By far the most common injury for runner is the dreaded "shin splint". A shin splint is
actually three conditions, two of which are associated. Essentially, shin splints mean
only one thing: You tried to do too much too soon. The condition manifests itself as a pain either
along-side the shin, or deep inside the shin. The pain is persistent while running, but
usually subsides when you stop. Many times the pain is only mild, and more gung-ho runners
will try to ignore it until it eventually gets worse.
The first condition often associated with shin splints is not a shin splint at all, but
has similar symptoms. New runners who run on irregular surfaces, or returning runners who
try to exercise at their old levels will oven stress the tibia (shin bone). Bones actually
flex when they are stressed, and though they don't break they can develop small stress
fractures. During the course of activity these stress fractures go unnoticed, and a
are part of the bones natural strengthening process. However, with repeated stresses the
fractures won't heal, and may even expand developing into a break. To determine if your
shin splints are actually microfractures, grasp your lower leg with your thumb together over
the shin bone, thumb pads resting flat against the bone (do not use your thumb tips for this).
Rub your thumbs down the length of your tibia until you get to the ankle, and then back up
again. If at any single point along your tibia you should feel a sharp pain in a specific area,
this could indicate a microfracture. If the pain is over a much larger area, it is probably
a typical whack-the-coffee-table injury (you actually receive several of these in a day
and don't notice because your mind is preoccupied). An actual microfracture will be in a very
small area, and will usually go across the bone, not along the length of it.
If you suspect you have a microfracture, you should stop running immediately. See you doctor,
who may take an X-Ray. If you have microfractures, they should heal very quickly, and
you can resume running in no time. To keep your fitness routine in line, you can take
brisk "power" walks. A power walk will help maintain your cardiopulmonary health until you
can get back to serious running. You may also want to look at your diet. Low calcium intake,
low levels of magnesium, and a lack of vitamin C will make your bones and muscles fight over
these essential minerals. Also, if you are a woman over 40 or are pregnant, you will require
extra vitamins and minerals anyway. Anyone on an exercise routine should be taking a
After microfractures, real shin splints are the most common affliction. Shin splints result from the
swelling of the muscle that runs alongside the shin bone. In one type of shin splint,
the outer lining of the muscle will have too much pressure on it from the muscle itself,
and this will result in an aching feeling. In another type of shin splint, the sheath
around the shinbone itself becomes irritated by the pressure of the inflamed muscle
against it, and by the stresses on the attachment points between the muscle and the
shin bone. This is (thankfully) a temporary condition, and explains why shin splints
rarely hurt any other time then when you are running.
To deal with shin splints, first take some kind of anti-inflammatory pain reliever like
ibuprofen. Even when you're not feeling the pain, the muscle and surrounding tissues are still
inflamed. For severe cases, you should bring an ice pack with you. Immediately after running,
you will need to do warm down exercises. Following that, ice your shins for about 10 minutes.
If the thought of freezing your legs is not appealing, you can use a thin t-shirt or light towel
to keep the absolute icy cold out while still cooling the muscles and tissues down. Icing the
shins tightens up blood vessels in the area to reduce swelling, but it is important that blood gets
in there, so after that 10 minute period you may want to wrap your shins with a neoprene wrap to
keep the muscles warm. Also, dial back your running for a week or two. Don't keep overdoing it if
you don't have to. A good power walk, or a light jog will keep you in good condition.
Hyper-extension and Stress Injury
Probably more common than shin splints, but usually less debilitating, are hyper-extension
injuries. These are also known as "pulled" or "sprained" muscles. Generally speaking the number
one cause of this type of injury is poor stretching. Before starting any exercise, you should
stretch all of the muscles associated with that exercise. There are several different kinds
of stretches, and it would take too long to explain them all. Runners World has a page that lists the
most common types of stretches. You should stretch both before and after your exercise to
keep muscles limber, and you should also stretch during 'breather' periods during your exercise.
Also, if you feel a muscle starting to get tight, you should stop, stretch that muscle for a few
seconds, and start again.
In addition to stretching, you should incorporate warm-up and warm-down periods into your
exercise regiment. For runners, you would never cold start a sprint or long distance run. Instead,
run a nice easy quarter mile at a moderate pace, then walk it out. Stretch your muscles, and keep moving,
walking, and talking to keep your body at an elevated pace while you wait to start your run.
Where you run can often be as important as how you run. Uneven surfaces will stress your ankles, hips,
and calves while you fight to stay vertical. Try to run on grass or packed dirt while avoiding pavement.
