The Way You’re Running Could Be Breaking You
“Turn your setbacks into comebacks.”
The beauty of running, and what drew me to the sport in the first place, is how accessible it is. As long as you have running sneakers and a safe road to run on, the running world is truly yours. You don’t need a ton of sports equipment, you don’t need to rent space to run in, and you can really run at any time that you feel comfortable doing so or that fits your schedule.
However, because of how accessible it is, more and more people are getting into running and signing up for distance events—which is awesome for the sport of running, but not always awesome for runners’ health and longevity in the sport.
With the rise of online coaching programs that are not tailored to individual athletes, but are more of a “one size fits all” training guide to get runners from the coach to a 5k, 10k, and half or full marathon, more and more individuals are jumping into running and not properly building mileage, incorporating strength training, and ultimately, getting injured.
While I fully support a new runner chasing a new running goal, nothing makes me happier than hearing someone say, “I think I want to train for a marathon”—going from zero to one hundred when it comes to running can lead to tons of long-term health issues if done the wrong way.
I often equate this to any other sort of sports competition. Let’s say you wanted to do a powerlifting competition (yes, I am speaking from experience). You would not immediately jump into back squatting and deadlifting weights that are way too heavy for you without consulting a coach or properly building your lifts, right? My lower back hurts just thinking about that! So why would you immediately jump into distances at speeds that you have never done before, without proper training?
In addition to the mileage new runners are hitting, there are also a myriad of other issues that could lead to nagging long term problems. What if your stride is off? Are you running in the correct shoes? Are you fueling properly? While “DIY” running is great for overall health and wellness, training for a distance event should be done with the help of a qualified coach!
As someone who has been running for more than two decades, even I could use a little help from the professionals. While I am qualified in run coaching (and got into coaching to counter the plethora of online, canned training plans available out there), I am absolutely not qualified to diagnose and treat running injuries, or in injury prevention techniques, such as analyzing gait or testing hip and ankle strength.
Entering my Slow and Strong Era
That is why I sought the help of someone who is qualified in this to help me with my running maintenance, Dr. Nyssa Midden of Flowstate Physiotherapy. As I transition from a fast road marathon runner to my “slow and strong” lifting and trail running era, I realized that this is a major change on my soon-to-be-40-year-old body, not just in my events of choice, but the way my body moves. Lifting heavy and running on trails is completely different from racing on paved surfaces. Climbing hills, jumping over puddles, navigating roots and rocks, trying to control my body on steep downhills—this all adds up! After running a ten-mile trail race last weekend, I noticed that I had some lower back pain and my ankles felt unstable on the latter miles of the race, and decided that I wanted to seek help from an expert to figure out what I can do to make sure I’m running long and lifting heavy for a very long time.
Enter Dr. Nyssa! I arrived at Flowstate Physiotherapy and she showed me the beautiful space, and then we jumped right into my injury screen. I told her that I had suffered a stress reaction in my foot six years ago, and it still affects how I run to this day. She tested my hip and ankle strength, and we determined that my leg strength is very uneven. Following that assessment, she had me run at my average race pace for 5 minutes on a treadmill so she could check out my stride and foot strike. This was also fascinating; after looking at the videos she took of me running, we realized that my right leg strike is very straight, while my left leg strike is noticeably more crooked. She then gave me some really easy exercises to do to help strengthen my hips and help with some muscle weakness in my ankles.
According to her official report that she emailed to me following the visit, my cadence was approximately 168spm; I have a mid foot strike; my impact is normal; my leg swing has good stride length and hip extension; I have an excessive left arm abduction arm swing when moving forward but otherwise normal; my posture is normal and upright; and my alignment assessment was “left lateral trunk lean during left midstance, excessive left foot supination at terminal swing to foot strike.” She also sent me the recommendations to focus on improving hip and ankle stability and motor coordination.
Why does this matter?
