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How I Stopped Getting Constant Running Injuries

I had one running injury after the next for five years, and then finally ran injury free for 10+ years. I shared how to stop getting running injuries in this post — and what I learned after injuries popped back up last year.

Nearly all runners deal with injuries. But just because it’s common doesn’t make it any less frustrating and disheartening.

how to stop getting running injuries

How to Stop Getting Running Injuries

When I first start running races back in 2004, I dealt with constant running injuries. My most common and persistent injury was illiotibial band syndrome (aka IT band syndrome). It caused me to cancel my plans to run my first marathon in 2006, even after ramping up to 20 mile training runs.

The next year, I trained for a half marathon but had to walk for about 5 miles on race day because I was in so much pain, from my IT band flaring. And in another half marathon later that year, I hobbled across the finish line so badly that they had the first aid team coming at me immediately.

how to stop getting running injuries

But then… I blissfully started enjoying years of injury-free running. From 2008 through 2019, I ran relatively injury free, other than some niggles here and there. I was able to train consistently without major injuries. And that consistency allowed me to improve my speed, endurance and break all my PRs. Today, I’m sharing what helped me run injury free for so long and what I think caused a return of injuries in 2019.

How I stopped getting constant running injuries

1. Mobility work

My first injury-free training cycle came in 2008, six months after I starting consistently practicing yoga. I was amazed. In 2007 I had run multiple races with severe pain (despite a prescription for prednisone to help with the injury) and was under the care of an ortho. And yet, despite his treatments, I was still running injured. I started yoga and the IT band issues went away.

Yoga helped strengthen my weak glutes and hips, and also helped me get in regular stretching, which I was NOT good about doing, even as my mileage ramped up. While I now know to find a sports-specific ortho and ideally a physical therapist who is also a runner, yoga addressed a root issue that I didn’t know I had and my doctor didn’t address.

how to stop getting running injuries

For my 10 year stretch of injury-free running, I was doing yoga 1-2x a week. In the last 1-2 years, my yoga practice has been much less frequent. But, I am much more consistent with warming up, stretching, foam rolling and getting sports massages. I bought a Hypervolt massage tool last year and that was incredibly helpful for loosening tight muscles and releasing knots leading up to the 2019 Boston Marathon.

I shared more more details on my pre-run warmup, stretching and recovery routines in my running course, which is open for enrollment for another week!

how to stop getting running injuries

2. Proactively addressing small issues before they become big issues

As a newer runner, if something felt off or started to hurt, I pushed through the pain. I felt like I HAD to log the miles on my training plan or I would fail come race day. Now I know that the best runner on race day is a healthy runner. If I show up to a start line injured, there is no way I can run my best.

So, as soon as something starts to feel off, I take steps to address it. These are the top three things that helped me run marathons the past three years, increasing my mileage and training intensity each year. (And, I set PRs in each. First at the Wrightsville Beach Marathon. Then at the 2018 Boston Marathon and again at the 2019 Boston Marathon.)

Physical Therapy and Dry Needling

When I was training for my second marathon (and attempting to get my first Boston Qualifying time), I started having IT band issues again, in addition to glute pain. My training buddy Kate kept telling me that I HAD to try dry needling. Finally I got desperate and gave in, even though I was squeamish of needles. Dry needling and physical therapy have transformed my training and are a regular part of my training. Addressing issues early on has helped prevent so many niggles from turning into bigger problems that require big chunks of time off.

Sports Massage

These are not relaxing massages. These are intense and very uncomfortable. But regular massage helps dramatically, especially whenever my weekly mileage starts to jump over 40 miles a week.

Strength Training

I never consistently strength trained until I started CrossFit. Granted, yoga was a form of strength training to be sure, but as my yoga habit waned (story for another day), I added CrossFit into my schedule. That created some issues with balancing training load, BUT CrossFit made me much more comfortable in the gym. I added muscle, which helped me run more powerfully, helped prevent injuries from muscle weakness, and I showed up to races a LOT stronger. While I don’t do CrossFit anymore, I have continued to strength train 2-3x a week. Last year, that meant going to the gym and doing my own strength workouts. This year, since our gym is closed due to COVID, my strength training involves mostly bodyweight workouts or workouts with 8 lb dumb bells since that’s all I have at home!

how to stop getting running injuries

3. Not running through pain

When I was training for my first marathon, I was very hard on my body and mind.  If I had to walk part of my 18 mile run because of pain, oh well. I needed the mileage! If it hurt, I tried to ignore it and keep running. I needed to run for X minutes or X miles, no less! Besides, no pain, no gain right?? Wrong. Now, yes, I feel discomfort all the time when running these days. (Heck, especially these days since I’m 8 months pregnant!) But I’ve learned over the years of training for over 50 races that there is a big difference between discomfort and pain.

