10 Things You Should Start Doing Right Now to Avoid Running Injuries

By Daniel Fleck, PT, DPT, OCS, Owner of High Performance Physical Therapy 

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Running is the second most popular form of exercise on the planet – only behind walking. If you like the idea of a free outdoor activity that can be done just about anywhere – and walking just doesn’t quite do it for you –running may be the answer.

Running offers countless benefits. These include improved cardiovascular health, increased bone density, longevity, improved cognition, better sleep, and even increased happiness. It’s no wonder so many people are out there crushing mile after mile and trying to get better at running.

That all sounds great. But, this is a physical activity involving ground reaction forces and potentially a whole lot of impact step after step. If you rush into running, you may wind up on the sidelines with a running-related injury before you even get to show off those nifty new compression running pants. 

Please keep in mind that this top 10 list about how to prevent running injuries is not all encompassing. It is in no way to replace individualized medical advice. The very first thing you should do in the steps to avoid running injuries is see your primary care physician. Make an appointment to get a physical exam and stress test if needed to make sure you can safely endure an exercise program. This is especially true if you have a history of cardiac, vascular, or pulmonary disease. When the doc gives you the nod, follow the tips below on how to avoid an injury while running for a healthier and happier you.

How to Avoid Running Injuries

10. Find a pair of running shoes that fit and are comfortable the first time you run in them. 

Some of the best research studies come from the military because of the ability to control so many variables. This study by Dr. Joseph Knapik out of the US Army Center for Health Promotion and Preventative Medicine is no different. They showed that indifferent to foot type, the runners who ran in shoes that were the correct size and the most comfortable were the least likely to experience a running related injury. 

To benefit in the same ways and avoid runner’s knee and other injuries, get sized and try on multiple pairs. Find a store that has treadmills and run in them. Pick the most comfortable pair and maybe most importantly, do not listen to the unqualified shoe salesman when they attempt to upsell you because you “overpronate.” Pronation is a normal movement pattern. So, without a trained eye, a knowledge of biomechanics, and a recording device that allows slow motion playback they are blowing smoke.

9. How to prevent running injuries by getting your nutrition right. 

This tip for how to avoid knee pain when running doesn’t just apply for marathon runners. Having the right meal at the right time before a run significantly impacts the outcomes and how your body responds to strenuous activity. Hold off on the chicken parmesan until after the run. For some great specific information check this article out.

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8. Only increase one thing at a time – distance, speed or intensity. 

It may sound like common sense. But, all too often I see patients in my office that jumped from 2 mile runs to 6 mile runs basically overnight because they were feeling great that day. Yes, there will be times you feel better than others on a run. However, that does not mean double your distance or speed. Even worse, increasing your speed and overly increasing your distance in the same training run.

If you want to increase your distance safely and avoid running injuries, follow the 10-25% rule. The formerly held 10% rule had no evidence backing it up. In fact, it was busted by Nielsen et al in a study published in JOSPT. Here, they showed that any increase below 30% did not increase running related injury (RRI).

7. How to prevent shin splints when running through a dynamic warm up and cool down. 

Often overlooked due to time constraints or the old adage “if it ain’t broke don’t fix it.” What if you did that with your car and never changed the oil? You’d be in the market for a new engine after that one seized up due to viscosity breakdown. Don’t let your body break down because you neglect the 2 minutes before and after to do some walking lunges (before) and foam rolling (after).

6. Hydration, hydration, hydration! 

Hydration means water PLUS electrolytes. Crucial distinction when it comes to how to avoid knee pain while running. A couple of my favorites are Nuun tablets to drop into your water bottle.If you want a little extra kick, check out Tailwind. These hydration tablets were designed by endurance athletes. They contain just a tad of caffeine and all the glucose you’ll need in addition to the essential electrolytes your body needs on a long run.

5. Minimize your “vertical displacement”. 

This is also known as your “bounciness” or your “up and down motion.” Essentially, it’s wasted energy. All it does is increase the ground reaction forces or impact your body must absorb. So how can you prevent knee pain when running due to this type of motion? Just try keeping your eyes level with the horizon as a focus.

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4. Aiming to take between 170 -180 strides per minute can help avoid runner’s knee. 

Sounds like a lot, but this range has been proven and validated in research studies to minimize and avoid running injuries. Get on a treadmill and set a timer for 60 seconds. Then, count how many times your left foot touches down then double that when you're done. This will give you your strides per minute. 

If you are in a super low range that means you are over-striding and putting undo stress on your body. But don’t fret; there is a fix that can help you avoid running injuries. Try increasing your strides by 5% by running to songs with BPM in the range you’re aiming for. Once you are comfortable in this new range after at least a few runs, keep repeating this process until you reach the ideal range. It’s important not to increase by more than 5% intervals at a time.

3. Get two pairs of the same running shoe and switch them out each run. 

As great as technology is for running shoes, the geniuses behind the latest and greatest shoes haven’t figured out how to return shoes to their shock absorbing capabilities after a good concrete pounding. Running shoes will not be as effective at absorbing ground reaction forces the day after a run. Therefore, if you are running or planning on running back to back days, getting a second pair is a great solution to how to prevent running injuries. They usually bounce back within 24 hours or so. 

It’s also a good idea to buy a new pair to swap out with a pair that is halfway worn. This way, you don’t go from a completely worn-out shoe (with not much shock absorption or even tread left) to a brand-new pair. This swapping method has been a proven way to prevent knee pain while running and reduce other RRIs.

2. Slow down to a walk to self-assess your symptoms if you start to experience pain. 

If you experience any type of musculoskeletal pain (non-lactic acid build-up or cramping pain) during a run, slow down! This will slow your self-produced pain blocking chemicals such as endorphins and enkephalins. So, you can really get a sense if the pain is serious or not. The last thing you want to do is turn a stress reaction into a stress fracture by running through the pain.

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1. How to avoid an injury while running by supplementing with a strength training program. 

It’s tempting to just check out Instagram for some random exercises. But, these will not be specific nor necessarily good for anyone even if the person doing them has a nice physique. There is a better way to learn how to avoid running injuries.

Instead, see a physical therapist with a strong background in strength and conditioning and running. They can design a strength program just for you. To make finding the right PT even easier, use the BetterPT platform! With direct access, you can find a physical therapist, book an appointment, and start getting treated – all without a doctor’s referral. When you get the right treatment plan and learn the best ways of how to prevent knee pain while running, you can stay running longer without injury.  

Dr. Daniel Fleck is a physical therapist at High Performance Physical Therapy with a Bachelor’s Degree from Binghamton University  and a Doctorate in Physical Therapy from Stony Brook University. He is an Orthopaedic Certified Specialist earned from the American Board of Physical Therapy Specialties. Dr. Fleck is passionate about sport-specific and functional fitness, employing an evidence-based therapeutic approach utilizing various techniques to ensure excellent patient care.

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