Overuse injuries in runners – what are some key factors in prevention

Although these days I coach more strength and power athletes, one of my biggest passions has always been helping people with their running technique, both sprinting and running over a long distance.

The body is an impressive machine, and its ability to withstand load over time is amazing.  It is also very frustrating when your body will NOT accept load over time and you keep getting little niggling injuries.

So, how do you improve your running technique and avoid injuries?

An article that I particularly like was produced by Alan Hreljac et al. who worked for the Calfornia State University a few years ago.  They evaluated the lower extremity overuse injuries in runners.  This study was published in 2000, which is a while ago, but I still feel it is very relevant to what we do as coaches.

He talked about the overuse injuries of the musculoskeletal system occurring with large number of repetitive forces, which is below the acute injury threshold of the structure, but cumatively producing a combined fatigue effect over time. 

The injuries that were talked about were Achilles tendonitis, jumpers’ knee or chrondromalacia patellae, plantar faciitis, shin splints and stress fractures.

Running happens to be one of the best ways to develop an injury such as the ones listed above.

Hreljac et. al. proposed that factors that contribute to the injuries were:

  1.      Training
  2.      Anatomical
  3.      Biomechanical variables

So, the study’s results were:

The results indicated that runners using a running stride with less impact forces and a moderate rapid rate of pronation will have a less likelihood of injury.

In terms of the key 3 factors:

  1.      Training Variables: There is consensus among many researchers that training variables account for a large majority of injuries.  Many individuals who have suffered from an overuse injury must have exceeded his or her limit of running distance and/or intensity.   In my opinion, this is where having a really good coach, that understands the science, and then the art form of managing each of their athletes is absolutely critical to success in an endurance sport.
  2.      Anatomical Variables: This study found that the sit and reach test, which tests hamstring flexibility was the only anatomical variable that was significantly different between two groups of non-injured and injured runners.  This could mean that lack of flexibility could lead to overuse injuries in runners.  Poor flexibility could mean that you are placing stress on adjacent joints, or indicative of a muscular imbalance.  It has been found though that stretching as a means of a warm up or cool down is not effective in reducing overuse injury effect.
  3.      Biomechanical Variables: Rapid pronation and touchdown supination were found to be greater in the injured runners’ group.  This change was considered significant.  There are some studies, which have suggested that, the Achilles tendon angle and greater maximal pronation velocity has been found in injured runners.   The main differences between this study and others was that they had used injured participants and this study used participants that had a previous injury but who were currently uninjured. 

The magnitude and rate of impact loading were found to be significantly greater in the injured group in this study and this indicates that these factors could be associated with overuse injuries.

The conclusions that this study draws are ones of common sense when it comes to managing injury and work load in running athletes.  What is important is to identify poor loading patterns, training overload and absence of appropriate rest intervals in training load and intensity BEFORE you become injured.   The way that someone loads onto their feet in running is considered very important in predicting lower limb injuries in running, however there are a number of factors that would indicate that training style and load are just as important!

The take home message here is to get a coach who will help you improve your running load and intensity over time, but also to have a coach that can help you with the anatomical and biomechanical variables that will make you a better runner and more importantly, an un-injured runner!

I offer sessions to help runners improve their movement competency to focus on flexibility, the way you load as you land and your strength and power to assist you with being able to maintain your training load to prevent injury.  To book in for an assessment, either face to face or on a skype call, please call 4927 8190, or email glenn@vectorhealth.stagingarea.net

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