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Run Forest, Run!

Updated: Jun 23, 2019

Did you, or someone you know, make a running goal for 2019? Maybe you are making strides toward completing your first 5k, or perhaps you have set your eyes on ‘the holy grail’ and want to finish your first marathon? Whether you are pursuing that first 5k, marathon, or something in between, we need to have a serious discussion about injuries, what causes them and how to prevent them. Why do up to 79% of endurance runners sustain some type of injury that causes them to miss training sessions, and even races?


Let’s start with what I (and probably you) have heard many runners say cause their injuries. People feel variables such as running shoes, form/heel strike patterns, muscle imbalances, and ground reaction forces are the cause of their running issues. While it is true that working on one or a combination of these things may reduce your risk of injury, they are not the primary reason runners get injured. Too much, too soon is the real reason. Let me explain!


I have read numerous sources on running related injuries and treated many injured runners. I have done all of the above, advised on shoe wear, worked on strength and form, because I know those will reduce my patient’s risk of injury. However, I have the same conversation with them that I am about to share with you on ‘too much, too soon’. All of us adapt differently, but we adapt. This is where I apply Wolff’s law, which says ‘the body responds to the demands imposed on it’. The easiest example of this is a man that punches a tree. If he were to start punching that tree everyday, the bones would not heal. However, if he starts punching the tree once a day every three days, then eventually punches the tree 5x a day every three days, so on and so forth. The bone and skin will start to adapt and tolerate that activity. This takes time and patience, which many of us lack.


Let’s apply Wolff’s law to running. If you decide you are going to start training for your first 5k, but have never run before you cannot simply start running 20 miles a week. You must first get your body use to the impact. I start people with a walk/jog combination, and I adjust their schedule based on how their body responds. This means watching for signs and symptoms of possible injuries, which the ‘cookie cutter’ programs don’t do. Now, if someone doesn’t have the right physical therapist, or coach, to properly guide them on this correction, they might think it is just soreness typical with training. Then two weeks, a month, or 3 months later they are in seeing their doctor because the didn’t adjust accordingly and now have to take time off of their running and possibly miss their race.


So, do running shoes matter? Yes! They help align your body which helps you adapt better. Does strength training matter? Yes! Improper use of muscles leads to improper adaptation which can lead to injury, thus proper strength work helps you adapt better. Does form matter? Yes and no. If you progress your training properly your body will adapt to that style of running. But, if you improve your form, your body may adapt faster because of how the forces are now better distributed through your kinetic chain. But, ultimately it comes down to proper training progression, and that progression depends on your running/sport history, genetics, age, and weight.


Whether you are in the early phase of your training or your race is right around the corner, getting with a running-specialized physical therapist, or coach may help you reach your goals in a safer way. For those of you experienced in running, it may mean waiting an extra 3 months or more to reach your PR goal. But, wouldn’t you rather get there injury free so you can keep running?


Daoud A, I., Geissler G, J., Wang F, Saretsky J, Daoud Y, A., Lieberman D, E. Foot strike and injury rates in endurance runners: A retrospective study. Med Sci

Oestergaard Nielsen R, Buist I, Srensen H, Lind M, Rasmussen S. Training errors and running related injuries: A systematic review. INT J SPORTS PHYS THER. 2012;7(1):58-75.

Predictors of running-related injuries in novice runners enrolled in a systematic training program. a prospective cohort study. SPORTEX MED. 2010(45):4-4.

Bertelsen ML, Jensen JF, Nielsen MH, Nielsen RO, Rasmussen S. Footstrike patterns among novice runners wearing a conventional, neutral running shoe. Gait Posture. 2013;38(2):354-356


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