Why Do I Get Injured Running?
This is a question that many people ask, and unfortunately there is a lot of conflicting information about how injuries occur and how you can prevent injury.
Pose Method is a system for teaching athletic technique, and as such the method was developed with a deep understanding of human movement. With that in mind a framework for understanding how injury occurs and how to stay injury free is built into the principles themselves.
The following formed a series of twitter "tweets" by coach Jon Port (@jonppose) with the intention of answering a simple question "Why do I get injured running?"
Pose Method is a system for teaching athletic technique, and as such the method was developed with a deep understanding of human movement. With that in mind a framework for understanding how injury occurs and how to stay injury free is built into the principles themselves.
The following formed a series of twitter "tweets" by coach Jon Port (@jonppose) with the intention of answering a simple question "Why do I get injured running?"
Causes of Injury
There are 4 categories for cause of injury
1.Leverage
2.Force contradiction
3.Flexibility
4.Strength
The first two are predominantly technique (skill of movement) issues.
1. Leverage
2. Contradiction of Forces
3. Flexibility
4. Strength
1.Leverage
2.Force contradiction
3.Flexibility
4.Strength
The first two are predominantly technique (skill of movement) issues.
1. Leverage
- Common injuries caused by excess leverage in running are runners knee, shin splints, stress fractures.
- Extending your limbs outside the centre line running through your body (vertical to the ground) causes excess torsional force at landing.
- Extending your lower leg (a lever) ahead of it's knee joint causes runners knee (if heel landing) or medial shin splints (if forefoot landing). (see Eccentric Loading of Knee)
- To remove the lever in front of the body, focus on lifting your ankles only upwards as you run which creates a vertical alignment of the centre of masses of your joints.
- Don't bend in the middle when running which create a leverage around the hip joint. This causes back pain in running. To resolve, make sure you keep your trunk in the same vertical line through your body.
- If you leave your leg to lag behind your body when running, your other leg will straighten and swing forward to counter balance which causes excess leverage.
- The correct body position in running is a "Pose", where the centre of mass of all body parts are aligned vertically and knees are kept slightly bent. This position aligns your bodyweight over the ball of foot allowing your body to "accept" gravity and remove leverage. Any deviation from this "Pose" will result in potential excess leverage.
- You will hugely reduce the risk of running injuries such as runners knee, ITBS, shin splints, stress fractures, compartment syndrome by reducing leverage (aka using the Running Pose. (See Forefoot running study : This study used Pose Method training for the biomechanic changes of the runners)
2. Contradiction of Forces
- Contradiction of force is when 2 opposing forces occur together at the same time.
- Common running injuries related to contradiction of forces are muscle strains and tendon injuries such as achilles tendonitis, plantar fasciitis.
- The most common reason for contradiction occurs when an eccentric contraction is opposed and resisted by a concentric contraction.
- Eccentric contraction (stretching force) happens when your bodyweight stretches your muscles and tendons out as you land on the ground.
- Concentric contraction happens when you use internal muscle efforts to hold tight or move a joint.
- If you hold a muscle+tendon tight when it is being stretched, there is an opposition of forces (a contradiction) which results in muscle or tendon strain if carried on for too far/long a duration.
- The biggest cause of contradiction in running is pushing/digging into the ground with foot and leg as you run in attempt to move the body further/faster.
- Pushing into the ground as bodyweight is loaded results in overuse running injury often achilles tendon and/or plantar fascia.
- To avoid achilles and plantar fascia injury lift your foot directly up from ground, don't push it down into the ground. Lift the foot continuously into the Running Pose.
- Other examples of a contradiction are with hamstring injury. If you lift your knees high up when running, the quadriceps muscle group over-power the hamstring group and result in hamstring strain or tear (especially when sprinting). Don't drive knees up!
- How can you reduce contradiction of forces when you run and help reduce your chance of injury? Firstly you have to learn to relax when running i.e. reduce your internal muscle efforts. Instead learn to hold the correct body position and just let your weight fall forward as you pick your feet up underneath you into the Running Pose.
- Driving, pushing, forcefully thoughts and actions in running cause injury quickly and *reduced performance*.
- *Special one for forefoot runners: don't point your toes and hold your heel high in the air. This causes a contradiction around the ankle joint and results in achilles tendinitis
3. Flexibility
- Flexibility is the ability of a limb to move around a full range of motion of its joint. It directly relates to joint mobility, muscle/tendon elasticity, and relaxation of muscles.