The softer surfaces will absorb the impact of you coming down on each step while concrete, cement, and
asphalt will jar your joints. A 200 lb man can have as much as 1200 lbs of force per square inch exerted on
his joints while jogging. Also, know your course. If you're new to a trail, you should walk or jog it
first to look for roots that protrude, holes in the ground, or anything else that might catch your foot
and cause you to trip or sprain a joint. If at all possible, try to find a public track. Often community colleges and
high schools make their tracks available to the general public during off hours. In addition to being paved
with impact-absorbing rubber, they are of a uniform length and will allow you to better gauge your
running progress. There will also be other people there, and you might meet a running partner or
pick up some good advise.
Piriformus Syndrome and Achy Breaky Butts
This is a rarer condition, and even a lot of active runners will never have a problem with it. Other people
confuse it for bursitis or sciatica. All three share common symptoms: A sharp throbbing pain in the
hip or buttocks, sometimes radiating down the leg and to the back. First, lets look at the other
two causes of achy butts.
Bursitis is an inflammation of the bursa. Bursae are tiny sacks that lubricate joints or areas of the body
where two tissue meet and move over each other. Bursitis is usually associated or confused with
arthritis because joints work the hardest, and need the most lubrication. Bursitis also affects the
tendons and ligaments in the body, but because they are soft tissues it's a bit rarer for them to be afflicted by bursitis.
Bursitis is rarely a problem for runners, and usually is the result of poor mechanics. You'll find that
most injuries are the result of overuse and abuse, and bursitis is no different. Take an anti-inflammatory,
rest well, and try to work on your form.
Sciatica is the inflammation or irritation of the sciatic nerve. The sciatic is a very large nerve
which travels from your lower back down the inside of your legs. Inflammation of the sciatic or any
other nerve is often caused by (believe it or not) medications which irritate the nervous system,
or drugs such as caffeine, ephedra, ma huang (an ephedra bearing herbal remedy), or any kind of
"stay awake" pill. You should already avoid these on principle. Unfortunately, inflamed nerves
tend to stay inflamed for a long time. The best remedy for sciatica is to drink plenty of water,
and make yourself comfortable. It can take several weeks or a few months for any drug to completely
leave your system, just as it took several weeks, months, or sometimes years for you to suffer
its effects. Other causes of sciatica include poor form, or a biomechanical problem like scoliosis
of the spine, fallen arches, osteoporosis resulting in a hunched back, or poor posture or gait.
Runners may get sciatica because they pronate (lean forward) when they run.
Another cause of sciatica is itself a cause of achy butts, and that is Piriformus syndrome. This
condition, like shin splints, often comes form a sudden rise in activity that causes a particular muscle
to become inflamed. It can also come from over-extending your stride, which places excessive
stress on the piriformus muscle. This muscle attaches to the top of your femur, and anchors it to the
inside of your hip. The piriformus is responsible for swinging your leg to the side and twisting it.
In most people, the piriformus rides over the sciatic nerve, and in a few cases the sciatic goes
through the branches of the piriformus. Because of this, sciatica can be caused by an inflamed piriformus,
or they can both coexist at the same time. If your achy butt is associated with lower back pain,
it's likely that you have a combination of these two. Luckily, recovery from this is quick, and
prevention is easy. Once again, poor form is a big cause, and poor stretching is an accomplice. To
overcome piriformus syndrome, stretch the muscles of your hip by sitting with your legs crossed and bent.
Your one ankle should be over the other knee. Then, grab your knee and pull it to your chest. You
will also want to strengthen this muscle to prevent reoccurrence of the pain in the future, and this
can be accomplished by good old fashioned sideways leg lifts.
This surprisingly common condition has one name, but many different causes. The symptoms always include a
pain in the knees. This is most common among older runners and over weight people. When you are running, a
lb of fat on your gut is the biomechanical equivalent of 3 lbs on your back. Unfortunately, waiting until
you lose weight puts the cart before the horse.
First, you need to know the cause of your 'runners knee'. The most common causes are chondromalacia and
osteochondritis. Chondromalacia is an insufficient amount of cartilage in the knee joint, and is
usually from the body not being able to replace cartilage as fast as you damage it. Diet is very
important here, and you should make sure you are getting enough protein. If you exercise regularly, or
you have runners knee and exercise irregularly, you should be getting .7 to 1.0 grams of protein
per pound of body weight a day. Since most people who are on a diet will be starved for protein,
or because most of us are on high carb diets, an alternative to eating right is to take joint supplements.
