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10 Tips for Avoiding Running Injuries by Rachel Keller No one likes to face injury, but runners especially seem prone to injuries. And it's no wonder since a runner's feet strike the ground anywhere from 800 to 2,000 times a mile, at a force of about three to five times his body weight. I have been fortunate in that I've remained relatively injury free, but I have had experience with injury: an ankle sprain, knee discomfort, hip pain, and fatigue from overtraining. Other than the sprain, most of my injuries were minor. A couple days of rest, chiropractic care, and stretching helped me recover from my aches. However, I know many other runners and nonrunners who constantly face injury and pain. While many listen to their body and back off, others ignore the pain and keep pushing to a higher level--a new personal record or goal. While some injuries are unavoidable, others are preventable. The most common injuries runners face are shin splints, runner's knee, plantar fascitis, and inflammation of the iliotibial band (known as Iliotibial band syndrome or ITB Syndrome). Shin splints occur as pain or soreness in the shin region. They can sometimes lead to stress fractures. Runner's knee is an aching soreness around or under the knee. An inflammation of the connective tissue along the sole and its attachment to the heel bone is plantar fascitis. ITB Syndrome is an inflammation on the outside of the knee joint, which begins as an ache but can progress to a painful burning sensation. Here are ten tips for avoiding running injuries: 1. Invest in good quality running shoes for your foot type. You are setting yourself up for injury if you don't have the right shoes or if you fail to retire your shoes after 300-500 miles. I made the mistake of buying "cheap" running shoes. It didn't take me long to realize I needed better shoes. I went to a specialty running store where I received expert advice. Now, I will never run in anything but quality running shoes. For more information about getting the proper shoe, check out Finding the Right Running Shoes 2. Be careful about increasing your workout or mileage too much too soon. If you're overtraining, you risk injury. (My brother has suffered from shin splints for this reason.) The general rule is that you should not increase your mileage by more than 10% weekly. Also your long run should be no more than 50% greater than your longest run in the week. If your second longest run in the week is 5 miles, then your long run should not exceed 10 miles. 3. If you're a beginning runner, avoid difficult and hard runs. As a general rule, you should wait until you've been running about a year and have built your mileage to about 20 miles weekly before attempting hills and speed training. That doesn't mean you should never run hills. Where I live, I'm surrounded by hills, so when I started running, I had little choice but to run hills, but I have had knee discomfort after increasing my mileage too quickly and running too many hills too fast. Be careful when running hills--especially going downhill--that you maintain control. (See Hill Running With an Attitude for more information.) 4. Take a day or two of rest. I exercise six days a week, but I only run four days a week. By incorporating a day of rest and cross training, you lessen your chance of injury. I cycle and participate in aerobics on my nonrunning days. I love running, but I don't want to risk all those injuries that many runners face. Often, once you suffer injuries, your body is more susceptible to those same injuries. Yes, there are runners who run every day and have no problems, but I don't want to take that chance. 5. Run slower and on softer surfaces. Concrete is the hardest surface and provides little shock absorption. Roads paved with asphalt are better. Cinder tracks are the most resilient. If I have the choice between sidewalks and the streets, I choose the street as long as it's safe. When I run along a four-lane highway I choose the sidewalk. To not run there would be sheer foolishness. 6. Watch the camber on streets. The middle of the road is the best part to run on, but it is also unsafe. Some roads have very steep camber, so avoid running on the edge of those roads. If it's not a busy road, you can run more on the road, or else try running off the road. When running off the road, be careful of holes or loose stones you may slip on, or any other hazardous situations. Don't run with your head down all the time, but be aware of what's underfoot. (I suffered a sprained ankle when I first started running because I slipped on wet grass going downhill and twisted my ankle after falling into a little hole.) 7. Stretch both before and after your workup, but warm up a little before stretching. Walk or jog an easy mile, stretch and then run your course. Don't forget to stretch at the end of your run after you cool down. If you fail to adequately cool down and stretch after a workout, and especially after a race, your muscles will tighten and you will be stiff and sore the next day. To prevent this walk or jog slowly and then stretch. The longer your run or the harder your race, the longer you need to cool down afterwards. I usually plan the last mile or 5-10 minutes as an easy jog and then I walk for a few minutes. After a race, I walk/jog for at least 10-15 minutes. 8. Do strength training exercises for the lower and upper body. Lunges and squats, when executed properly, are great leg strengtheners. 9. Also, watch your running form. Not only does that help to prevent injuries, but it also helps you run more efficiently. To maintain proper posture and efficiency, hold your head high. Relax and avoid tensing your muscles. If your body is aligned properly, your feet will land on a line directly in front of you. Be aware of your arm movements. Keep your arms bent at about 90 degrees. Dangling them or holding them to your chest will cause a loss of power in your stride. They should move forward and backward with the opposite leg, your hands brushing your hips. 10. Listen to your body. While some muscle aches or discomforts are to be expected when you push yourself, pain is not. Pain is your body's way of telling you that something is wrong. If you continue exercising through pain, you risk injury. And if you have an injury, take some time off. You risk more damage and your recovery will take longer if you don't! When I twisted my ankle in that hole, my ankle hurt a little, but I could still run, so I decided to keep running. After running another mile, I knew something was wrong. I stopped, but the damage had already been done. The next few weeks, a sprained ankle prevented me from running, doing aerobics and weight training. Then, I had to gradually build my strength back in my ankle before I could resume my regular activities. If I had not tried to push myself, I would have recovered much more quickly. Always listen to your body and don't push through pain. Nutrition for Marathoners and Others By Art Liberman