If you are a runner, you know just how much being able to lace up the sneakers and hit the trail or sidewalk means to not only your health and fitness but also your sanity. The last thing you want is to be told that you need to take 6 weeks(or more) off from running just to get foot pain from plantar fasciitis, knee pain, hip pain from bursitis, or low back pain to calm down. Apart from staying healthy for many, running with others is their “adult time” away from the pressures of work and home and losing this time because of an injury is not on their list of things to do. In addition, the 6 weeks that the doctor wants you to take off(if they’re not telling you to stop running altogether) will usually have additional time off once you resume running again because while rest may have doused the flame of the injury, it has not fixed the reason you got hurt in the first place. So why do some runners never seem to get injured while others have a hard time running several days in a row let alone a race training schedule? For most, it is in how they prepare to run. If you’re over 25, gone are the days when you can just lace up the shoes and head out the door. That’s especially true if you are hitting 40+. Often if we are missing strength in our knee stabilizers or missing mobility in our ankles, the force of each step is then pushed into the joints. This often leads to achy knees when going up or downstairs, foot pain that you notice when you first step out of bed, or low back and hip pain as you add miles to your training program. It helps to know exactly what each joint needs and how each joint is at the mercy of the joints and muscles above and below (so if you are having knee issues, often the ankles or the hips can be part of the problem). Why do you ask? While a previous injury is the number one risk for a later injury, the number two risk factor for an injury is a difference in strength, stability, or mobility when you compare one leg to the other. In fact, with a reach test, a difference of just 1.6 inches is enough to increase your risk of an ACL tear. How? Because your body will find a workaround and this often leaves you achy, stiff, and sore. Example? Are you always stretching your hamstrings and no matter how much you stretch them do they always seem to stiffen back up? Why? The stiffness could be coming from your back, could be from your glutes, or could be from your knee…Regardless of the location, stretching your hamstrings is treating the victim…not the cause. Once you start running again, your knee swells, your foot hurts, or your bursitis flares leading to more time off, more stress, weight gain, and loss of something you love doing.
Mistake #1 Not taking enough time to prep the joints and muscles for action
Often when we’re feeling stiff or achy, the joints of the spine, hips, knee, ankle, and foot are often to blame. For example, if I have too much stiffness in my ankle then it can’t absorb my impact as I’m running and transfer to the muscles. Instead, it makes the foot or the knee have to compensate. This then tells your nervous system that there is some error going on which then makes your muscles supporting the ankle and foot stiffen up to try to protect it. Often when you fix the mobility of the stiff joint, then the joints above and below as well as the muscles supporting them are able to work like they’re meant to. (Joints that need more mobility are the ankles, hips, and mid-back). Just like the knots you get between your shoulder blades when you are driving too long or sitting in front of a computer, your body can develop them, and most often does, in any muscle. They often feel like tight little balls of muscle, when you push on them and they can sometimes hurt (just ask anybody who’s tried to foam roll their IT band). So, as part of your warm-up and run prep, use a foam roller, peanut, or lacrosse ball to “scan” for areas of pain or tightness. These are the muscles that will often be overly sore from your workout or run. This is mostly because they can’t work the way they are meant to when they have these knots. Your body often tells other muscles to pick up the slack (in jobs they weren’t meant to do) leading to more tightness and soreness. Once you’ve found the “spot” then apply pressure + 1-2 minutes of deep breathing to get it to release and move on to other knots.
Pro tip: You don’t need to smash the muscle, just enough pressure to know you’re on the spot is enough.
Mistake #2 Not fixing the foundation
Most of the runners I treat were able to get away with running without training for it (like lifting weights, foam rolling, stretching, etc…) until they picked up an injury. Often there isn’t any single moment they can think of that caused the injury. Whether that is runner’s knee aka patellofemoral pain syndrome, plantar fasciitis, or hip bursitis often these injuries creep up on you. Sometimes you rest to “fix it” or start limiting your miles but it often flares back up once you get back into training. With most of the runners that I see with this kind of pain, often they haven’t trained their control muscles like the “rotator cuff of the hip” muscles the glutes and piriformis. This often leads to the thigh bone rotating in(not supposed to do this) when you make an impact with the ground which then grinds your kneecap on the outside of the groove it slides in and then makes your arch flatten out putting extra stress on the plantar fascia and joints of the foot. Sometimes it comes up from the foot or ankle and our “tires are flat” i.e. our foot muscles can’t support us. Sometimes our main muscles, the calves, quads, and hamstrings are strong but the supporting crew is weak. It's basically like shooting a cannon from a canoe. Taking care of these hip “rotator cuff” muscles and building stronger foot control muscles usually fixes a lot of the underlying stability problems.
Mistake #3 Not varying the surfaces
Always make left turns at the track? Always running on the side of the road? Never varying your route? All of these can make for imbalances and repetitive motion injuries. Varying stride length(trail running), surfaces, and route can strengthen running muscles and joints. You can do this by making one day a trail day, another a hilly neighborhood day, and another a road day and see if that starts to not only improve your stiffness or pain but also gives your body the break it needs from the same repetitive motion.
Bonus Mistake: Too many miles on the tires. I’m guilty of this, wearing my shoes until I can’t help but notice that my feet and knees no longer feel good in them…and that I actually feel better in other shoes than my running shoes or I’m now slipping and sliding on trails even if I’ve still got some tread left. Usually, that means it is time to get a new pair of shoes.
Confused about where to start? Book a call from the comfort of your home or office and on your schedule with one of our Running Injury Specialists. You can schedule your call here. Need help now? Come by and talk with one of our Doctors of Physical Therapy at no charge. We offer FREE consultations, which give you the opportunity to come in and meet us and see for yourself how we can help you.
Here are just a few of the things you will learn in one of our free consultation:
What is the underlying cause of your pain? (hopefully nothing too serious!)
Roughly, how long will it take to fix the problem?
What to do to help – which doesn’t include painkillers, resting or surgery etc.
What other, natural, drug free methods are there to speed up recovery alongside treatment?
Our consultations are great for anyone that may be “unsure” if physio is right for them, and they give you the opportunity to ask questions and see for yourself if we can help you.
If you’d like one of our limited free consultation sessions, please click here to schedule your free consultation or CALL us on 850-765-2779 to make a no-obligation enquiry.
About The Author
Dr. Brandon is the owner and a Physio at Body Mechanix Physiotherapy and Fitness. Four of his favorite people call him daddy while he's been married to his other favorite person for 20 years. He enjoys teaching martial arts and is a Mestrando in Capoeira while in the mornings, he can be found working out with the guys in F3 around town. He's the author of 4 pain relief guides for sciatica, low back, shoulder, and knees and the lead contributor to the Active Tallahassee Blog.