Running pain-free

Runners and joggers’ injuries are not much different from those suffered by anyone else. What makes runners unique is the far greater frequency and severity with which they are injured. With proper training and running form, most foot and leg injuries suffered by athletes can be prevented.

When walking, people put stresses on their feet equal to 120-150% of their body weight. Running increases these forces to 300-800% depending on the terrain and the individual’s running form. With stresses of such magnitude, otherwise unnoticeable, mechanical problems are exaggerated. These can include one leg that is shorter than the other, an abnormal twist in a bone or a joint that is unable to bend as much as it needs to.

Weight is also magnified in a runner. Every extra pound of flesh adds 3–8 pounds of stress on the foot. For every muscle that pulls on a joint, there is another muscle that pulls in the opposite direction (an antagonist). Some antagonists are naturally stronger than their counter-part. Exercises such as running exaggerate these imbalances.

The large muscles in the back of the lower leg are a prime example. Normally very strong, these become much stronger and tighter with running. Left alone, they soon overpower the opposing muscles in the front of the leg which are weaker to begin with. As a result, the ability of the muscles in the front of the leg to lift the foot becomes increasingly more difficult.

A tight Achilles tendon will reduce the foot’s ability to bend up (dorsiflex) at the ankle. If the foot can’t dorsiflex adequately at the ankle, it will bend somewhere else, usually at the joints in the middle of the foot. An assortment of maladies, ranging from Achilles tendinitis to heel spurs and bunions can result from this problem alone. By stretching the back leg muscles, this particular problem is easily corrected.


Most athletes understand the importance of stretching before a run. But the cool-down afterward is equally important. Unfortunately, because many are in a hurry to go home and shower, the post-run stretches are often skipped. Injury can be avoided by taking a few extra minutes to cool down properly.

Don’t bounce when stretching. Ease into a stretch and feel its tension.

Hold it there for 10–15 seconds and then ease out. There may be a mild burning sensation in the muscle but there should not be any pain. There is an old saying of “no pain no gain.” Baloney! If it hurts, you are probably hurting yourself. Bouncing causes small tears to form in the muscle. These heal by scarring. Over time, scars contract. You end up with just what you were trying to avoid–a shorter muscle.

Some runners who feel tightness during a run will interrupt their run for a brief stretch of those muscles. This is particularly effective for Achilles tendinitis.

Overstretching is may cause damage too.

Every athlete is different. There are no good hard rules governing the duration of the warm-up, cool-down and individual stretches that can be applied to all athletes. Common sense and careful listening to your body are still the best guidelines.

Jogging should be a pleasant experience.

The following tips may help make it one. Start slowly—especially if you have not been exercising regularly. Allow your body to adapt to the new stresses. Beginners especially expect too much too fast. Over-use syndrome soon overtakes them and spoils the fun.

A physical exam should be considered if you are past age 35 and have been sedentary.

Wear running shoes in good repair. Heels worn on one side create a mechanical problem for which the body must compensate. Loss of cushioning means greater stress and shock with each step. Also, the back of the shoe where the heel sits (shoe counter) must be firm. If not, hindfoot stability is lost. All these factors and more result in stress and pain. Shoes, like tires, wear out.

Wear loose fitting running shorts and shirt. Tight, restrictive clothes and jeans are to be avoided. Dress appropriate to the weather. Sweat suits, gloves and a hat in the winter are a must.

Choose a terrain to meet your ability and body’s needs. Take to the hills after you’ve mastered the flats. Runners with knee and Achilles tendon pain would do best to stay off the hills. Runners with a rigid, high arched foot often have problems with shock absorption. Softer surfaces will help reduce the trauma of each step. Everyone should keep off rough, bumpy terrain. Ankle sprains are all too common here.

Avoid banked tracks. These act to create an artificial leg length discrepancy. In runners who already have one leg shorter than the other, the difference is magnified. If you can’t avoid a banked track (that includes the street), consider alternating direction with each run.

Run upright. Muscles work more efficiently this way than when you lean forward. You will run faster and with less effort. Leaning too far forward is a common cause of back pain.

To increase speed, increase the number of strides per minute but not the stride length. Overstriding is a common initiator of leg pain.

Swing your arms forward and not from side to side in front of your body. This avoids unnecessary body twisting which is another common cause of low back pain.

Run relaxed. Unclench your fists, relax your shoulders and run loosely. A tight posture leads to muscle strain and injury.

Find your best routine and stick to it. A common denominator in running injuries is change: the athlete has recently changed either their distance, pace, shoes, terrain or running style.

Changes must be made gradually. Distances should rarely be increased by more than 10% a week.

Try to run later in the day. Studies have shown a significantly higher incidence of injuries among morning runners. Presumably the muscles are naturally more stretched and warmed up as the day progresses and less prone to injury.

Don’t ignore pain. Pain unrelieved by rest should be looked into. Your body will usually tell you when something is wrong. Listen to it before permanent damage is done.