Running, particularly outdoors, is one of those sports where you have to take care. Even the great Paula Radcliffe said during one of her marathons that she was mindful not to look back over her shoulder, for fear of tripping over a pothole in the road. With cars, dogs, pedestrians, loose paving stones and slippery grass to negotiate, there are many dangers in going out for a simple run. Then there is the fact that running has a considerable physical impact on your body. Running is wonderful for it in many ways, but you have to be mindful of the strain it will impose. So managing and mitigating injury is a crucial element in the world of the runner. Injury – as explained by Bupa on its bespoke site, www.bupa.co.uk/running – can happen in two ways. You can injure yourself either through trauma (say, falling off a kerb) or overuse (running too much). First, let’s look at overuse. If you are running too often, too long or too fast, it’s not good for you, especially if you have only just started. What are the key areas likely to be damaged? “Most injuries are to the muscles or the tendons (the bit that joins muscle to the bone) and tendon insertions in the leg,” says Bupa’s sports physiotherapist, Simon Fairthorne. “Either in the patella tendon below the knee or the Achilles tendon at the heel. Effectively what happens is that mini injuries to the tendon, minuscule tears, don’t heal properly. The fibres within the tendon eventually change their shape and size and become weakened. Scarring forms and a whole series of subsequent chemical reactions make tendons sore and painful.” “People generally have to stop running until it settles down but that shouldn’t mean the death knell for all exercise. The tendon won’t get better with rest alone. Tendon injuries require specific physiotherapy-guided exercises so that good-quality tissue can be restored in the tendon. It is also the role of the physiotherapist to work out how to maintain your cardiovascular fitness while your tendon gets better so that you’re back training as quickly as possible.” For those who have a metabolic condition such as diabetes, you must take extra care since, as Fairthorne explains, tendon repair is a complex process and is slower in people with diabetes. Every runner should have an ice pack in the fridge. This is in case of a sprain, a bruise, a pulled muscle or aching tendon. “Any time you feel pain in a tendon, you are advised to ice the tendon,” says Fairthorne. “If you suspect a pulled or torn muscle, ice it. If you notice any bruising there will probably have been some internal bleeding – again, ice immediately.” If you do have an injury, it is good to remember these two words: PRICE and HARM, as the Bupa site explains. PRICE stands for protect, rest, ice, compress and elevate – the things you should do if you suffer an injury. And HARM is the opposite – it stands for the things you should not do: heat, alcohol, running and massage. Also crucial to healthy running is a pair of well-fitting shoes, which must be the correct length and width. Do not buy these in a hurry; you should spend at least an hour choosing your shoes. A blister, aches, even niggles such as a blackening toenail shouldn’t be ignored. Sometimes such complaints can signify an ill-fitting shoe, socks that are too tight, or a poor running route (lots of downhill running can force your toes forward and damage them). They can also be very painful. Good shoes are vital – but so is knowing how to run in wet weather, particularly with the arrival of autumn. Simon Fairthorne knows that now the cold, wet weather is almost here, his clinic will be full of injured runners who have slipped on wet leaves, or fallen over on muddy grass, or not seen a pothole in the gathering gloom of twilight and stumbled into it. “I know I will start to see an influx of runners with simple sprains.” How long will a minor sprain take to heal? Around three weeks – and this, for a regular runner or someone new to running, is a long time. How can you treat a sprain? Rest, plus simple balancing exercises and a stint of physiotherapy. Should runners always stretch? Probably yes, but gently. Never stretch aggressively after exercise because this can aggravate small strains. Simon Fairthorne recommends runners not only stretch gently before or after a run, but also take a weekly yoga class, because this encourages greater muscle flexibility and, as he says, “it makes sense that flexible muscle is less prone to injury. Elite runners are notably flexible. And most of us eventually want to emulate elite runners, don’t we?” Yes, we certainly do. If you are inspired by the Bupa Great North Run and would like to take up the challenge next year, why not start now? For beginners, Bupa offers a series of training programmes designed to ease you into running, including the Walk to Run programme for those who have never run before. For more details, visit bupa. co.uk/running or telegraph. co.uk/ buparunning