No, every run doesn’t always feel good, especially when training for a big goal. It’s uncomfortable to run faster or longer than your body is used to but that’s sometimes required to make improvements. But I never run through tears from pain or pain that causes me to change my gait. If I’m feeling true pain, I stop running. (And if I forget my own advice — which you’ll read below — I typically end up with an injury.)

If I feel pain, I stop a run early or take a couple extra days off. It’s always better to listen to your body and take time off for a shorter period of time than to deal with a longer, forced time off due to injury.

Remember that it’s okay to adjust your training.

Having a running coach helped with this a lot. But even before then, when I self coached for years, I learned to listen to my body and if something wasn’t feeling quite right, I’d adapt my plan to give my body an extra day off or an extra recovery day. I’d shorten my long run or reduce the number of prescribed repeats on an interval day. I’d postpone a tempo day or switch an easy run to an elliptical day. I don’t follow a training plan EXACTLY as written simply because it was written down like I used to. I let my body and common sense have a say in the matter as well.

Crosstraining

4. Crosstraining

I used to believe that a workout wasn’t a “real” workout unless it involved running. And to be honest, that’s still a mindset I struggle with since I just love running so much. But, I quickly learned last year when I was running 60-70 miles a week that cross-training was essential. It allowed me to train on days that my body was feeling less than stellar and allowed me to keep working on my cardiovascular endurance. It reduces impact from the repetitive motion of running, strengthens other muscles and helps prevent burnout.

In January, Tommy and I gifted each other a Peloton and that’s been incredibly helpful for cross-training as I recovered from my first major injury in years. (We especially got lucky since we ordered it before the increased demand when gyms closed due to Covid.) One of the keys to cross-training is to find something you truly enjoy so it enhances your overall training, both mentally and physically. This post has more details about why cross-training is so important and the best types of cross-training workouts.

Fueling appropriately

5. Fueling appropriately

So often athletes focus on increasing their mileage or intensity, but neglect to give the same amount of thought and effort to improving their fueling. The more you train, the more you need to eat. It’s that simple. And, it’s important to make sure you’re getting the right kind of nutrition, particularly carbs. This post talks about the importance of carbs and this post talks about what I eat in a day while marathon training. I also have a lesson in my running course about what to eat before, during and after a run.

There is research that also shows that endurance athletes are prone likely to have injuries if they are underfueled. So, if you keep having injuries and you can’t seem to pinpoint why, it may be worth working with a registered dietitian who specializes in sports performance to identify any gaps in your eating habits. InsideTracker is another great resource for analyzing your bloodwork and diet.

 

Learning from my injuries

Okay, so what about the string of injuries I had last year? First plantar fasciitis, then a torn ankle tendon. In retrospect, I can more easily identify what likely caused those injuries.

Plantar Fasciitis 

With plantar fasciitis, I ramped up my mileage pretty quickly and then didn’t take enough time off after a BIG training block. I went right from the 2019 Boston Marathon in April, into training for the BolderBoulder 10K in May and then the American Fork Half Marathon in June. I promised myself I’d run the 10K and half marathon easy… but I didn’t.

Then I came home from the half marathon and literally the next day, went to running camp. I eventually recovered from from plantar fasciitis, but man, it was frustrating. It still flares occasionally but I’m much more proactive with treatments.

Posterior tibial tendon tear

With this, I simply didn’t pay attention to pain vs. discomfort. It started when I rolled my ankle while trail running. I didn’t think much of it since it didn’t hurt to run and kept running for another 8 miles that day. The next week, things still felt fine so I just kept running. But about a month later my ankle was really bugging me, and by then, I’d forgotten about rolling my ankle.

I thought  I just needed more time to warm up since I was “getting older” but I ignored the fact that the pain changed my gait and it got worse throughout my run. I kept running and running through pain for months, until finally, I literally couldn’t and had to walk home from a run. Eventually, an MRI showed a torn tendon, but that wasn’t diagnosed for 6 months after my pain started. And at that point, the damage was likely much worse than what rolling my ankle likely caused.

More tips to avoid overuse injuries and recurring injuries.
  • Stay consistent in your workout routines. Taking large chunks of time off and then diving right back in as if you hadn’t is a recipe for disaster.
  • Evaluate your training plan and timeline. Make sure you don’t try to build up your mileage or intensity too quickly! (I have a lesson in Get Your Run On about how to choose the right training plan for you.)
  • Evaluate and adjust your goals, if necessary. Giving yourself realistic racing or timing goals can help you avoid unnecessary injuries or strains. And if you’re recovering from an injury, remember that your endurance and speed will take some time to come back.
  • Know your injury history and what your weak spots are. As I’ve gotten into my early to mid 30s, it seems I’m prone to lower limb issues, e.g. plantar fasciitis, ankle instability, etc.

