Injuries in runners. What are the most common injuries in runners and how to prevent them?
Published: 24 June, 2023 - Updated: 26 October, 2023 | 8'
As we have read in the article on sports injuries, why we get injured and which ones are the most frequent, injuries are one of the main limitations in sports practice. That’s why, whether you haven’t started running yet and are thinking about it, or if you are already a beginner, intermediate or advanced runner, it is important to be informed in order to reduce the risk of getting injured as much as possible.
What should we know before starting to run?
Firstly, if you are considering starting to run, the best recommendation to avoid injuries is to start gradually. As explained by Crys Dyaz, personal trainer and physiotherapist, “for example, start with twenty or thirty minutes a day, alternating between walking and jogging periods, always avoiding the feeling of “getting out of breath”. Little by little, the jogging time will increase and the walking time will decrease. The keys are progression (going from less to more) and continuity (consistency).”
Continuity is an important factor, as if we are not consistent, we lose the progress achieved. There are data indicating that in just 3 weeks of physical inactivity, a 40% loss of the achieved state is estimated.4,11
Energy intake in runners
“In addition to training, you must consider nutrition,” explains Crys Dyaz, who is also a personal trainer and physiotherapist, as well as a nutrition specialist.
The energy intake should cover the caloric expenditure, which varies according to the intensity of the activity, training level, body composition, sex and age, exercise duration and ambient temperature. “It is recommended to consume some food two hours before exercise (commonly known as pre-workout) that should preferably be high in carbohydrates, and at the end of the exercise (commonly known as post-workout), the food should be high in protein, completing a total of 4-5 meals a day,” adds Doctor Yaiza Acosta, sports doctor and specialist in nutrition and applied dietetics.
“Remember that energy needs and certain nutrients increase with physical activity, so it is important to follow a varied and balanced diet. If you have a specific diet (vegan, ketogenic, among others), then it would be advisable to seek guidance,” concludes the doctor.
Hydration in runners
Another fundamental factor for starting in the world of running is the importance of being well hydrated before, during and after training. “A general recommendation would be to drink between 400 and 600 ml of water or a sports drink 1 or 2 hours before exercise,” indicates Dr. Acosta. Likewise, after finishing the workout, replacing the water and electrolytes lost through sweating is essential.
What basic tips or advice would you give to prevent the most common sports injuries?
Both specialists agree on the following tips that you can consider when practicing sports in a healthy way:
- Undergo a medical check-up before engaging in sports.
- Take into account physical condition and age when choosing the type of physical activity.
- Learn about sports technique.
- Do not exceed the maximum capacity for effort, especially during growth.
- Use the appropriate sports equipment and clothing.
- Choose the appropriate location.
- Perform a warm-up and stretching exercises before physical activity, working the muscles from the more general to the more specific ones. Going from rest to intense physical activity without warming up can cause injuries.
- Don’t abruptly stop the physical activity, for example, by performing 15 minutes of light activity before finishing.
- Stretch again after physical activity to normalize muscle tone.
- Once injured, wait for recovery before resuming physical activity.
- Maintain healthy lifestyle habits and a varied and balanced diet. Drinking water and providing the necessary nutrients to replenish fluids and calories lost during training is essential.
Does running technique and foot strike type affect injuries?
Each runner’s technique during the race will be influenced, among other factors, by the foot strike of the athlete when walking and/or running, differentiating between pronators and supinators.
“Knowing beforehand whether your foot is pronated or supinated can prevent injuries related to foot strike,” says Dr. Acosta. Simply “by paying attention to the wear of the sole of the shoes, we can guess what our foot strike is like,” adds Crys Dyaz.
Both specialists also agree on the importance of avoiding inappropriate footwear.
Who gets injured more, pronators or supinators?
A pronated foot is one that involuntarily moves, causing the sole of the foot to turn outward to stabilize itself when walking. That is, “pronators are those who land with the inner side of the sole of their foot,” clarifies Dr. Acosta.
A supinated foot performs the opposite movement, deviating the foot inward and tensing the external ligaments of the ankle. That is, “supinators tend to support the outer side of the foot,” again clarifies Acosta.
The most common foot strike is pronation, while “the “supination” foot strike, by tensing the ligaments to a greater extent, can experience a greater number of injuries, both ligamentous and/or tendinous, as well as at the joint level,” affirms the specialist.
What are the consequences of running with poor technique?
In general terms, there are three repercussions derived from inadequate running technique:
- Physical repercussions. These are one of the most frequent consequences, due to injuries from falls, blows or overloads, overtraining, cardiorespiratory problems and even sudden death.
- Psychoemotional repercussions (apathy, lack of motivation, irritability or sleep disturbances). These can arise from overtraining or sports competition, which in some cases leads to excessive self-demand.
- Psychosocial repercussions. Social relationships with family and friends can be affected by the demands of performance.
What are the most common injuries for runners?
The most prevalent injury among runners is runner’s knee or iliotibial band syndrome. In second place, tendonitis and muscle injuries are the most frequent injuries; followed by ligamentous injuries, and finally bone injuries.
How do I know if I have runner’s knee?