Most people see marked improvement in knee pain with a combination of MSM and glucosamine chondroitin.
These are available just about anywhere you can buy vitamins. You will need to take this combination for
a few weeks before you will notice the improvement, but unless you have a combination of dietary
or other factors (such as arthritis), you will usually be better in a few months, and
will not have to resume taking these supplements. Another cause of osteochondritis is mechanical and often
related to shoe wear. If the foot is out of whack, say from a heavily worn insole, it will also throw
the knees out of alignment. The kneecap or patella rides up and down over the knee joint in a channel.
A misaligned leg will tend to make the patella ride up out of the joint, or track to the side, and
the groove and patella will be worn unevenly and excessively.
MSM and glucosamine chondroitin also work for the next culprit, Osteochondritis. Osteochondritis is a
swelling of the cartilage and the bone tissue itself as a result of impact injuries. Initially,
you should treat osteochondritis as any other kind of injury. Ice it first for about ten minutes,
then keep it warm for the rest of the time. After a while, your body will usually adapt to your running
condition and you may only rarely need to take supplements or give treatment to your knees for this.
Finally, the runners knee that is actually 'runners knee' is caused by a muscle called the illio-tibial
band. This is that tight little muscle that runs down the outside of your leg from the hip bone to the knee itself,
and attaches at the base of the femur. Because part of the tendon that attaches this muscle rubs against
the femur, it will become inflamed during running. This manifests itself as a pain on the outside of the
knee. Runners knee is usually caused by poor stretching and over use. You should ice the knee for about 10
minutes, and then wrap the knee with a neoprene sleeve to keep it warm.
Torn Anterior Cruciate Ligament
You ever wonder why your knee won't bend backwards. Well given enough force, it will. But preventing
that from happening is the job of the Anterior Crucial Ligament (ACL). The ACL is a single ligament
that splits and crosses over itself. This ligament is very strong because of the fibrous nature of
ligaments, and can withstand several tons of reverse pressure. However, a twisting of the knee or
colliding with another runner while the ACL is extended can tear the ACL resulting in a painful and
unrecoverable injury. Many sports stars have their careers set back or ended altogether after
suffering a torn ACL. The good news for runners is that it is very rare, even for the most vigorous
athletes. Moreover, it is 100% preventable for a runner. Simply watch where you are going, never take
tight turns, and never lock your knee straight.
Good Running Shoes
The most important thing to a runner is their feet. Since it's usually not practical to run
barefoot, you must have good shoes for running. First, you have to realize that buying shoes
is not about what the cost is, what looks cool, or what special features are built into the
shoe. Shoes with air or gel in the sole are good for absorbing impact, and are a good idea for
training. However, for competition (marathons, track meets, etc), the energy they absorb also takes
energy away from your stride. You shoes should be snug, but not so tight that you can't feel your
toes. Select a shoe that is going to give you good support, and if you have fallen arches or
flat feet, you should consider getting an orthotic insert to align the bones of your foot. These
can range from $50 to $200 US, but are much cheaper than seeing a doctor about injuries caused by
alignment. Finally, the only time you should wear your running shoes is while you are running, except if
they are new shoes in which case you should wear them for about a week to break them in. If you try to go running
with new shoes, chances are good you'll develop a blister on your foot that will set you back
days in your training. Also, if you have narrow feet or tend to roll your foot, you should make
sure you get a shoe with wide soles for stability.
I cannot stress the importance of shoes enough. They aren't just for your feet, but for your
whole body. A shoe that is excessively worn or broken-in will cause your body to misalign, and
can lead to the aforementioned injures of the hip, ankle, knees, and will also place undue
stress on your back, arms, and neck.
Everything in your body is connected. Because of this, form is important. Bad form will slow you
down, hinder your performance, injure you, and damage your morale. Ironically, though anyone
with legs can run, most people don't do it right. The biggest mistake people make is to take
short choppy steps. If you can power walk as fast as you can jog, then you need to extend your stride.
Short choppy steps will cause knee problems, ankle problems, shin-splints, and generally won't
improve your running at all. If you absolutely cannot run any faster, than power walk. A
power walk is a much lower impact and more energy efficient stride than the short-step jog.
