Leading Causes of Injures in Runners

I just read a rubbish running-injuries related "research" summary on Runner's World. Rubbish in the sense to the way the "research" was done, and rubbish in the sense to the way it was reported.

Here's my take, and reply:

25 years of 'research' (collected wisdom, really) based upon coaching runners, endurance athletes, and athletes in run-based sports has taught me a few things about injuries. 

Firstly, there are two types: (1) acute, such as a joint sprain, a jar, or a contusion; (2) chronic, overload and recurring (related injuries) which normally come on over time...getting slowly worse and often ignored by a runner. 

The causes of these are always an individual mix of three main factors (a) mechanics: normal structural or functional alignment which is either inherent (the way you're born and built) or external (eg. shoes, camber, surface), (b) loading: what, how much, how fast and where (eg, hills) they run, and (c) time.  

Most runners get injured simply because they do too much (fast) running to soon, or make (relative) sudden changes to their running/training load. 

Central cardiovascular fitness can improve over a few days. Muscle function improves over a week or so. Yet tendons, joint structures and bones can require weeks and months to adapt to new loads (dependent upon mechanics, and training and injury history). 

It comes as no surprise that the most common run injuries are Achilles, hamstring, gluteal and ITB tendon related or foot, shin, knee and hip joint/bone related. 

Secondary injuries are common too because an initial injury was neither rehabbed properly, it's causes weren't eliminated, or the runner progressed back towards 'normal' training to soon. 

Magazine and on-line articles that promote "must do", "need to do", and "should do" sessions - which are often watered down sessions from elite or competitive athletes do not help the mindset of beginning and mass-participation runners in regard to "load" or "change in load" (too much of 'x' to soon)  :-)

Training Traps - Finale

We all got into running for one reason or another – some of you recently, a few of us many years ago. You enjoy the active and running lifestyle for your own reasons: health, fitness, wellbeing, state-of-mind, participation, performance, perfection or podium and, in some sense, pride.

Some things have changed; some things haven’t. Your training comes to reflect the reasons why you run. The basics haven’t changed: you still need to run to get running’s benefits: swim, cycle and gym are good, but not as good.

You want training to be what you want it to be, and effective. Yet, amongst the technology, self-professed gurus, and Coach-google, basic training errors are still made: many out of running’s present culture, some out of habit and ego. Are you trapped by these?

Remember, what works for the pros and what are promoted as “the best”, “the most effective”, “the ideal”, “the latest” or “short-cuts ” are rarely what they are made out to be. They simply don’t work for most. Perhaps these are your trap?

Through 2010-14 I held discussions, meetings, race and program reviews, and constructed strategic performance plans with over 700 runners and coaches (and 350+ triathletes). I've shared the Top Ten Run-training Traps with you, and a cure or ‘get-out’ with a long-term prevention strategy for each.

No-one sets out to fall into a traps, or make training errors. If you’re in one, get out. And stay out.

Plan your training. Ensure it’s progressive, cyclic, varied and, importantly, that it relates to you – your experiences, your capacities, resources and aspirations. Keep a log and journal of what you do. Review, reflect and re-work according to it and your plan.

Heed the lessons and advice of others, yet don’t blindly follow it or a squad. Learn to listen to your body, for it will tempt and test you as you train and trick it.

Rethink the training and ego battles, particularly those with numbers. Avoid the traps. And, the next time you race – knowing that you’ve done all that you can in training – go hard, and go well.

Trap 10: Not Listening To Your Body...

Believe it or not, the laws of physics, chemistry, mechanics and biology do relate to you, too. Attempting to avoid them, believing that you’re too, err, special, or regularly cutting-corners or cheating, only lead down five paths: fatigue, ill-health, injury, guilt and shame.

Learn to listen to your body. Heed the signs from Mother Nature and her brother, Time. Your body has an infinite wisdom, yet you need to give yourself permission to listen, hear, and act accordingly...

