Running Injury Prevention: Do’s and Don’ts
We put five common maxims to the test
Outside's long reads email newsletter features our strongest writing, most ambitious reporting, and award-winning storytelling about the outdoors. Sign up today.
It’s every runner’s nightmare. You’ve put in months of training for a major race, and then, just before the big event, an injury forces you to withdraw. We know. It’s a major drag.
Dedicated athletes try to avoid this dreaded scenario by using any of a number of injury-prevention techniques to keep healthy. We asked acclaimed fitness author and coach Matt Fitzgerald for feedback on five of the more common ones to see whether they’ll actually help keep you off the DL and ready to show up healthy on race day.
The Claim: You might not feel supercool on the elliptical trainer, but alternate low-impact training allows you to keep in shape while not exacerbating a running injury in the making.
The number one way to prevent an injury, Fitzgerald says, is to nip it in the bud.
“Most injuries with runners don’t occur suddenly,” he says. “They start off as a warm spot. Three days later, that warm spot is soreness, and if you don’t listen to it, three days after that, that soreness is pain. And then you’ve got an injury that forces you to take six weeks off. But if you respond with a hair-trigger reaction to red-flag pain, you can save yourself a lot of injuries, and it never gets beyond an ache or a pain.”
That’s when cross-training can save the day.
“If you’re too sore to run, usually you’re not too sore to get on the elliptical trainer or ride a bike,” says Fitzgerald. “So if you have something to fall back on, you don’t have to panic about losing fitness even though you’re giving your body a chance to heal from something that is affected by running and only running.”
Running on Soft Surfaces
The Claim: You should to seek out soft surfaces like grass or dirt trails to minimize the strain on your joints and reduce your chances of a stress fracture.
“The reason that the injury rate in running is so much higher than in other endurance activities like swimming and cycling is that it’s a high-impact activity,” Fitzgerald says. “So anything, or almost anything, you can do to reduce the amount of impact force you’re subjecting your body to is probably going to reduce your risk of injury.” Staying off concrete may or may not be one of those things, as the body tends to strive for consistent impact forces, treading lighter on concrete and harder on soft surfaces.
Although there is little scientific evidence to confirm the soft-surfaces approach as a viable injury-prevention technique, many elite runners and their coaches—including Galen Rupp, Mo Farah, and Alberto Salazar—swear by it, and there’s something to be said for the wisdom of the crowd.
“Kenyan runners avoid asphalt at all costs,” Fitzgerald says, “and I would trust the best practices of the best athletes.”
The Claim: A few years ago, barefoot or minimalist running was all the rage. As it turns out, owning a pair of Vibram FiveFingers might not be the panacea we were all hoping for. (More than 150,000 claims were filed in a lawsuit against Vibram for making unscientifically supported statements about their shoes’ ability to make runners less susceptible to injury.) Now a number of runners have gone in the opposite direction, donning shoes so fat and wide that they look like floatation devices in the hopes they’ll soak up damaging vibrations.
Fitzgerald says you shouldn’t believe the hype either way.
“As far as we know, there’s no real evidence to show that minimalist shoes reduce injury risk or that maximalist shoes do,” he says.
The right shoes do make a big difference, however, and the key to finding the right pair, according to Fitzgerald, is refreshingly simple.
“There is research showing that when runners are simply allowed to choose the shoes that are most comfortable for them, based on several options, there is a meaningful reduction in injury risk. And that, to me, makes a hell of a lot of sense, because your level of comfort in a shoe is not noise. It’s not arbitrary. It’s your body telling you, ‘Hey, this shoe allows us to run the way we want to run.’”
While a shoe may feel comfortable when you first try it on in the store, it takes some time to figure out what works best for you. Fitzgerald says that the right running shoe is the one that still feels comfortable during the tenth mile of a ten-mile run.
The Claim: If you don’t run, you will not get injured when running. Since total abstinence isn’t an option for passionate striders, a short hiatus from the sport may give the body time to recover and, so the thinking goes, contribute to the longevity of your running life.
Matt Fitzgerald warns that it may be better to adopt a low-mileage, low-intensity training regimen for a few weeks, rather than to forswear running altogether.
“Mandatory rest can be good for recovery and restoring motivation,” Fitzgerald says. “But from an injury-prevention standpoint, remember that injuries occur when people are just starting out or increasing their running. Runners who get injured a lot are the ones who are more erratic in their training, so I wouldn’t want to advise runners to become more erratic. That’s a common problem. You have people taking a month off and then coming back, and that is when they get injured.”
To bolster his point, Fitzgerald cited a study on high school cross-country runners, which found that the athletes who didn’t run during the summer were far more prone to injury during the fall than those who had trained throughout the off-season.
The Claim: A massage, be it from a professional therapist or self-administered, is one of the most common ways to loosen up sore, tight muscles so they’re less prone to injury.
The question is whether this is really an injury-prevention technique per se or just a way to make you feel better after a hard workout. According to Matt Fitzgerald, it may amount to same thing.
“This is another one where there’s no science that will say that either of those modalities [i.e., foam rolling or getting a massage] will reduce injury risk in runners, but it can’t hurt, and I would suggest it probably does help,” Fitzgerald says. “Specifically in certain particular, targeted circumstances, like when you have an issue related to scar tissue, which I actually do right now. I’ve got a hip-flexor thing, and I perform self-massage on it every night, and it makes the difference between being able to run the next day and not. That’s pretty powerful anecdotal evidence that the stuff can absolutely make a difference.” At least in preventing further injury to tight spots.