So why is this important? Because as a runner for years, and a runner who is aging into her forties, these misalignments and small issues can build in the years to come, and without proper assessments, I never would have realized that my running was slightly off! The exercises and recommendations Dr. Nyssa gave me are so easy to do and so helpful, and this is something that all runners should absolutely do—there is so much room for error in this sport if you are battling small (or major) injuries and are unsure about whether your posture, gait, or muscle weakness could be the culprit.
A conversation with Dr. Nyssa
In addition to my own running, I also work with lots of running clients who oftentimes have questions about aches and pains they deal with while running, and because I am not the expert in this area, I turned to Dr. Nyssa to help answer some questions I had about injuries and injury prevention in the running world. A giant thank you to Dr. Nyssa for helping with this, and I cannot recommend her and Flowstate Physiotherapy enough.
Coach Kelly: What are some of the most common injuries you see in runners?
Dr. Nyssa:The most common running injuries I see are knee pain, achilles tendinopathy, plantar fasciitis, shin splints, hip pain, and bone stress injuries (stress fractures and stress reactions).
Coach Kelly: Are most of these injuries typically from overuse, or from not incorporating (enough) strength training into their training plans?
Dr. Nyssa: This is a complex question, and I think to answer it it’s better to think of injuries as being “over capacity” vs “over use”. Strength training helps increase your capacity to handle the load of running. So if you are trying to run a lot of miles and/or intense workouts and are not doing strength training, it’s likely that your body will have a hard time handling that amount of work without breaking down.
However, plenty of people who do strength training consistently also get injured, and it’s because they are still over-reaching their body's capacity. Sometimes this happens in a single session (i.e. you fall and land on your hip, or you run too fast without being warmed up and strain a muscle), but more often than not it happens over time.
The most common reasons running injuries happen are from increasing mileage and/or intensity too fast, or not allowing your body to recover enough between sessions. There are a lot of factors beyond strength involved in that, including nutrition, how long a person has been running, sleep, and life stressors.
TL;DR: If you aren’t doing strength training, you are more likely to get injured because you likely have a smaller capacity to handle running, but it’s not the only factor.
Coach Kelly: What does a typical follow-up plan look like for most runners—do you give runners "homework" to do, or do you usually do all your treatment plans in person?
Dr. Nyssa: I always give homework to my runners. Although a lot of runners I work with benefit from manual therapy and/or dry needling, and working together in person is important for making sure form and technique is correct with exercises, a majority of the improvement happens with what my runners do when they leave the clinic.
All of my sessions are an hour long, so that my clients understand and are confident with what they are supposed to be doing when they leave. A runner’s follow up plan is completely individualized to them and their current situation, but it typically includes specific exercises, directions on how to adjust their training and track progress before the next time we meet, and tips on how to improve recovery. How frequently we follow up in person is dependent on when they need hands-on care or adjustments or progressions to their plan.
Coach Kelly: How much does a runners' gait directly affect how they feel, i.e. how many times do you directly correlate someone's gait to nagging running injuries?
Dr. Nyssa: Running gait is one piece of a bigger puzzle to a runner’s injury. Oftentimes when a runner is having an injury, there is a correlation to their gait as to why that area may be absorbing more load OR how a person has changed their gait because of their pain. However, there is no one perfect way to run, so it’s important that we always look at the entire picture (strength, training load, mobility, etc) vs. just one piece when determining why an injury happened and why they are having pain.
Coach Kelly: What is the best piece of advice you can give to a potentially injured, potentially spiraling runner?
Dr. Nyssa: Take it one step at a time! A lot of times when runners are injured they try to do everything all at once to fix their problem, and then it can be really hard to tell what is helping and what is not. With this, you have to trust the process and give things time to work—if you panic and rush you might stop doing something helpful before it has time to make a difference.
So, in summary, take care of yourself as a runner. Build gradually, incorporate strength, and work with professionals!
Running fast is cool, but running safe, smart, healthy and for the long term? Way cooler.
Xo