·      Too little respect for Mother Nature:

Get out: accept that her 3.5 billion years of experience carries a little more weight than yours. Learn to listen for her signs, hear them, and act upon them. Better now than later, too

Prevention: read about and listen to the experience of others, and the expertise of professionals. Learn from your errors, and don’t make them mistakes. Aim to train regularly and consistently and not merely to record numbers

·      Too little respect for ‘listening to your body’. Learn and know what to listen for

Get out: that raised resting and easy-session heart rate and perceived effort, heavy legs and inertia to get out of bed may be saying, “ease up today, champ”. Respect that.

Prevention: that tender, sore, red, inflamed spot by a bone, tendon or joint that persists or get’s worse upon getting out of bed, warming up, or when you’ve cooled down is telling you something more serious. Respect it even more

·      Too little understanding of “pain”. What we experience in long or hard races is ‘Self Induced Discomfort’. It’s not true pain or suffering. Understand and respect the differences and train to physically and mentally reduce or cope better with SID, and minimize pain.

Get out: pain is Mother Nature’s warning sign that something is not right – that damage is about to be done, or has been done.

Prevention: minor injuries come with the territory if you train and race hard. Overuse, chronic and recurring injuries aren’t a badge-of-honor. Prevent them through improving your mechanics and technique, and through progressive cyclic, varied and individualised training

·      Too little injury prevention training. Most injuries can be prevented.

Get out: pay attention to little niggles, sore spots, a sore-throat fatigue , and dodgy mechanics and/or poor technique. A few lighter days now may save you missed weeks or months of training later

Prevention: get a video analysis of your swimming and running mechanics and technique. Perform a functional strength assessment too. Emphasize alleviating deficits, anomalies and imbalances. Use targeted and specific strength and mobility training on a regular basis

·      Too little respect for Time. Remember…planning, patience, persistence and power produce performance. Patience and persistence pay respect to Time:  

Get out: focus on training consistency and regularity.

Prevention: ‘Stacking’ or accumulating sessions over time (not all the time) is what brings success. Persistence provides performance. It will take at least 6-8 years to realize your potential.

·      Too light and too lean. Optimal body weight and body composition for performance and health aren’t the same things:

Get out: avoid the trap – too light and too lean is not necessarily better

Prevention: record and log your body weight and body-fat (and strength or power) in a standardized manner. Graph them alongside consistent training blocks and race-results. Associate both to find what works best for you

·      Too much dwelling on a poor session or poor race

Get out: value that no one session or race will make you, but they do have the potential to break you.

Prevention: Review, re-work and move on

·      Too much reliance upon technology and toys:

Get out: leave the gadgets and toys at home occasionally. Learn their shortcomings too – look-up “cardiac drift”

Prevention: re-learn and appreciate how and why there’s merit in simply going for a swim, a bike and a run without measuring it. Learn more about feel and be dictated less by numbers for, in the heat of competition and racing, your body dictates what you do -not prescribed numbers

·      Too much reliance upon synthetic foods and nutrients. Gels, powders and supplements are not major food groups, macronutrients nor micronutrients.

Get out: go to the fresh-food stands of the local market more often than you go to your local sports-store or cycle-shop. Differentiate between day-to-day real food and race-relevant “nutrition” that works best for you

Prevention: visit your sports-medicine specialist and discuss relevant performance- and health-related blood, urine and saliva tests to provide a baseline on various elements such as iron, other minerals, antioxidant status, hormone balance, blood glucose and cholesterol. Follow up with a visit to a registered dietitian or nutritionist and work out a plan. Work that plan too.

How well do you listen? 

What do you hear?

Trap 9: The Terrible Toos 3 - sameness

Training is simply the accumulation of repeated exercise or training sessions. That doesn’t mean that you should repeat the same types of sessions week in or week out. Of course, practical and life constraints make daily/weekly structure – more accurately, routine - imperative for most. 

But, within that, your training sessions can and should vary in their nature, structure and content on a daily, weekly and mesocycle basis.  They should reflect the objectives of the block or phase you’re in, your training age and developmental stage, and any necessary daily flexibility. Don’t base them on whims, group agreement, a squad approach, what you did last week, nor lazy/slack planning.

·      Too much haphazard training repeated week after week (see Traps 1, 2, 5, 6 & 7).

