Injuries are more likely to occur during periods of increasing running mileage than they are during periods of steady mileage. Also, one of the major health consequences of excessive sitting is muscle imbalances. Over time, spending hours of every day curled up in a seated position causes some muscles to become abnormally tight and weak and others to become just plain weak. Such imbalances are known to result in pain and dysfunction in the low back and other areas, reduced performance in sports and exercise activities, including running, and sports injuries, including runner’s knee.

Common running injuries include:

Shin splints – Pain along the shin bone (or tibialis muscle), running along the front of the leg from knee to ankle. Caused by heel-striking/overstriking/poor strength and stability are all big culprits in shin splints. In concert with this or separately, too much ground contact time/low cadence. Sometimes feels better after warm up. May be swelling and tenderness. Try arch supports or shock-absorbing inner soles. Get a diagnosis in case it’s something more serious (stress fracture). Apply ice and elevate to reduce swelling, stretch lower leg muscles. Lay off running for a few days. Change up the surface you run on. Wear compression socks. Change shoes, gait retraining.

Runner’s knee: Pain around the knee, (inside of the knee, the top of the kneecap or below the kneecap), is typically caused by quad tightness, causing the knee to track poorly and resulting in irritation around it. The pain is present during running and when descending stairs or when rising from a chair after prolonged sitting. An ache in the front of the knee and around your kneecap in the morning can be a sign of runner’s knee, or patellofemoral pain syndrome (PFPS). Hip weakness is common in individuals with PFPS. Strengthening of the hip abductors and rotators, may be a good addition to your cross training program. If your quads are weak or you have poor foot mechanics, your kneecap will move left and right, creating pressure, friction, and irritation. As you clock up the miles and stride out your misaligned steps, your kneecap rubs against the end of your thighbones. This wobbling and rubbing grinds down the cartilage underneath your kneecap so that it becomes rough, like sandpaper. This makes your knee unable to bend smoothly and efficiently. The pinch will be worse when running down a hill, walking down stairs, squatting down, or sitting with a bent knee. It happens when the kneecap gets misaligned and no longer sits in the trochlear groove — the notch at the end of the femur bone. This type of injury can result from overuse of the knee or under-conditioning of the hip and inner quadricep muscles. While PFPS is quite common in runners, it can also occur from many other sports and activities. Strengthen hip abductors, quadriceps, and deep abdominals, stretch glutes, calves, quads and hamstrings. Icing your knee before bed can reduce swelling and minimize overnight symptoms. You can treat persistent discomfort with the standard RICE method (rest, ice, compression and elevation), by staying off the affected leg, applying ice at 20-minute intervals, wrapping it lightly with a bandage and elevating your knee above your heart whenever possible or try massaging the quad. In the long term, physical therapy can correct any hip weakness or quadricep imbalance to help with recovery and prevent future injury. Stretch glutes, calves, quads and hamstrings. Wear, and be properly fitted for, running shoes. Could take anti-inflammatories. Sum up of causes: weak quadriceps, overuse or an increase in mileage, knock knees, tight hamstrings or calves, previous injury, overpronation or supination, running on uneven surfaces. Apply ice immediately after running, could take anti-inflammatories, may need physio and/or gait retraining.

Achilles tendonitis: You’ll feel pain and stiffness in the Achilles, the tendon on the back of the heel that attaches to the heel bone, or in the soleus muscle, which runs along the back of the lower leg. Sometimes you’ll feel it in one or the other, other times the pain will be in both areas. Causes include excessive ground contact time from slow cadence; ground contact time allows the leg to wobble and overload the Achilles and/or soleus or an increase in hill running. Rest until pain free. Massage the area to gauge the level of soreness and feel how it is healing.  As soon as pain flares up, elevate and apply ice. Probably arisen from overuse, improper running style, poor footwear, over-tight muscles or just a slip of the ankle. If the area is sore after a few days’ rest, then see a doctor. Running on softer surfaces can relieve pain, but avoid overly soft surfaces like sand. Add eccentric strengthening exercises for calf muscle, deep tissue massage.

