Ask Pete: Why do I keep getting injured?

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QUESTION

Why do I keep getting injured? Do I have bad genes?

ANSWER

For most runners, it’s not their genes that are bad, it’s their training plan.

Some runners do get injured due to genetics. Osteoporosis and osteopenia can lead to stress fractures, for example. Predisposition to osteoarthritis is a factor in knee and hip degeneration. And, speaking as a member of one of the top masters (age 40+) running clubs in America, the physical condition baked into our genetics known as “getting old” can certainly contribute to a pulled hammy or two.

But the reality is that you—and most of the millions of runners who get injured each year—are probably suffering from the more common ailment known as “incorrect training.” Or what I like to call training like an idiot.

Runners often roll their eyes when I suggest they’re training incorrectly. After all, what do I know about the struggles of average runners? I’m a 57-year-old physiological freak who still runs sub-16-minute 5Ks on 80 miles a week of distance, intervals, drills, and more. “You should thank your parents for giving you good genes and bone structure!” wrote a Facebook friend recently. “That’s 90% of the game!”

Maybe. Except that I when ran 80 miles a week back in my 20s, I suffered three stress fractures, Achilles tendinosis, IT band syndrome, medial tibial tendinitis, plantar fasciitis, and etcetera ad nauseum. Same story in my early 40s. Lots of training, lots of injuries.

So either my genes have improved with age—or perhaps I stopped training like an idiot.

Here are five things I’ve adjusted in my training since the injury-plagued days of yore, things I’d suggest you integrate into your own training plan:

1. Target incremental improvement: Your body can only improve a little bit at a time, so never train harder than required to trigger that improvement. No monster interval sessions. No 3-hour hill runs out of the blue. Training too much or too hard only increases the tissue damage associated with injury—without adding any benefit.
2. Take a balanced approach: Yes, you love distance, hate speedwork. But you have three types of muscle fibers, and distance trains only one of them. Since all are used in a race, train them all. Otherwise, expect engine breakdown the first time you put pedal to metal.
3. Do injury-prevention exercises: You have weak spots that don’t get trained by running alone. Do eccentric exercises for hamstrings (e.g., Nordic curls) and calves/Achilles (e.g., heel dips). Do lower-body resistance training for muscle and connective tissue development. And keep in mind these exercises aren’t competitions. Just do them. Don’t win them.
4. Schedule adequate recovery: Feeling good isn’t a green light to train hard again. Training damages muscle and connective tissue and depletes your body’s resources. First, repair and replenish. Then add an extra recovery day to allow improvement. And remember that muscle strengthens faster than connective tissue. Most running injuries occur because runners base workouts on muscle development—and forget that tendons, ligaments, and bones are lagging behind.
5. Have confidence in your body: Stop poking, prodding, rolling, freezing, shocking, and otherwise assaulting your body as a daily remedy for the normal aches and pains that accompany training. You wouldn’t pick at a scab. Stop aggravating your body. Time is the only sure-fire recovery tool. Runner, heal thyself.

When I was younger, I pounded every interval workout, ran distance too fast, and raced every chance I got. In short, I treated every run as if it were an isolated test of my will to persevere. Nowadays, I take 3–4 weeks off every year, then return to running with a week of walking, followed by a couple weeks of walk-jogging, following by the gradual introduction of all the above. I still get injured. We all do. But I’ve now gone two years and counting without so much as post-workout calf soreness.

Need more? A 2015 meta-analysis of 400 running injury studies concluded that “a history of previous injury and of having used orthotics/inserts was associated with an increased risk of running injuries.” Other risks were harder to substantiate. Nothing about bad genes. The authors recommended “customized training and/or specific exercises” to avoid injury. A 2016 study on injuries among half marathoners and marathoners suggested that “interval training on a regular basis may be recommended to marathon runners to reduce the risk of injury.” Again, no endorsement for gene therapy.

Bottom line: Don’t covet better genes; instead, avoid injury by implementing better, smarter, more well-rounded training.