STOP Injuries before They Start

We runners do prehab training—namely mobility, core, and strength work—in order to continue to do the training we really want to do: running. However, just mindlessly performing these routines and continuing to run through tightness, aches, and pains will not get you the results that you want.

Most injuries develop the same way: You feel a tightness somewhere as the result of a dysfunction in the body tissues, likely in the muscle, tendon, or fascia tissues. If you don’t address that tightness, it progresses to become an ache or a pain. Then if you continue to ignore that, it leads to a full-blown injury that sidelines you from running.

The Runner Injury Path: Tightness > Ache/Pain > Injury

What we want to do is to interrupt this pathway as early as we possibly can.

The first thing to do is to use mobility work to find the areas of your body that are tight. Think of it as your own personal MRI machine, letting you peer inside your body and find the spots that, if you ignore them, might lead to injuries. Focus on the areas that you find, and give them extra attention. This process works great for plantar fasciitis, Achilles tendonitis, shin splints, runner’s knee, IT band syndrome and hamstring tendinopothy.

If that doesn’t alleviate the tightness and you find it progressing to become an ache or pain, it’s time to do the following for one to three days:

• Reduce your training load (volume of running) by 25–50%. This will give your body the time it needs to fully recover. During this time, you can substitute low-impact cross-training to encourage blood flow and keep yourself limber.
• When you do run, avoid anything that makes the ache or pain worse. For instance, if running uphill makes your calf hurt worse, stick to flat running.
• See a body worker for treatment. This can be a physical therapist, masseuse, chiropractor, acupuncturist, etc. These are people who are experts in manipulating bodies. If you can, find one who specializes in working with runners.
• Do your mobility work two to four times a day.
• Reduce inflammation by taking an ice bath one to two times per day, avoiding foods that cause inflammation, and taking anti-inflammatory medicine (if you choose and/or are instructed by your doctor).
• Do things that make you smile and laugh as much as possible. This helps to reduce your stress hormones so that your body can recover faster.
• Prioritize sleep. Your body does a huge amount of self-repair when you sleep, so make sure you’re getting at least 8–10 hours. (And any time you can lay down, lay down. Rest. Rest. Rest.)

After completing that regimen of treatment for one to three days, ease (don’t rush) back into regular training. I often have runners go out on day four and walk for 5 minutes. If all feels good, they then jog slowly for 10 minutes. If everything still feels good, they walk for 5 more minutes. That’s it—just a short test run to see how things are feeling. Usually they are feeling fine, so we take the next three to four days to gradually ramp back up to their normal training level.

If you find that those one to three days of treatment don’t do the trick, it’s time to reduce the training load even more. Take your already-reduced training volume and cut it by another 50–100% for one to three more days, and follow the same treatment protocol. After that, if things feel better, you can return to the 25–50% level of training for one to three days before easing back into full training.

Ninety-nine percent of the time, if you follow this proactive injury-interruption strategy, you will be back to training pain- and tightness-free in no time. And of course, none of us like to reduce our training, but I can promise you that it will not hurt your fitness to have a slight temporary reduction. What will hurt your training is letting a small issue turn into a sidelining injury that takes you out for weeks or months. Don’t let it get to that point.