Blisters: wear running-specific moisture-wicking socks and good shoes. You may even have to go up a shoe size.

Plantar fasciitis: Pain in the bottom of the heel that’s worse in the mornings and after walking and running. The plantar fascia is the thick band of tissue that runs across the bottom of your foot, connecting your heel to your toes. Plantar fasciitis usually originates from a tight calf, which reduces range of motion in your lower leg. With no ability to flex, your leg pulls harder and harder on the plantar tissue. Contributing factors are anything that overloads your calves, like hill running, overstraining, poor hip flexor mobility or poor body weight shift from slow cadence. Can be from wearing incorrect shoes without enough arch support. Any drastic change to footwear can cause your calves to tighten protectively. That’s why many runners who adopt barefoot-style shoes pay the price if they don’t decrease their miles and transition gradually. Taking time off from running will typically ease the pain, but not the problem.The more you run during this treatment, the slower you’ll make the process by tightening your calf, so it’s best to reduce your miles and avoid hills. Massage the calves. Stretch the leg and foot, roll a ball under your foot. Stop running until injury heals, wear night splint, change shoes, gait retraining.

Iliotibial band syndrome, or IT band syndrome: pain on the outside of your leg most common by the knee but could be anywhere up to the hip. The ITB is a band of thick fibres that run from your hip to the outside of your knee. Friction of the band against your knee can cause irritation and pain on the outside of the knee. Where you feel it is typically not the source of the problem. Pain presents in the knee, but is caused by weaknesses higher up the chain in your hips and glutes. Heel-striking and overstriding are the main culprits. When we heel-strike, we’re not able to utilize our feet as the first stabilizer. That sets off a stabilizer. That sets off a reaction up the stability chain to your ITB, quads and hip flexors. Hip flexors get tight from being overworked from poor glute stability. This tightness pulls on the leg, causing tightness to the quad and ITB area. Shoes with high stack height and mushy cushioning contribute by causing poor stability and weakening your feet. Massage the quad to help break up adhesion and tender spots. Heel-striking is a primary form issue that can cause ITB pain, so form work is key. Stabilize your hips by training your core and butt. Gently stretch the area that runs from your hip to just below your knee. It is similar in origin to runner’s knee. While this pain is more common ‌during‌ activity, it can also manifest as aching overnight. The IT band is a thick, fibrous band of tissue that starts in the front of the hip, runs along the side of the thigh and anchors on the outside of the tibia (shin bone) below the knee. If you have weak hip muscles, the IT band will overcompensate to try to stabilize the leg. As it does so, it can create friction over the front of the knee, which manifests as a sharp, stabbing pain. Treat with ice at the site of pain, stretch the IT band and physical therapy can help to correct the hip weakness. Strengthen hip abductors, gently stretch the area that runs from your hip to just below your knee, deep tissue massage.

Stress fractures: Stress fractures can occur in the lower leg (tibia) and foot (metatarsals) and are usually related to overtraining. Stress fractures will present as focal points of pain, usually on the front of your shin bone (tibia) or on the top of your foot (metatarsal). The pain will likely increase over a period of a few weeks and become severe and sharp, especially during running or walking. Stress fractures require rest and usually a walking boot or crutches to take pressure off the limb. Always see a doctor. Stress fractures: pain in the lower leg, foot, shin or groin that doesn’t decrease. Always see a doctor.

Arthritis: It’s fairly normal to wake up with creaky joints, especially as we age. If your discomfort eases as you go about your morning routine, there’s no cause for further investigation. But, if your morning knee pain aches around the kneecap, along the joint line in the middle of the knee and on either side of the knee, it could be caused by osteoarthritis. This pain is classically worse in the morning upon waking and improves over the course of the day as the joint “loosens up.” Knee osteoarthritis can be diagnosed with an X-ray. While there is no “cure” for degenerative changes in the knee, there are several treatments that can help minimize symptoms including anti-inflammatory medication, steroid injections, hyaluronic acid injections, platelet-rich plasma injections and knee replacement surgery. Lifestyle changes can help ease morning knee pain and keep you more comfortable throughout the day as well. In the morning; circle your ankles; extend your legs in bed; bend at the knee and hip before getting out of bed; follow up with a hot shower to ease your muscles; and, add in periods of gentle activity throughout the day. Hip osteoarthritis can masquerade as knee pain. If you are an older adult with normal knee X-rays, talk to your doctor about getting a hip X-ray as well.

