Summer is in full swing, and many running enthusiasts who have been in hibernation over the long winter have started jogging/running outside again. Both running and jogging are excellent forms of aerobic exercise and may benefit a person by improving their cardiovascular fitness, strengthening their bones, strengthening their muscles, and burning calories to maintain a healthy weight.
With such great potential benefits also come potential risks for injuries. It has been shown that 30-79 percent of runners sustain running-related injuries. Injuries are more common in recreational/seasonal runners and typically involve the thigh, knee, calf or ankle.Although some injuries are traumatic, most are due to overuse, improper training, and various recurring factors.This is actually good news because with proper training modifications, proper guidelines and better training habits, a jogger can in fact prevent or limit overuse injuries. Many research studies consider three main factors as predominantly contributory to common running injuries.These three factors are training errors, improper running footwear and various anatomical differences.
Typically a novice runner should begin with jog/walk intervals, starting with a 4:1 walk to run ratio, and slowly building up to a 2:1 jog to walk ratio. During all phases of training it is important to listen to your body and stay hydrated and well nourished. When an individual can comfortably jog for 20-30 minutes, three to four times per week, and wants to increase mileage, then a 10 percent total increase of previous week’s mileage should be used for safe progression. Novice runners should rest more frequently (every other day), while more experienced runners should still consider taking one to two days off per week to prevent injury and allow their bodies to recover. Rapid increase in mileage, rapid increase in speed, interval training (hills etc.), and inadequate recovery time have all been proven to increase risk for running in- juries. The surface that you run on can play a role but not as great as we once thought. Common recommendation is to avoid running on concrete, however recent studies suggest that surface does not seem to make as much of a difference as intensity, frequency and duration of training. It is true that concrete is the hardest surface to run on, and grass is least impactful on your joints. New recommendations from University of Michigan simply suggest that runners should run on various surfaces, and pay greater attention to training.
In 2009, a research article in Sports Health journal concluded that weakness of hip stabilizing musculature leads to atypical hip, knee and ankle mechanics, which increases forces in the leg during running/jogging. For instance, a person who is knock-kneed is likely to have a greater inward torque on the knee, and may have a more pronounced flat foot. Abnormal mechanics over greater distances, especially with high impact sports, result in greater risk for injury.
Fortunately, those mechanics and strength/stabilization deficits are correctible to some extent, and can significantly decrease a runner’s risk for injury. As a physical therapist I always observe anatomical variations in people. I closely assess the kinematics during walking and running to determine appropriate course of action, in order to limit abnormal stresses on the joints and muscles.At times a recommendation may be as simple as proper footwear or foot/ankle support. Yes, a proper individualized shoe may help prevent injury by providing better alignment for your foot, and therefore decreasing excessive torque on the ankle, knee and hip. Other times treatment may consist of multiple components such as adjusting stride length, improving core, hip and knee strength, and most importantly helping runners understand how their mechanics make them more susceptible to injury.
A small injury may lead to a much greater one if not addressed quickly. I strongly recommend that all runners, but especially those who are just starting to run, and ones who sustained previous injuries, see a trained specialist, someone who can analyze their mechanics, and make proper recommendations for injury prevention. A skilled physical therapist should be considered a great resource. Remember, in New Jersey you can be evaluated and treated by a physical therapist without a referral from your doctor.
Dr. Moczerniuk is a doctor of physical therapy, member of American Physical Therapy Association, and a clinical director at db Orthopedic Physical Therapy of Manalapan LLC, located at 120 Craig Road, Suite 2. Dr. Moczerniuk can be reached at 732-462-2162 or via email at [email protected] www.dborthopt.com.