Running: Injury Prevention (Part 1)

It’s finally above 50 degrees in most of the continental United States. What does that mean for most of you? Now that it’s nice: running season. Time to strap on your kicks and go running, right?

Sure, but not before working on some of the things that will be discussed, after the jump. Our topics today will be footwear and flexibility.

Running is a single leg stance exercise, if you weren’t aware of that before. Moreover, it is a very important movement in many sports. What I’m going to talk about today are concepts and exercises that you should be doing to help keep your bad self from getting hurt trying to get back into whatever you’re doing: getting back into basketball, the local 5k, marathon training, or even preparing for the zombie apocalypse.

Since I haven’t nerded out and am worried about the relevance of my articles, so we’re going to be getting back to the literature combined with my sweet, sweet sense of humor.

Footwear:

may not be for you.

Minimalist running? Not for everyone. While we are beginning to see an increase of studies looking at barefoot running and their effects on the body, a few of the studies I have seen show that minimalist running is best supported with Vibram Five-fingers shoes¹, I’m not excited by the fact that the rubber toes keep your toes separated (as opposed to running completely barefoot). This has yet to be analyzed in a research setting, but having your toes separated while running can’t be good for your feet.

If you roll up a napkin and run it in between your fingers to keep them separated, then try to make a fist or do anything with your hand, you end up using the muscles in your hands and even more of the muscles in your forearms to do certain movements. This is essentially what I feel is happening when you run in Vibrams – but I have yet to see any literature proving or disproving ankle overuse injuries.

Shoes like the Nike Free 3.0 were shown to have more difficulty replicating barefoot running, even though the shoe has a thinner and more flexible sole.² Bonacci et al. looked at the movement of highly trained runners wearing Nike Free 3.0s, Nike LunaRacer2, and the athlete’s original shoe. They found that regardless of the shoe, the runner’s mechanics were unchanged regardless of shoe type.

Now, we can’t all believe the hype and press that is given to a shoe, nor can we deduce automatic conclusions from reading 2-3 articles on PubMed. I only present this information to be processed as food for thought.

if you’re running in these and complaining of pain, I might punch you

In terms of wear of your shoe, your shoe should be replaced after substantial wear to the sole. From personal experience, running is a very variable activity between individuals which can be further complicated with shoe choice. I would stick with a neutral shoe if you are just starting out or if you’re unsure. Going to your nearest Jackrabbit or specialized running store (I wouldn’t recommend going to a Modell’s or Sports Authority) will net you someone who is familiar with running mechanics and can point you in the right direction.

Flexibility:

[insert ridiculously good looking woman stretching here to distract you.jpg]

Static versus Dynamic or Ballistic stretching is usually what it comes down to in most settings and is the most frequently received question I get: “Should I do static or dynamic stretches?”

The answer is both in moderation (as is most of my answers). Static stretches are important in achieving and maintaining flexibility, while dynamic stretches are important in warming up. In regards to prevention of injury, the literature generally points to a favoring of static stretches – but the history of stretching is a cloudy one at best and ultimately is inconclusive towards whether or not you will keep from getting hurt.³ What will keep you from getting hurt is a good warm-up and proper mechanics, which will be discussed in Part 2.

Flexibility is still an important topic anecdotally in terms of running; tight muscles in the hip flexors and quadriceps will pull your hips into an anterior tilt during the extension or push-off phase while running which may ultimately lead to back pain, which I have seen (and experienced) during my career as a soccer player and physical therapist.

The longer you hold these stretches and more frequently you do these stretches, the better your flexibility will be. Holding for greater than 1 minute is ideal, but living in NYC, I laugh (and die a little) inside when patients complain about doing something that will fix their pain.

Here are some important static stretches that you can do to work on flexibility:

Hip Flexor (AKA the Tim Tebow)

On one knee, put your other foot forward and squeeze your glutes to push your hips forward. Hold for 1-2 minutes. You’ll feel a stretch in the front of your hip that’s not forward.

Dynamic Hamstring Stretch

Laying on your back, hug one knee to your chest in a 90 degree position. Then straighten that knee until you feel a stretch in the hamstring. You may also feel it in the calf if you pull your toes towards you. Hold that stretch for 4-5 seconds, then relax. Do that 10x.

Gastrocnemius Stretch (Wall Runner’s stretch)

With your hands against a wall or other immovable object (just make sure you yourself are not an immovable object), get into a lunge position and make sure the back leg is straight and the heel stays on the ground. Lunge deeper to get a stretch on the back leg. Hold for 1-2 minutes.

Soleus Stretch

the variation of this picture is stretching the back leg, and not the front leg. stop looking at her butt.

Just like the gastrocnemius stretch, keep your front knee bent and heel on the ground. Bend the front knee towards the wall and then hold the stretch. Hold for 4-5 seconds, then release and repeat. 10x.

These are a quick introduction to the stretches you should be working on to maintain some flexibility while running and prevent future injuries due to compensation and overuse.

Get stretching, get moving!

Erwin

Feel free to tweet @e2winnn or email at erwintsb@gmail.com for any questions topics you’d like me to cover.

Sources:

1. Squadrone R, Galozzi C. Biomechanical and physiological comparison of barefoot and two shod conditions in experienced barefoot runners. Journal of Sports Medicine and Physical Fitness, 2009; 49.1:6-13.
2. Bonacci J, Saunders PU, Hicks A, Rantalainen T, Vincenzino BT, Spratford W. Running in a minimalist and lightweight shoe is not the same as running barefoot: a biomechanical study. Br J Sports Med 2013; 47:387-392.
3. Fields KB, Sykes JC, Walker KM, Jackson JC. Prevention of running injuries. Curr. Sports Med. Rep. 2010; 9(3):176-182.