- Stretching and flexibility are not the same. Stretching mainly has some limited use in rehabilitation after injury, but *not* injury prevention itself.
- Flexibility has an influence on injury prevention if your body position is being limited by an inability of your joints to move through a required range.
- Common inflexibility for runners is hips and ankle joints which can cause muscle strains and muscle tightness with the potential for tendon strain.
- Do flexibility exercises after running. Extend your limbs through their full range of motion, don't hold the muscle tight, instead focus on relaxing the joint. A relaxed joint will naturally allow the limb to extend further.
- Recovery of natural flexibility takes time. It's important to understand that our brain limits our flexibility, but gradually it learns to allow more. Your reward for diligent exercises is greater range of motion, greater joint elasticity (springiness), ability for your joints to relax when running.
- Flexibilty serves *proper running technique* which is the most important factor in injury prevention.
- Joint soreness is often related to a lack of activity, sedatory lifestyle. Movement is the best way to keep healthy joints
4. Strength
- Lack of or improperly developed strength has an impact on your ability to maintain correct body position.
- Strength requirement in running is related to an ability to hold correct technique over a speed or distance, and is *not* related to power in running.
- There is no 1 particular muscle that is more important than another in running. Muscles work in a coordinated chain, and the whole chain must be strong.
- Nevertheless, common areas of weakness (often due to lifestyle) are hips region, thoracic region, lower leg, ankle/foot, hamstring region.
- Your hips and thoracic area must be able to support correct posture of the body so that your centre of gravity is maintained as your body rotates forward during the running movement.
- Squats performed correctly with foot flat on ground and structure of spine maintained are excellent exercise for hips and thoracic spine.
- Hip strength is of prime importance. Week hips result in your body being out of position, which cause muscles to overload causing leverage related pain. Do "core" exercises to strengthen your hip region.
- Lower leg strength is important for muscle/tendon elasticity of your body. Without elasticity, movement becomes flat, dead, and forceful.
- The lower leg muscular/tendon system works eccentrically. Do NOT do concentric exercises (calf raises), these increase the chance of injury (see Eccentric Treatment)
- The Best strength exercises for lower legs/feet are hops on 2 feet and 1 foot while barefoot. Skipping rope is also excellent.
- Most strength exercises that you need can be performed with your own bodyweight. But wobble boards, leg weights, weight machines are useful additions.
- Proper developed strength+flexibility of joints alongside proper technique and body position will help you to a lifetime of injury free running.
Running Injury Myths
Here, we look as some of the most common advice given for injury prevention and expose them as myths.
1. Shoe cushioning prevents injury.
There is no research that has been done that confirms this to be the case. A heel strike has a significant impact transient (sharp peak force). It is true that cushioning reduces the transient slightly. But compared to the smooth curve of a proper forefoot landing it is still significant.
Compare Impact Transient of Heel Landing with Impact Transient of Forefoot Landing
2. We are born either a neutral, over-pronator, supinator.
This is not true.
Over-pronation is a leverage issue when the leg+foot extended ahead of body resulting in the ankle collapsing as weight rotates over. Over-pronation is particularly a problem with heel strike since the heel is inherently an unstable platform of support for bodyweight. Land under the body in the proper "Running Pose" to remove the excess pronation.
Supination (lateral side foot land) is really related to a desire to reach for the ground to protect the body, in an effort to reduce loading. Supination is more deeply connected to an inherent fear (in the mind), as an attempt to try and reduce some pain in your running. To remove supination work on elastic exercises (skipping, hopping) that emphasise your bodyweight loading/unloading naturally from the ball of foot.
Proper technique and good muscle condition will remove over-pronation and supination from your running, without the need for "technical" shoes.
3. Overuse injury is caused by running too far or fast.
Overuse = Misuse. You are doing something wrong. Over time your body gets overloaded and breaks down. Address what you are doing wrong.
4. Runners knee is due to weak quadriceps.
The quad muscle+tendon stabilises the patella, but the reason for "runners knee" is leverage around the knee joint. The main cause is a heel strike ahead of the knee joint. (see Eccentric Loading of Knee)
5. Running on hard surfaces too much causes injury.
A heel strike on a hard surface causes a sharp impact transient. When running with a correct forefoot technique, the surface doesn't matter (see Lieberman Study). This tells us that it's not the surface that matters but how you run on the surface.
