Below is a guide to a safe return to running in order to prevent running related injuries. We’re seeing an increase in people running now that gyms are closed, however a sudden change in exercise could lead to injuries if you’re not well prepared.

1. Gradually increase you running distance and intensity:

Once you start to get the feel for running and begin experiencing some of the physical and mental benefits, you may surprise yourself with your running ability. You may feel like you’re capable of running longer distances or increasing your pace. However, going too hard too soon is not the answer. Whether you’re a recreational runner or professional athlete, the human body does not cope well with sudden increases in training load or intensity. Studies have shown that runners that increase their amount of training kilometres and pace per week are more likely to experience overuse injuries (Hein et al, 2007). 

Planning your week: 

• The safest way to plan your running week is to plan runs on non-consecutive days. 
• Mix your week with strengthening exercises. Try aiming for 2 strength sessions a week on a day separate to your run. If you need to blend the two sessions (run and strengthening) go for a run in the morning and a strength session in the afternoon. 

Key points when just getting started: 

• Start at a nice easy pace, where you can comfortably talk. 
• Initially ensure you run on fairly flat terrain as hills significantly increase the challenge/load.  
• Aim for an amount of time to run rather than distance. 
• Initially try running 1-2 minutes on and 1 minute off and repeat this 5 times. 

Don’t increase everything at once i.e:

1. How fast you’re running
2. How far/long (distance/time) 
3. Amount of hills 

Further into increasing your running: 

• Ask yourself – How did you pull up 24 hours after your run? If you experience muscle soreness the next day it means your body isn’t accustomed to this amount of load yet. Therefore, it is advisable not to increase load further that week.  
• Gradually progress the training distance/pace by no more than 10% a week. 
• Programming: Step up, step back. When you’re increasing the time/distance, do this for 2-3 weeks then for a week reduce off again to recover and repeat. 

On the whole – consistency is key! Having large gaps between running days (eg 1 week or more) also means you’re more at risk of injury. 

2. Participate in conditioning exercises 2-3 times a week

Exercise involving repetitive movements such as running, can put lots of stress on the body. Weakness or inefficient function of core and stabilising muscles can lead to less efficient movements, compensatory movement patterns, strains and overuse injuries. Studies show that conditioning exercises to maintain muscle length, activation patterns, strength and stability should be incorporated to prevent running injuries (Fredericson & Moore, 2005).

A balanced relationship between adequate muscle length, strength and function is needed to maintain good alignment of the legs whilst running. This will reduce excessive forces placed on particular joints such as the hips and knees. Your core muscles and glutes act to stabilise your pelvis as you run. If these muscles are not functioning effectively (especially as you increase your running distance or speed) your body may compensate by overusing other muscles around the hips/knees. 

If you’re not someone that enjoys strength training, don’t worry. You only need a few basic exercises (which can be without any equipment). 

Key conditioning tips:

• Initially, strengthening should target your glutes, core, quads and calves. Muscles only get stronger when exercises are progressed over time. It physiologically takes 6-8 weeks to strengthen a muscle, so there is no quick fix to improving your muscle strength. 
• Targeted strengthening ensuring correct technique during exercises will be best at preventing injury. Our physiotherapists at Port Melbourne Physiotherapy & Pilates are always happy to assess you and come up with more specific conditioning exercises to help you avoid running injuries.   

A tight muscle is usually tight due to weakness or overload. This can be a key sign of increasing the running km’s/time too quickly and the muscles are not able to tolerate that amount yet. 

Warm up well before your run by performing this 3 part warm up (Alexander, Barton and Willy, 2019):

1. Dynamic lower body movements that move your joints through the full range of movement (6-8)
2. Starting at a slow easy pace (walking or running) for around the first 5-10 minutes
3. Conclude the warm up by doing 3 x 100m strides  

Here are examples of dynamic movements (dynamic stretching): 

• High knees 
• Butt kicks 
• Walking lunges
• Leg swings side to side, front to back
• Walking out calves in downward dog position

After the run, continue for a slow walk (5 minutes) as a warm down. 

Static stretching (30 second hold or longer) was previously thought to reduce risk of injury, however there is no evidence to support this (Alexander, Barton and Willy, 2019). Doing static stretching prior to training has actually been found to impair performance. Static stretching can be done after your run with the aim to assist with relaxation. 

Stretching/mobility for problem areas can relieve the feeling of tightness and ease pain. This in combination with targeted strengthening is advised. 

Recommendations for maintaining good mobility include: 

1. Stretch your quadriceps, calves, hamstrings, glutes, adductors, hip flexors, quadratus lumborum (side of your lower back) and thoracic rotation
2. Spikey ball your tensor fascia lata (TFL) and glutes
3. Foam roll your iliotibial band (ITB) after running to prevent knee pain and vastus lateralis (outer quad muscle)  

Check out some of our other related blogs:

1. Delayed onset muscle soreness
2. Foam Roller
3. Common running injuries 

References:

1. Acaile, R., Tarantino, D. & Maffuli, N. (2018). Overuse injuries in sport- a comprehensive overview. Journal of Orthopaedic Surgery and Research, 309(13). https://doi.org/10.1186/s13018-018-1017-5
2. Alexander, J., Barton, C. and Willy, R., 2019. Infographic running myth: static stretching reduces injury risk in runners. British Journal of Sports Medicine, pp.bjsports-2019-101169.
3. Brauner, T., Sterzing, T., Gras, N., & Milani, T. (2009). Small changes in the varus alignment of running shoes allow gradual pronation control. Footwear Science, 1(2): 103-110, DOI: 10.1080/19424280903133920
4. Corporate Fitness Club (2016). Self-Myofascial Release (SMR)- Foam Rolling. Retrieved April 29th, 2020, from: http://www.corporatefitnessclub.com/cfc-blog/2016/10/3/self-myofascial-release-smr-foam-rolling 
5. Fredericson, M., & Moore, T. (2005). Muscular balance, core stability and injury prevention for middle- and long-distance runners. Physical Medicine and Rehabilitation Clinics of North America, 16(3): 669-680. http://doi.or/10.1016/j.pmr.2005.03.001 
6. Hein, T., Janssen, P., Wagner-Fritz, U. & Grau, S. (2012). Do lower extremity kinematics and training variales affet the development of overuse injuries in runners? – prospective study. Journal of Foot and Ankle research, 46 (5). https://doi.org/10.1186/1757-1146-5-S1-O46
7.  Hreljac, A. (2005). Etiology, Prevention, and Early Intervention of Overuse Injuries in Runners: a Biomechanical Perpective. Physical Medicine and Rehabilitation Clinics of North Amercia. 16(3) 651-657. https://doi.org/10.1016/j.pmr.2005.02.002
8. Meglio TV (2016). TFL Exercise Massage Ball. Retrieved April 29th, 2020 from: https://www.youtube.com/watch?v=gWVGsnCuQ8E