READY TO RUN
After a long winter your body may be more prone to injuries
Every Spring I love watching my fellow runners take to the streets again — but it’s less fun seeing my waiting room fill up with preventable running injuries from people pushing themselves too hard too fast.
People can easily strain ligaments, muscles and tendons because their bodies aren’t used to the shock of running again. And for those who didn’t exercise at all over the winter, getting your cardiovascular fitness up to speed is another strain on the body — a double whammy.
The most common running injuries I see include iliotibial band syndrome (where the fibrous band of fascia running down the outside of the thigh becomes inflamed), Achilles tendinitis, hamstring strains, plantar fasciitis (pain in the heel and bottom of the foot), stress fractures and runner’s knee, which is irritation around the kneecap.
Research shows that after a few weeks of not running, your body’s tolerance starts to deteriorate. After three months, you return to newbie status and should approach the sport like any other beginner. Your body needs to build itself up again: muscles and tissues need to adapt to absorb the shock of pounding on the pavement. It’s not a process you can rush.
This means you can’t just start
where you left off last fall. Dial it back to less than half the time or distance you ran previously, limit yourself to two to three runs a week, and space them out. I would even start with just 10 or 15 minutes for those first couple of runs. Stop while you’re still feeling good, not when the aches and pains begin. Increase by 10 per cent a week, unless you were a seasoned runner previously — then you may be able to build back up faster. Meanwhile you can do aerobic activities like swimming and cycling or elliptical to build up your cardiovascular fitness.
And there’s no shame doing a run-walk — for example five minutes of running and one minute of walking. You could also just start with fast walking, and
when you can do 30 minutes without aches and pains, start running.
How do you know when you’ve gone too far? With running, you don’t want to feel any nagging pain other than the usual postexercise muscle soreness. You don’t want to see swelling or bruising, or hear any kind of sudden popping noise, which may indicate a muscle or ligament tear. Please stop at once if you experience these things and seek the advice of a medical professional.
When they do feel pain, people often try to tough it out and keep running. I frequently see people who kept running on a stress fracture, despite feeling sharp pain. These injuries are especially common among people
who run every day and don’t give their bones a chance to recover and remodel. (Without that crucial time lapse, the bone is breaking down more than it’s remodelling itself, causing small cracks.)
To recover, I tell these patients you must take two months off high impact exercise — or you could be looking at surgery down the road and a much longer recovery.
Sometimes the way you run makes you more prone to injury. I often wince when I hear the pounding of a very heavy tread. Landing too hard can cause stress fractures, shin splints, runner’s knee and even arthritis. You can learn to land more softly by keeping your feet lower to the ground.
Another major problem is weak hips. Contrary to belief, running doesn’t necessarily strengthen your muscles, especially your crucial hip and core stabilizers. When I see runners listing to one side or with knock knees when they land, it’s often because of weak hips. It’s a very destabilizing problem that often leads to problems in the knees, or lower back issues like herniated discs.
Another injury-causing gait is the long stride. You want your foot to hit the ground under your body — not far out in front, where all your weight lands on your heel.
The way you run is so important to injury prevention that I often recommend patients get a “gait or running assessment” from a physiotherapist or running coach. Little tweaks can make a huge difference.
Warm-ups are important too. Rather than ordinary “static” stretching, research shows that “dynamic” stretching is more effective. This means adding movement to your stretch: squats and lunges, for example, are great for getting blood flowing to the legs, or starting out with a brisk walk to warm up. Do this before your run, and then stretch out tight muscles like calves afterward.
And finally, before you hit the road, make sure your shoes are not worn out. If you have no issues like plantar fasciitis or foot deformities, I usually recommend just a lightweight running shoe with a flat heel.
Dr. Awan is a lecturer in the Division of Physiatry, and a sports medicine doctor in Toronto.