Introduction
It is estimated that 40 million U.S. citizens run. They run to start or maintain an increased level of fitness, for psychological rewards, to allow participation in fun or competitive events, or just for the plain fun of it. Unfortunately, because of lack of conditioning, improper training techniques, poor equipment, or faulty biomechanics, injury commonly occurs.
Starting a running program
If you have not been involved in a running program certain guidelines should be used. A medical evaluation should be performed if:
¿ you have a medical problem (heart disease, arthritis, knee or back condition, etc.)
¿ you're over 35, overweight, or a smoker
¿ you're unsure of your medical condition
Training
Sixty percent of running injuries result from training errors, and therefore can be cured with guidance. Gait anmormalities, body alignment, shoes, and the environment account for the other forty percent. One of the most common errors is increasing the mileage or intensity of workout too quickly. The Oregon method of alternate easy/hard day training should be used. Exercise variety such as biking, weinnimg, aerobic, weight training, reduced running, or rest should be perforned on the easy days. If a specific area of your body is stiff or hurting it is sending you a signal to stretch or reduce your monotonous pace, help you actively stretch your muscles, and increase your heart rate. The American College of Sports Medicine suggests for maximum cardiovascular benefit that you exercise 3-5 times per week at 70% your maximum heart rate. Your maximum heart rate can be estimated by subtracting your age from 220.
Example: 220-40 yrs. of age = 180, 180 x .70 = 126.
Environment
Terrain, temperature, and humidity are the most important environmental factors affecting most runners. The ideal running surface is flat and soft. The softest surfaces in decreasing order are mulch, grass, dirt, syntheric, asphalt, and then concrete. Occasionally too soft or mushy surfaces do not give the ankle enough support. The run should be varied by changing terrain, the side of the road, and limiting downhill running. Appropriate clothing, fluid replacement, and acclimatization are important. The humidity can be more dangerous than the ambient temperature.
Musculoskeletal Abnormalities
Variations or abnormalities in the body's musculoskeletal mechanics can increase one's susceptibility to injury. This is common in runners because of the repetitive overload to the body part. An abnormality in one area (short leg) may cause a problem in another part of the chain (i.e. the hip). Knee injuries account for almost half of all running injuries. Gait analysis, diet, alignment, strengthening exercises, training programs and orthotic shoe inserts all play a role in treating knee injuries. Orthotic devices are special type of arch supports that are inserted into one's everyday and/or running shoes. An off-the-shelf variety may suffice or the physician may prescribe a custom fit type. They have been found to be very beneficial. Ankle instability, hip problems, back problems, and foot abnormalities are also leading causes of injury in runners. Foot abnormality like a high arch or flat arch (over pronation) can cause stress injurt or fractures in the foot, leg, thigh, or hip. Appropriate orthotics may be indicated.
Shoes
Shoes are divided into two types - training and racing. The majority of people use training shoes all the time. A lighter shoe that allows you to go faster also sacrifices support and cushion. A visual inspection of your shoes may reveal them to be in good shape but actually they have lost considerable shock absorbing capacity. Look for asymmetrical shoe wear. The shoe store should allow you to wear and run in the shoes before you purchase them. They should feel good instantly and not require a "break in" period. The shoes need to have plenty of room in the toe box, soft but not mushy soles, and a firm heel counter to give stability.
Common Injuries Planter fasciitis - this is irritation on the sole of the foot near the heel.
Metatarsalgia - pain across the ball of the foot.
Stress fractures - these are small fractures occuring because of
over-stress in the area.
Achilles tendinitis - this is irritation in the tendon in the back of the leg to the heel.
Shin splints - there are many different causes of this catch-all term such as tendinitis and increased pressure in the muscle compartments.
Chondromalacia - wearing and pain under the kneecap.
Knee internal derangement - swelling and pain can be caused by cartilage tears, loose pieces, tight bands, or wearing.
Strains - or muscle pulls occur in the thigh, pelvis area and back. They are due to poor muscle strength, tightness, or poor form.
Summary
Most runners can expect to sustain an injury or health problem. All runners will experience mild to moderate discomfort but it should subside with reduced
running or rest.