I hope this post helps you avoid running injuries! If you do get a running injury, evaluate what happened and be smart about how you return to running after an injury or time off.

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26 Comments

  • Reply
    feener
    at

    i so need to do yoga or strength. i also believe in not doing back to back days or at least always hard/easy, not 2 hard days in a row. i also recently went to a chiropractor who did ART and find that it really helps.

  • Reply
    Larkin
    at

    Hi Terri- thank you SO MUCH for this post. I literally just came back from a run that I decided to walk most of because I was in pain and felt a little off. I too have struggled with running injuries and it’s really helpful to see all the things I’ve been thinking written out. Hope you keep up the injury free running. And thank you!

  • Reply
    Lauren
    at

    I could definitely afford to listen to a few of these. I’ve been guilty of running through the pain of so often and although I’m definitely getting better at this, I still feel the need to run almost every day. Teaching spin has been a great diversion from that though.

  • Reply
    Alysha @shesontherun
    at

    I have runner’s knee and I completely agree with the yoga. it’s amazing how tight areas can affect completely different parts of the body. Since I also have flat feet, wearing orthodics and doing hip strengthening exercises helps too.

  • Reply
    Katie @ Healthy Heddleston
    at

    Great tips! Love love! My husband and I both have Vibrams and he has benefitted from them SOOO much! I on the other hand can only run short distances in them because my left two little toes get a pinched feelings. I recently bought a minimalist shoe (where the toes aren’t separated) and am going to see how those work out!

  • Reply
    janetha
    at

    Easy! By not running! 😉

  • Reply
    Jamie @ Don't Forget the Cinnamon
    at

    I’ve also struggled immensely with IT band issues due to my malformed hips (darn you hips!!!) For me, it took taking several months off of running to focus purely on strengthening my hips and butt. And I also avoid running daily and listen to my body! In the summer when I can stand ice touching my body, I ice after every run as well, even if I’m not feeling any pain, just in case there’s a teensy bit of inflammation.

    Two years injury free-wow!!!! That’s awesome!

  • Reply
    Becky
    at

    Thanks for sharing all of this. I have battled shoulder and neck issues and after spending every last penny I had on orthopedic surgeon visits, scans, chiropractic adjustments and months of PT, I discovered yoga. It has changed everything. I wish I could have all that money back that was really just thrown away on things that really didn’t even scratch the surface of helping my body. Also, I started walking and running with Nike Free 5.o shoes about 2 years ago. I used to have hip issues, a knee popping issue and also shin pain with running. I have not had even 1 single issue with any of that since I bought my Nikes. It’s amazing what a bare-foot running shoe can do for me! I will likely step down to the 3.o on my next pair. I am passionate about sharing with others the benefit of yoga and the barefoot running shoe. Glad to hear you are too!

  • Reply
    MacKensie Gibson
    at

    I had the EXACT same experience when I started running in my Vibrams. I didn’t even realize how severe my heel strike was, and now I run in simplistic running shoes, but I’ve kept the form that I started with my Vibrams and my knee injuries have almost completely disappeared. I am so thankful.

  • Reply
    Amber @ Busy, Bold, Blessed
    at

    I”m on the other side, I was running in a minimalist shoe when I started but then started to get really bad hip pain, which all went away once I got some more supportive Mizuno’s. Right now I’m dealing with some knee pain from tweaking my knee tripping over something a few weeks ago. The big races I’ve been training for since January are coming up this weekend and at the end of the month, so I’m just trying to find a balance between being prepared and getting injured. I’ve definitely been taking some extra rest days and ice is my friend!

  • Reply
    Abby
    at

    definitely agree with all of these–especially the Vibrams! I haven’t had any more than minor aches and pains since i started incorporating minimalist running into my life. I’ve been slipping on it recently tho..gotta get back to it!

  • Reply
    Sarah
    at

    I suffer from ITBS and you’re right-it HURTS!!! I tried stability shoes, a knee band, extra stretching and only running 2-3 days a week. It helped a little, but I still couldn’t add mileage without significan pain/limping. Any run more than 2.5 miles was going to lead to pain. About 2 months ago, I finally bought the foam roller. Holy Cow-what a difference. Just this morning, I ran a quick 4 miles PAIN-FREE-which was impossible 2 months ago!

