Endurance sports have become an increasingly popular part of modern day exercise and training programs. Running is plagued by a high proportion of knee injuries because of the “high impact” nature of the sport.  Endurance athletes running more than 25 miles per week have an annual injury rate of 30%. Approximately 50% of these injuries occur in the knee! I’d like to help you avoid these injuries, so here’s some advice from an Orthopedic Sports Medicine Specialist and Ironman distance Triathlete who loves running!

The great majority of running injuries are due to overuse and improper training programs.  The most common errors involve a sudden change in frequency, duration, and/or intensity of training with insufficient recovery in between workouts.  Additionally, improper gear selection, fit, and poor biomechanics play major roles in endurance related injuries.  

Generally, an athlete should start with a 6 week strength and conditioning program that prepares the body for running.  These should be focused on hip and core strength with an emphasis on running technique. Single leg exercises also help to balance strength and body awareness that is critical to proper running form.

The next phase should include a “run/walk” program that gradually increases the time spent running versus walking.  Plan for increases of no more than 10% per week with regard to duration and distance. Find shoes that feel most comfortable on your feet and swap them out for new ones every 500 miles.  This simple advice has been shown to correlate with lower injury risk instead of picking the shoes that look best and wearing them until they blowout.

Poor running style has also been shown to have a high correlation with injuries in runners.  Runners who over-stride and land on their heel are more prone to knee injuries. The trick to avoid this style of running is to focus on “running cadence”, which is the number of steps taken per minute.  Runners who can get close to 180 foot strikes per minute have been shown to have better running form and up to 40% less impact in their knees than those with lower numbers. Use metronome apps to help with this, or go old school and count while timing with a watch.

Lastly, and most importantly, listen to your body!  This is a phrase that my patients hear often. It’s ok to take a day off if you’re not feeling up to the task.  Training modifications at the earliest signs of injury usually allow continued sports participation, but pushing through pain typically adds to the recovery time.  If you’re not sure of your condition or taking longer than usual to recover, an evaluation with a sports medicine specialist can be beneficial. An early and accurate diagnosis often times results in a more rapid return to injury free running.  We’re here to help!

Brad Bernardini MD, FAAOS – Fellowship Trained and Double Board Certified Orthopedic Surgeon and Sports Medicine Specialist