The stronger and more stable you are, the more training you can tolerate,” says Gillanders. “It’s hard to stay fit and run well if every other week you are chasing your tail because you are banged up. How you care for your body catches up to you one way or the other.”

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