Your stride length is important. The goal is to get a fairly long stride, but you have to
work up to that in order to not injure your periformus or knees. As a start, you want to try
a stride that is at least 1/2 as long as you are tall. For instance, a man who is 72 inch
should have a 36" stride. This is actually about the same as your stride when you are power walking,
but the difference is in the mechanics of how you run compared to how you walk. Eventually,
you should work your way up to a stride that is almost as long as you are tall. Ironically,
you will use much less energy to run fast with longer stride then with short strides because
of the way the body is designed to recycle energy.
As important as your stride is, so is your posture. Many people who run tend to "pronate", or lean
forward. If ever there is a time to not slouch, it's when you are pounding along the pavement.
Pronaters will have back, neck, and most notably knee problems. When jogging or running,
your back should be straight up. When you are sprinting, you may pronate lightly, but not
excessively. In addition to throwing your body out of alignment, pronating also hampers your
breathing by limiting the amount of expansion the chest can comfortably do. People who
pronate also tend to look downward at the track, effectively restricting their airway and
hampering their breathing.
A big no-no some people do while running is moving their arms. When you are sprinting, you need
to pump your arms in order to maintain your balance. But when you are jogging or running,
pumping your arms only does one thing. It makes your arms tired. You want to try to hold your
arms down by your sides as if you were walking, and swing them just enough to maintain your
balance. This keeps your arms and shoulders from being tired, and doesn't take up oxygen that
your legs need.
General Tips for Any Exercise Routine
Speaking of oxygen, breathing is probably one of the biggest limiting factors. Stop smoking
whatever you smoke, and you'll pick up minutes on your run. The goal in breathing is
not to get as much air into your lungs as possible, but to need less air. Cardiopulmonary
efficiency is more important than being able to hyperventilate. Work on your breathing by
breathing through your nose as much as possible. When you can no longer do that, then
breathe in through your nose, and out through your mouth. The only time you should have
to breathe through your mouth only is when you are sprinting 440 and 660 meter dashes (roughly
1/4 or 3/8 of a mile respectively). The air you breathe before you start sprinting is the
air that fuels your sprint, so if you are running for time take deep breaths, but if you
are training for a run then you should focus on controlling your breathing. How you breath
is also important. Take deep breaths, and exhale quickly but gently. You should inhale over
four steps, and if you breathe in too fast than hold your breath until you have completed
those four steps. How fast you can get air in and out of your lungs is not nearly as
important as how long there is fresh air in your lungs that can be absorbed into the blood
stream. If you've ever felt pain your side, that pain is caused by trying to breathe too fast.
Of course, as with any exercise routine good nutrition is important. While I mentioned protein,
anyone who is serious about running will want to eat a well balanced diet that includes lots of
whole foods. At the same time, you'll feel better when you ignore junk foods like potato chips,
candies, French fries, and breads made from bleached white flours. You'll also want to avoid
caffeinated drinks packed with sugars like soda or coffee. Instead of sodas, drink water and lots of it.
When you're running - and you will enjoy it - you will sweat profusely and that water has to be
replenished in order for your body to function. Avoid drinking heavily, but don't turn your back
on alcohol altogether. Studies have show that light drinkers who enjoy a glass of wine or beer a
night have overall better heart health.
Earlier, I had addressed not using 'energy pills' on principle. To anyone aware of the danger
of using steroids, that principle also applies to pills which artificially modulate the bodies
natural energy state. With exercise, your body will naturally elevate its natural energy state.
You will have more endurance and more motivation, but for beginners it is tempting to
get a little edge by taking 'herbal diet pills'. The primary component in many of this pills is
chemically similar to methamphetamine - a dangerous drug. Merely using these drugs - much less
abusing them - can cause heart damage in addition to irritating the nervous system. This same
rule applies to so-called 'energy drinks', which may give you a little pick up, but will never
sustain you for long.
One exception to the 'energy drink' rule are legitimate sports drinks
like Gatorade and Powerade. These drinks replenish needed electrolytes and help keep the body
going during longer periods of exercise. Failing to replenish these vital chemicals will
lead to a condition known as hypnotremia which, while annoyingly painful is rarely life threatening.
Symptoms of hypnotremia are similar to heat stroke. If you don't like sports drinks, or they
upset your stomach, you can simply add 3 grams of normal table salt to every liter of water. One
thing to keep in mind is that hypnotremia is an extreme condition, and unless you commonly compete in
Ironman or Eco-Challenge like competitions, you won't likely have to deal with it. Just stay
Proper form, concentration, stretching, and warm-up/warm-down periods are the best way to
prevent injuries, and will allow you to enjoy the health benefits of running.