Runner’s knee is a non-specific term for a common knee injury in runners. This condition is also known as iliotibial band syndrome, “since the tendon known as the “iliotibial band,” which extends from the hip down the outside of the thigh to the knee, rubs against the outside of the knee joint, causing localized pain on the outer side of the knee,” explains the doctor.
Typically, a runner without recent history begins to gradually develop pain or discomfort around the kneecap, in the outer compartment of the knee. A typical symptom is that running uphill (especially downhill), climbing or descending stairs exacerbates the pain, and it will continue to increase progressively if the athlete continues training despite the discomfort.
It is described as a progressive and sharp pain that disappears when running is stopped and reappears upon resumption, requiring rest and physiotherapeutic treatment to achieve recovery.
Most common muscle injuries in runners
Muscle injuries can be classified, from least to most severe, as: strains (incapacitate physical exercise), muscle cramps (a “knot” is felt in the area of the injury and can become chronic), and muscle tears (the pain is acute, intense, localized, and incapacitating).
- Hamstring muscle injury. It has a high incidence and recurrence. Most relapses occur in the first two months of returning to competition.
- Calf strain. One of the causes is not warming up before exercise, improper technique in exercise, or exercise that requires changes in direction, accelerations, or decelerations.
- Strain of the adductor muscles. This is the involvement of the adductor, major, long, and/or short muscles that limits hip adduction movements.
Most common ligament injuries in runners
- Tendonitis and ligamentous injuries. Tendonitis is an injury that can occur suddenly during sports, but mostly derives from the execution of repetitive movements over time, such as in long-distance running or overtraining.
- Achilles tendonitis. Inflammation of the Achilles tendon is prevalent in long-distance runners. There are external factors that can affect its appearance, such as the terrain on which one steps, the weather, or worn-out sports shoes. Since this condition improves during physical activity, its diagnosis is usually delayed.
- Sprains. This is an injury to the ligaments surrounding the joint and, depending on its severity, it is classified as grade I, II, or III if there is a complete ligament rupture with bone involvement. Ankle and knee sprains are the most common in runners. The former may be related to the unevenness of the surface on which one steps, and the latter to the performance of sharp turns during physical activity.
- Rotator cuff. These are minor injuries that affect the shoulder joint. The correct position of the shoulders, usually higher than normal during running, causes overload on the upper trapezius fibers, leading to this tendonitis. Strengthening the back muscles will improve posture and absorb impact on the shoulders when running.
- Plantar fasciitis. It affects approximately 10% of runners and is characterized by pain in the lower region of the heel, on the sole of the foot. Among the most common causes are poor technique, degenerative causes, or the use of hard surfaces.
Most frequent bone injuries in runners
Finally, the most recurrent bone injuries among runners are:
- Tibial periostitis. Inflammation of the periosteum of the bone causes pain at the level of the tibia.
- Stress fractures.
How to prevent running pains?
If you feel pain during a run, it is possible that you already have an injury. It is advisable to stop running and see a physiotherapist or your medical professional.
If it is an injury, it is advisable to wait for the appropriate period for recovery before resuming physical activity, ““and always progressively applying the tips mentioned above,” says Crys Dyaz, physiotherapist and personal trainer.
Does my genetics help prevent sports injuries?
Genetics is another factor that influences the prevalence of certain sports injuries, specifically Achilles tendonopathies. It is well-established evidence that some individuals have a genetic predisposition to chronic Achilles tendonopathy determined by the COL5A1 gene (collagen type V alpha 1), which encodes a tendon protein.6
If you want to learn more about How to recover from injuries and start running again, we invite you to read the next article in this series.
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- Runner’s World Essential Guides: Injury Prevention & Recovery: What Every Runner Needs to Know About Getting (and Staying) Healthy. Editorial: Rodale Books (September 4, 2012).
- Shimabuco Zegarra, A. H. Physiotherapeutic approach in runner’s syndrome. Inca Garcilaso de la Vega University, School of Medical Technology, 2022.
- Vílchez Conesa, M. P. Incidence of sports injuries in amateur runners. Culture, Science, and Sport, vol. 5, no. 15, 2010, p. 32.
- Walker, B. The anatomy of sports injuries. 2005 by Simeon Niel-Asher. ISBN:978-84-9910-120-0.
Content prepared by the specialists of the Scientific Information area of MARNYS with the collaboration of physiotherapist and personal trainer Crys Dyaz and sports physician Yaiza Acosta. This article is informative and does not replace the consultation with a specialist.
About the Specialist
Dr. Yaiza Acosta @dra_saludable
Dr. Yaiza Acosta holds a degree in medicine and surgery, specializing in physical and sports medicine from the University of Barcelona, and specializing in applied nutrition and dietetics. She also helps promote a healthy lifestyle through her social media accounts as @dra_saludable.
About the Specialist
Crys Dyaz is a certified physiotherapist, personal trainer, nutrition expert, and former elite swimmer from the Spanish national swimming team. She runs the CrysDyaz&Co sports center where she trains well-known personalities and promotes a healthy lifestyle through her social media accounts.