6. Inadequate arch support causes plantar fasciitis. Shoe insert is the best prevention (especially for flat feet).
The main reason for plantar fasciitis is contradiction of forces repeated over a long period. Inserts actually weaken the foot. The arch structure of the foot *strengthens* when weighted from top, but is extremely weak when force is applied underneath. e.g. Arch bridges can support great loads. It raises the question, if the strength of an "arch" has been known about for decades (even centuries), why are we trying to support our foot arch from the bottom which disables its functional strength?
See useful video by Nicholas Romanov on exercises for Plantar Fasciitis and a study on the effectiveness of plantar exercises
7. Running on forefoot causes achilles injury.
Achilles injury happens through incorrect running technique. Period. If you hold the heel up (run on your toes) your calf is acting concentrically. But, many studies show that proper function of the calf and achilles attachment is through eccentric work (see Do muscles function as springs). If you are forefoot runner let the ankle flex and heel lightly "kiss" the ground if necessary.
8. Icing heals injury more quickly.
Ice used *immediately* after trauma has some use against inflammation. After that, it only acts as pain relief and actually delays healing. Healing of soft tissues requires blood flow, and ice slows blood flow. It is better to use heat and massage techniques.
There is no current research that links the use of ice with improved soft tissue recovery, with research starting to come through that long term use has the opposite effect (see Does cryotherapy improve soft tissue injury)
1. Shoe cushioning prevents injury.
There is no research that has been done that confirms this to be the case. A heel strike has a significant impact transient (sharp peak force). It is true that cushioning reduces the transient slightly. But compared to the smooth curve of a proper forefoot landing it is still significant.
Compare Impact Transient of Heel Landing with Impact Transient of Forefoot Landing
2. We are born either a neutral, over-pronator, supinator.
This is not true.
Over-pronation is a leverage issue when the leg+foot extended ahead of body resulting in the ankle collapsing as weight rotates over. Over-pronation is particularly a problem with heel strike since the heel is inherently an unstable platform of support for bodyweight. Land under the body in the proper "Running Pose" to remove the excess pronation.
Supination (lateral side foot land) is really related to a desire to reach for the ground to protect the body, in an effort to reduce loading. Supination is more deeply connected to an inherent fear (in the mind), as an attempt to try and reduce some pain in your running. To remove supination work on elastic exercises (skipping, hopping) that emphasise your bodyweight loading/unloading naturally from the ball of foot.
Proper technique and good muscle condition will remove over-pronation and supination from your running, without the need for "technical" shoes.
3. Overuse injury is caused by running too far or fast.
Overuse = Misuse. You are doing something wrong. Over time your body gets overloaded and breaks down. Address what you are doing wrong.
4. Runners knee is due to weak quadriceps.
The quad muscle+tendon stabilises the patella, but the reason for "runners knee" is leverage around the knee joint. The main cause is a heel strike ahead of the knee joint. (see Eccentric Loading of Knee)
5. Running on hard surfaces too much causes injury.
A heel strike on a hard surface causes a sharp impact transient. When running with a correct forefoot technique, the surface doesn't matter (see Lieberman Study). This tells us that it's not the surface that matters but how you run on the surface.
6. Inadequate arch support causes plantar fasciitis. Shoe insert is the best prevention (especially for flat feet).
The main reason for plantar fasciitis is contradiction of forces repeated over a long period. Inserts actually weaken the foot. The arch structure of the foot *strengthens* when weighted from top, but is extremely weak when force is applied underneath. e.g. Arch bridges can support great loads. It raises the question, if the strength of an "arch" has been known about for decades (even centuries), why are we trying to support our foot arch from the bottom which disables its functional strength?
See useful video by Nicholas Romanov on exercises for Plantar Fasciitis and a study on the effectiveness of plantar exercises
7. Running on forefoot causes achilles injury.
Achilles injury happens through incorrect running technique. Period. If you hold the heel up (run on your toes) your calf is acting concentrically. But, many studies show that proper function of the calf and achilles attachment is through eccentric work (see Do muscles function as springs). If you are forefoot runner let the ankle flex and heel lightly "kiss" the ground if necessary.
8. Icing heals injury more quickly.
Ice used *immediately* after trauma has some use against inflammation. After that, it only acts as pain relief and actually delays healing. Healing of soft tissues requires blood flow, and ice slows blood flow. It is better to use heat and massage techniques.
There is no current research that links the use of ice with improved soft tissue recovery, with research starting to come through that long term use has the opposite effect (see Does cryotherapy improve soft tissue injury)