Prevent common injuries: warm up and cool down paying attention to hips, calves, quads and hamstrings. Cross train to strengthen muscles and give the body a rest from the running motion. Work on core muscles and put in lots of squats and lunges, calf raises, heel dips and leg extensions.

Post-injury running: returning is slow and steady. When injured continue with other low-impact activities. Return to running after you can walk for 30 minutes pain-free then start to incorporate a few short, easy runs on softer ground.

Some of this applies more so to trail running

Downhill running requires high skill, particularly eye-foot coordination and relies on eccentric muscle activation (activation of the muscle while lengthening).

Downhill running is also the sport that causes the most muscular damage and generally wrecks legs. As you run downhill, your quads simultaneously activate and lengthen to absorb the forces of running downhill. The more skillfully you can run downhill, the less wear and tear on your legs.

Legs can get cooked fast from the braking action. You’re sort of “getting your legs out of the way” and maintaining control while gravity does the work. Lean into the downhill, be mindful you’re not braking or leaning backwards. Make sure your downhill stride length allows a mid-foot strike – leaning back and heel striking puts the brakes on.

Think of “hot coals” in your approach to running downhill. Short (ridiculously) quick steps.

Allow the legs to turnover quickly, go with the flow down the hill.

Don’t push the pace.

Let gravity help but resist temptation to “let the wheels go”.

Rather than arms next to your body, extend your elbows out a few inches, “extend your wings”.

When it’s really steep, move in a zig zag pattern and allow the arms to cross over the body.

Utilize strength training exercises like squats, deadlifts, lunges to help your downhill running.

You will need at least 2-3 days of easy running after a hard downhill effort.

Mistakes made when running downhill:

Over striding: This occurs when your foot lands too far in front of your body. This risk here is that over striding essentially causes you to hit the brakes, which stresses your joints and can quickly lead to shin splints or other injuries. To avoid this, try to maintain a slightly shorter stride length and focus on landing directly beneath your hips.

Fighting gravity: Naturally, running downhill leads to acceleration. But often runners fight gravity or overdo it on the brakes. This also causes quadriceps stress, which can lead to muscle fatigue or even a strain. Focus on staying mentally relaxed and engaging your glutes and hamstrings to help maintain control; this will allow you to gracefully embrace the pull of gravity down the hill. Think about controlled falling so that your feet land softly just under your hips and you naturally accelerate as you settle into the rhythm of your downhill.

Having a poor posture: Efficient running form is where everything comes together, and running downhill is no different. If one element is off, your form can quickly spiral downhill. As much as people hunch over on the uphill, you’ll also see runners leaning too far back on the downhill, which can throw off their balance and alignment and lead to over striding and excessive lower-body impact. Try to maintain good posture with an upright position or a slight lean forward.

Long runs help boost your endurance and get you used to spending time on your feet. It is the single most important workout you can do. They strengthen your heart, your leg muscles and ligaments, they help burn fat as fuel, they boost confidence, and they can make you a lot faster. But don’t run them too fast, that can lead to injury, overtraining or illness. Long runs are for endurance, they reduce your resting heart rate, making your heart more efficient. The intensity of effort is low, and you should ensure a steady state is maintained. You should be able to conduct a conversation while you’re running. You may even walk at points. Don’t run long more than once a week. It is, after all, a hard session, requiring rest or easy days before and after. Long runs are traditionally done on Saturday or Sunday because that’s when most people have the most time. Also, long distance races are on weekends. Long runs go faster with friends!