    This is what I do/use now to prevent injury/pain:
    1. Use foam roller before and after each run (it hurts so good!)
    2. Additional Stretching
    3. Running only 3 days a week
    4. Weight lifting/cross training

    I’ve been seriously considering trying the Vibrams. I was worried about using them when I had so many problems with my IT Band. I’m glad to see that it’s helped you.

  • Reply
    Mrs Type A
    at

    Love this! I try to be conservative so as to not injure myself. I rarely run two days in a row, and if I do, it’s usually one day doing intervals and one day doing a slow, consistent jog.

  • Reply
    Faith @ For the Health of It
    at

    Thank you for this! I’m trying to build up mileage wisely for a future half marathon and I’m actually pretty freaked about overtraining and getting hurt. I’m hoping that running only 3 (maybe 4) times a week and counterbalancing with plenty of stretching and yoga will help keep injuries at bay. It’s great to hear from a seasoned runner that I’m on the right track!

  • Reply
    Claire @ Live and Love to Eat
    at

    I stopped 1/2 marathon training last year due to a tendon tear and this year thanks to ITBS. I feel like it’s God’s way of telling me I’m not meant to be a runner! I did recently up my yoga practice, and I hope some day to complete a half – injury free.

  • Reply
    Carrie
    at

    Stretching regularly has helped me tons, as has foam rolling and running SLOWLY for most of my runs.

  • Reply
    Ann
    at

    YOU (your encouragement and advice) were a huge help in my ITBS recovery last fall. Now I’m a regular yogi (well, I TRY at least, ha!), stretch more often (sadly, not always), foam roll when I feel especially tight, and am religious about sports massages when I train for a race. I haven’t tried Vibrams yet, but I’m so intrigued…maybe some day!

  • Reply
    lindsay
    at

    I’m having ITBS or knee pain right now and haven’t been able to run for 6 weeks. It’s killed my half marathon training, and after some strength training and suggested stretches/ST from a sports therapist, tried running 1.5 miles on Monday. I had to ice and ace bandage on Monday and Tuesday due to the pain. I’d been meaning to add more yoga in to my life, and I think this injury is the right thing to get me to finally do it.

  • Reply
    Shalayne Villarreal
    at

    I’m a yoga believer! Love yoga and I think it does SO much for the whole body (and mind too). I’m glad to hear that is part of what you attribute less injuries to – I’m a big believer.

  • Reply
    Stephanie @ Macaroni and Cheesecake
    at

    I’m so glad to hear that yoga helped you not be so tight. I had a foot injury this fall and they told me it was a direct result of extremely tight muscles in the backs of my legs. I’ve been stretching and foam rolling but haven’t tried yoga yet. Great call on the not running everyday too, my Physical Therapist told me not to do heavy weight bearing activities two days in a row and it has seemed to help. Hopefully we all stay injury free!:)

  • Reply
    Tan
    at

    This is a great post! I completely agree with the listening to your body suggestion. When training for my 2nd 1/2 marathon (could not do my first due to knee pain), I only ran 2-3 times per week, did pilates and taught 3 cycling classes for cross training. The key for me was to not run as much and incorporate pilates – I had zero injury pain for my race! I love reading what has worked for others 🙂

  • Reply
    [email protected]
    at

    What a great post! I totally agree with everything you said. After two running injuries I have switched to chi running (mid foot strike), integrated pilates into my workout schedule and cut back on running too many days in a row. It is so frustrating to be injured and I am hoping that these changes will keep me injury free 🙂

  • Reply
    Whitney @ Whit Likes Fit
    at

    This is a great post. I’ve struggled with IT band/knee injuries for 3 years and it’s horrible. I just want to be able to run without pain. I’ve done 2 rounds of PT, acupuncture, Dr’s, Orothos, MRIs, pilates… and I’m just now slowly starting to hurt less. My most recent PT has been awesome. She’s the 1st person who has stressed stretching! And she also encouraged yoga. My IT and knee pain is connected to tight hips and so really loosening those us has helped immensely.

  • Reply
    Ashley M. [at] (never home)maker
    at

    This is a great post. I’m about to start yoga up again because I am plagued with IT issues. I am also hoping to experiment more with Vibrams when the weather gets warmer. Thanks!

  • Reply
    Rachel
    at

    Yes! I don’t know about you but I ran track in high school where running every day was ingrained in my brain, so the whole “don’t run every day” thing was really hard for me to grasp, but once I implemented a roughly every-other-day routine it made a HUGE difference. That and I got my running gait analyzed, plus focus more on hip strengtheners, stretches, and yoga. World of difference, I haven’t been injured in 3 years!

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