of State of the Art Marathon Training In regards to all the aspects of marathon training and preparation, nutrition is one of the most important topics to consider. The best training schedules are worthless if runners fail to plan properly to meet their nutritional requirements for long distance training and racing. Areas of concern include general nutrition, guidelines for the long run, and nutritional issues for the marathon. General Considerations For athletes, water is the drink of choice for both general health and for runs lasting under 90 minutes. Sports drinks should be consumed (along with water) for runs lasting over 90 minutes in duration. Don't rely on your thirst mechanism to indicate signs of dehydration. Regarding running in the heat, it is virtually impossible to "catch up" on your fluid requirements once you sense that you're thirsty. It is vital to stay well hydrated throughout the day. The color of your urine should be relatively clear. Urine that is darker or approaches the amber color is a signal that you are dehydrated and need to drink fluids (preferably water). While there is much debate regarding the proper mix of foods, aim for 65 percent of total calories coming from carbohydrates. Emphasize healthy foods in your diet along with limiting fried and high fat foods. Preparing Nutritionally for the Long Run For the sake of this discussion, let's assume your long run is scheduled for Sunday morning. Drink lots of water all day Saturday. Eat meals high in carbohydrates for lunch and dinner Saturday. Selecting the "right" foods is an important area of experimentation. Avoid foods high in salt and excessive protein/fat all day Saturday. Drink about 16 oz. of water Sunday morning prior to your long run. Eat a light snack Sunday morning prior to your long run. This is also an important experimentation area in regard to food selection. Drink lots of fluids while running. Be sure to stop for water frequently throughout the run. For runs longer than 90 minutes, you MUST drink sports beverages (such as Gatoraid, Poweraid, etc.) every 2 - 3 miles. Drinking on the run requires careful planning of the route (making sure there is water available frequently along with places to stash sports drinks). Consider trying the new "gel" carbohydrate replacement products. Be sure to chase them down with water to avoid stomach cramps and insure absorption. A final thought... Please dispose of gel and energy product wrappers properly by throwing them away in trash receptacles or placing them in your fanny pack. Let's all work together to keep the environment clean! After the run is over, continue to drink fluids (water, sports drinks, or juice are all great choices). As soon as possible (ideally within 15 minutes), have something to eat to replace depleted glycogen stores. Research has shown that to avoid muscle fatigue the next day, carbohydrates should be eaten as soon as possible following long duration exercise. Marathon Nutritional Issues The Week Prior to Your Marathon As you scale back on the distance and intensity of your running during that last week before the marathon, realize that you will not be burning as many calories. Thus, you may gain one or two pounds if you don't cut back a bit on the quantity of your servings early in the week. Use care in selecting foods to eat during this time period, aiming for quality foods rather than snack/high fat products. Hydrate well the week before the marathon (water is best) and in particular, during the carbohydrate loading period (three days prior to the marathon). Research has shown that carbohydrates convert to glycogen more effectively when accompanied with the consumption of water. This is the time when you probably will gain a couple of pounds, but don't worry about it. This will be the fuel you will use during your marathon! If you are traveling out town, be sure to pack healthy snack foods you may wish to eat the weekend of the marathon. Eliminate the need to search for a grocery store that stocks your favorite foods. Also see Packing List for more information. If traveling by plane to your marathon destination, carry bottled water with you. Flying at high altitudes causes dehydration. As mentioned above, carbohydrate loading begins three days before the marathon. Choose foods for lunch and dinner that are high in carbohydrates (e.g., pasta, potatoes, rice, etc.). Don't neglect fruits, vegetables, and some protein sources however. Try to really scale back on fats during this time. The Evening Prior to Your Marathon Be sure to eat carbohydrate products that have been "tried and proven" during your training period. Keep pasta sauces simple, avoiding high fat varieties (e.g., alfredo, pesto, etc.) Avoid eating lots of salad items and vegetables (roughage) as these may prove to be troublesome on race day as they may cause digestive problems. Stick to water during the evening meal. Because coffee and tea contains caffeine, these products may make it difficult for you to fall asleep easily. Caffeine (along with alcoholic beverages) are diuretics which can lead to dehydration. The Morning of Your Marathon (Before the Race) Continue to drink fluids up to 15 minutes before the start of the race. Eat your final snack no more than 30 minutes before the start of the race. During Your Marathon Aid Stations - Do not pass up any fluid station. While it's okay to drink just water in the early miles, runners must consume sports beverages no later than after 90 minutes of running (and earlier if possible). Find out what works best for you in long practice runs. Water is usually offered at the first tables at an aid station with sports beverages served near the end of the station. Squeeze the top of the cup into a "v" shape to create a smooth delivery of fluid directly into your mouth if you choose to run and drink through the aid stations. If necessary, walk through the aid stations to be sure that you are able to consume the entire contents of the cup. If you decide to stop and drink, please get out of the way of other runners. Supplementing - Many runners now are taking advantage of the new gel products out on the market. These products will provide a fairly quick source of carbohydrates (energy). Be sure you chase these products down with water to avoid stomach cramps. Some runners find that stopping and eating a power bar, orange slices, jelly beans, etc. also provides needed energy. However, these items are seldom supplied at official marathon aid stations. Immediately Following Your Marathon After crossing the line, get something to drink (e.g., water, sports drink, etc.) Although it may be tempting, hold off on consuming alcoholic beverages until later in the evening if you feel so inclined. Within a few minutes of finishing, grab something to eat. After you return home or to the hotel, have a nice lunch. This should be a well-balanced meal that includes the majority of its total calories in carbohydrates. Don't overlook consuming at least 20 percent of the total calories from protein sources.