Fueling for long runs is essential if you want to avoid hitting the dreaded wall. It’s important to not begin your long run on empty, don’t skip breakfast if you’re heading out in the morning, even if you consume something simple like a banana or some applesauce. And make sure you’re hydrating well enough to support the digestion process. Keep fuelling on runs longer than one hour. To maintain your energy levels past an hour eat 30 to 60 grams of carbohydrates every hour after the first hour of a session (and upping your intake to 60 to 90 grams for runs that last longer than 2.5 hours). Your body is better equipped to handle simple carbs, as opposed to foods with more fibre and protein that take longer to break down. Nutrition is highly individualized, what works for the Boston Marathon veteran at the front of the group might not work for a runner who prefers a relaxed pace. You’ll want to do some experimentation to see what works for you, especially to avoid any complications on race day. After you finish your run, get some carbs and protein into your system within 30 minutes to jumpstart the recovery process, like a protein bar or recovery shake until you can have a proper full meal.

Avoid: caffeine, high fibre cereal with berries, sorbitol, spicy foods, dairy products, beans, lentils and legumes. Sorbitol is a sugar alcohol commonly used in products like gum or beverages to replace actual sugar and reduce calories.

The warm up is a crucial activity to prep your muscles for the demanding run/workout ahead. By increasing your core body temperature, a warmup speeds up the supply of oxygen to your hardworking muscles, promoting optimal performance. Additionally, this procedure boosts blood flow to the working muscles, priming them for the effort and effectively reducing the risk of injury.

The Science Behind Warm-Ups

Increased body temperature

By completing an active warm up before you begin the important part of your running (the race or workout itself), your body raises the temperature in your muscles, thus causing your body temperature to rise.

This in turn speeds up your metabolic processes (which is especially important if you are trying to lose weight) and your energy supply.

Enhanced muscle performance

The increased muscle temperature lowers muscular resistance (viscosity). This allows your muscles to contract faster and stronger, which is important if you want to race well!

Increased cardio performance

Warming up also leads to increased cardiac output and a higher respiratory minute volume, which are needed for higher oxygen uptake.

Better joint load distribution

Another positive factor is that even short-term loads cause the cartilage layer in your joints to thicken, thereby widening the bearing surface and thus achieving a better distribution of loads.

Injury prevention

A number of research studies have shown that a proper warm-up can reduce the risk of injury.

Particularly in the case of fast and explosive muscular contractions and movements that require good flexibility like hill sprints or finishing a race with a kick.

Warmed-up body tissue has been shown to be more resilient. Warming up can also help prevent injuries by improving your attention and increasing your ability to react.

*Last tip: If you’re warming up before a race by running, run enough before the race to hit your race pace off the start line.

Six ingredients for success; as much as possible, the goals you set for yourself should be: 1. Specific 2. Realistic 3. Measurable 4. Positive 5. Believable 6. Fun

Be sure your goals are stated in positive terms and are believable. For example, “I will maintain composure” as opposed to “I won’t lose my temper”.

You need to believe your goals are achievable and you have what it takes to realize them. Knowing that with the right amount of effort and precision, you can achieve your goal will keep your motivation high.

Keep a journal/log identifying your progress, or lack thereof. Visualize your success, see it, feel it and trust it, over and over again. Sometimes a journal alone wouldn’t cut it. What can keep you accountable and motivated is shouting out your plans for the world to hear. Maybe share goal with your running group. They can be enthusiastic and supportive in seeing you through to the finish line. They may sure you hit your training distance, ask about your progress or send you supportive messages. There’s no better way to stick to goals than letting everyone know about them, and no goal is too small.

But we must also pull out the mental weeds by the roots when doubt, fears and worries first get a foothold. These are self-limiting beliefs and a life-long journey, because after removing one weed, you will find another.

Unlike some activities, such as golf, we were born to run. And given time and practice, good form should follow. There is no need to change anything and changing could cost you efficiency. If you’re not plagued with injuries (in which case a gait analysis would be a good idea) then there’s no need to change anything. A specific change in technique doesn’t necessarily translate into better performance. Be pragmatic; any interference could worsen it. It’s important not to overload your mind with all sorts of instructions. If you’re running injury-free, don’t change. But…

• Run tall, relax your upper body, bounce less, swing your arms symmetrically, reduce torso rotation.

• Posture: Lower back not arched, head directly over your shoulders. Practice good posture throughout the whole day.

