How to Prevent Running Injuries

By Dr. Terry Gebhardt, PT, DPT

If you are a runner, you likely know how frustrating running injuries can be.  Many running injuries can be be due to the ground reaction forces associated with running.  The ground reaction force is the force exerted by the ground on the body in contact with it.  Running increases the ground reaction force 2-3 times your body weight.  When we consider how many times each foot hits the ground on your runs, we begin to realize how the cumulative effect of each foot hitting the ground can lead to injuries.  We can get away with having poor running technique, muscle weakness, or limited mobility for years, but eventually the cumulative effects will lead to injury.  Too many times, runners blame age on why they can’t run anymore.  While our muscles and tendons weaken with age, there is a lot that can be done to maintain strength and reduce the load on your body.  A good place to start is your running technique.

A recent study looked at 3 cues for reducing ground reaction force.  They were “change to a ball of the foot strike,” “increase cadence to 180,” and “stand up taller.”  Each of these cues given individually reduced ground reaction forces.  However, ground reaction forces were reduced the most when all 3 cues were given.  What does this mean for you?  Spending time focusing on your technique can reduce your risk of injury.  Many runners are heel strikers.  Highly cushioned shoes add to the problem and give runners a false sense of security that landing with a heel strike is OK.  Even if you think you land on your forefoot, I encourage you to take a video of your running to confirm.  I have had many runners think they land on their forefoot only to see they are heel strikers when we record their running.  One word of caution.  If you are a heel striker, changing to a forefoot landing will increase the stress on your calf muscles, Achilles tendon and plantar fascia.  Gradual progression will allow these tissues to adapt and get stronger.  See your physical therapist for more specific guidance on how to progress your training.

What is your current cadence?  Many fitness watches do this for you.  If not, count the number of steps you take per minute.  Each time a foot hits the ground is counted as one.  180 is a good target.  Many times increasing your cadence will help runners change from heel striking to forefoot landing.

Stand up tall means simply don’t lean forward at the waist.  Keep your head and shoulders up.  A forward lean from your ankles can be helpful and help keep your momentum moving forward.

I recommend spending a few minutes at the beginning of your running thinking about these things and checking in with them periodically during your run.  Thinking about them your entire run can make running much less enjoyable.  It takes time to change technique.  Being patient and progressing slowly will help keep you running pain free years to come.

Dr. Terry Gebhardt is a physical therapist and ultramarathoner.

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