Get out: Follow the plan that gives direction to your program and sessions

Prevention: Have a plan, not just a program. Work the plan, not simply follow a program

·      Too much emphasis on weekly volume (kilometres or hours), and too little focus on meeting individually planned aims, objectives and performance-related criteria

Get out: Numbers don’t dictate success; they simply fuel pride. Train with purpose, flexibility and joy. Don’t’ confuse progress measured by training-based numbers with development by performance-based criteria

Prevention: have an individualised plan. Work your plan

·      Too little direction: goals that are too lofty or too general

Cure: some training is better than none. Be realistic in relation to where you’re at, the time and resources available, and the progress you’re likely to make.

Prevention: get a coach, or mentor. Review your past, plan your present and progress toward your future

·      Too few priorities

Get out: focus upon 1 or 2 key elements per session, and do these well.

Prevention: Priorities should change dependent upon your strengths & weaknesses, your previous training load/s, and the objectives of your training cycle or phase

·      Too little variety in sessions (structure), locations, loading, routines and programs.

Get out: think, and create. Aim to do 1 thing different each session for a month.  

Prevention: Training loads can and should be systematic, progressive and varied. This isn’t the same as trying to go further or faster each week

·      Too much (run-) training when tired. Learn to ‘train to run when tired’, not simply ‘run when tired’

Get out: don’t beat yourself up too much with racing, run-training and complementary training. They’re all pieces to a puzzle. Watch the ‘quality’ of your running (ie. technique and form) when fatigued. Bad mental, technical and physical habits will return when fatigued during competition

Prevention: Train for improvement over time, not all the time. Make the time to learn, understand, practise, rehearse and train ‘running well’ when tried. Remember ‘better is better’.

·      Too much emphasis on ‘survival’ rather than ‘performance’

Get out: don’t beat yourself up physically and mentally with training or racing. Be wary of the language, thoughts, approach and habits you use in your approach to training and sessions. Think and train for performance, not simply surviving

Prevention: Build success into your program and progress, not failure. Use your log/dairy and plan to reduce the impact of the lows, and increase the duration of the highs

·      Too much reliance on the ‘squad’ or ‘group’ approach.

Get out: there is also a “u” (you) in sqUad and groUp, ensure you’re catered for.
Prevention: if you’re not catered for, move on. A good dose of solo-training isn’t a bad thing – race it, train it.

Do you fall into the sameness trp?

Trap 8: Terrible Toos - Recovery

To get better you need to train. Fundamentally you need to train regularly and consistently. 

Your ‘Smart Training’ (see Trap 2) plan will you have training hard and performing hard training sessions. To take advantage of your hard training, you need be able to recover, and allow your body to adapt - make more-or-less permanent changes in structure or function – to perform best when you ask it to. Poor performance, performance plateaus, loss of motivation, ill-health and injury result when this balance is askew for too long. Recovery – whether passive, active, or involving your easier sessions is vital.

·      Too little taper before key races, and long races.

Get out: rest up. All your hard work should be done before the last 1-3 weeks of your race. Take confidence in this.

Prevention: tapers come in different shapes and sizes. Try different ones, yet keep the taper basics: Progressively reduce your volume; keep some (race-pace) intensity; emphasise ‘easy’; keep your training frequency until the last few days; sleep, eat and drink well; try nothing new; use methods to promote recovery

·      Too little physical and mental recovery after key races or the race-season

Get out: take a well earned physical, mental and emotional break, particularly after key/priority and long (15km/10mile and beyond) races. Revisit family and friends

Prevention: schedule post-race down-times in your plan. Do not rush back into formal nor structured training, particularly after a bad or break-out race.

·      Too much recovery after key races or the race-season: On the other hand too much time off can make it a long tough journey back, especially through Winter.  Don’t let tendons, base-fitness and weight or body-fat ‘deteriorate’ too much while recovering.

Get out: have a scheduled date and activity to start being active again. Find a partner or friend to help. A walk or casual basketball, squash, gym or mountain bike session will help fill the hollowness and tip the inertia in your favour

Prevention: learn from your past, and from others. Formal or hard training doesn’t need to be your entry back, so plan for this. Listen to your body and mind, and progressively build your way back.

Is too much or too little recovery a trap for you?