• Look ahead and scan the horizon to prevent slouching and keep an eye on the road ahead (unless you’re running on an uneven surface).

• Lean forward about five degrees to maintain momentum. (To get the feel of five degrees, stand still on both feet, then shift your weight toward the balls of your feet without lifting your heels).

• Relax your arms and bend them about 90 degrees, letting them swing front to back (not across your midline) between waist and lower-chest level. Cup your hands loosely.

• Take quick, short steps instead of longer strides, which can hurt your lower back and tire you out. Land lightly between your heel and mid-foot, and let your foot roll smoothly forward. Push off with your toes. There is a hazard with the impact in over striding.

• Tapping your bum every now and then while you run is a simple way to remind your body to contract and engage your glue muscles as you run.

Just before your foot strikes the ground, your brain sends a signal to your muscles to prepare for impact. The muscles contract so that they can stabilize your joints. If this line of communication is any way weak or slow, the muscles won’t get this heads-up. As you push off from the ground to propel yourself forward, your hip goes into maximal extension. A major issue to consider during this phase of the running action is that if your hip flexors are too tight, you are more likely to excessively arch your back.

Aim for a comfortable and efficient stride length, avoiding over striding or taking excessively long steps–this can lead to tension and soreness in your legs and lower back. Pay attention to your foot strike, and while this subject seems to be forever in debate, a general consensus is that staying light on your feet with a quick turnover is helpful for most of us. Avoid leaning too far forward or backward.

The head and shoulders tell the body what “mood” to be in. Tension often originates in the head, face, and shoulders. Whenever athletes get tense, the first place it’s evident is in the neck and shoulders. Just about anything you can do to relax when running is beneficial, because relaxation equals energy conservation. To relax from the top down, start with your mouth, jaw, neck, and shoulders. Many athletes, particularly novices, suffer from cramping and pain in the shoulders – that’s nothing more than tension. Drop your arms; don’t hunch your shoulders. Just let your arms hang loosely, and the pain usually goes away. The best time to practice this conscious “top-down” relaxation is during speed sessions, when you are most likely to tense up.

Keep your shoulders relaxed and down: tension in your shoulders can lead to neck and upper back discomfort. Keep your hands in a very loose fist (imagine you are holding a delicate potato chip in each hand) and let your arms swing easily and naturally. Once in a while, shake out your arms and shoulders during your run, releasing any tension that has built up and giving yourself a quick reset.

The arms are the “jockey” to the body and the legs, are the “horse”. In long distance running, the arms play a far less important role than in sprints, where arm movement provides a counterbalance to the torque and forces being applied. This is also the role of the arms during distance running, but it’s far less critical. The arms follow the pattern dictated by the legs. Perhaps the two biggest factors to think of here are fatigue and tension. Tension is a more immediately rectifiable problem. If the arms become tense, that tension once again filters to the rest of the body. The hands in particular are important – clenched fists and tight, rigid wrists are signs of tension, so try to consciously relax these areas. Remembering also that tension in the arms is often the result of tension in the shoulders, neck, and face, as explained. Excessive arm movement is discouraged, because it increases the energy cost of running.  Arm swing affects trunk stability. An across-the-body arm swing tends to rotate the shoulders, or cause the trunk to sway, compromising core stability. Arms swing in a relaxed manner. Keep your elbows close to your body with your hands loose, which helps the entire body relax.

Notice the rhythm of your breath, and try to keep a steady, relaxed pattern. Taking deep breaths through your nose can help calm your entire body and reduce tension. Notice if you’re breathing erratically or shallowly and try practising diaphragmatic breathing (or “belly breathing”) to release tension that may be accumulating. Start by inhaling deeply through your nose, expanding your diaphragm, and exhaling fully through your mouth or nose. If this is challenging, try practising for a few moments before or after your run.

Every runner’s stride improves automatically in subtle ways as he or she becomes fitter. In fact, such improvement is a big part of what getting fitter really is. There certainly is not only one correct way to run. Be patient, and seek to constantly improve but never radically redefine your running. And remember to relax!