10 tips to keep running without getting injured
Nearly all runners deal with injuries. But just because it’s common doesn’t make it any less frustrating and disheartening. So today, I’m sharing my history with running injuries and how you can run injury free.
When I first started running races back in 2004, I dealt with constant running injuries. My most common and persistent injury in the beginning was iliotibial band syndrome (aka IT band syndrome). It caused me to cancel my plans to run my first marathon in 2006, even after doing a 20 mile training run.
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.
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 to Stay Injury Free Running
1. Mobility work
My first injury-free training cycle came in 2008, six months after I started consistently practicing yoga. I was amazed. In 2007 I had run multiple races with severe pain,and was under the care of an ortho. And yet, despite his treatments, I was still running injured. When I started yoga, 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.
For my 10 year stretch of injury-free running, I was doing yoga 1-2x a week. In the last 2-3 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 have my exact pre-run warmup, stretching and recovery routines in my running course.
2. Proactively addressing small issues before they become big issues
As a new 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. More on that below!
3. Do Consistent Physical Therapy (and Dry Needling, if available)
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 exercises have transformed my training and are a regular part of my routine!
4. Get Sports Massages
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.
5. Strength Train
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. I love Peloton strength classes, and they even have ones that are specific for runners.
6. Don’t run 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, 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. Over the years of training for 50+ races, I’ve learned 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 and/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.
7. Adjust your training
Having a running coach helped with this a lot. But even before I had a coach, 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. Now, I let my body and common sense have a say in the matter as well.
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, when training for the 2019 Boston Marathon and when running through pregnancy, I learned the value of cross-training. 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. Cross-training reduces impact from the repetitive motion of running, strengthens other muscles and helps prevent burnout.
In January 2020, Tommy and I got a Peloton and that’s been incredibly helpful for cross-training as I recovered from my first major injury in years (a torn ankle tendon). 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.
9. Use InsideTracker
This is a blood testing service that tracks your bloodwork and biometric markers over time. (You can see how my biomarkers have changed over time here.)
It’s far more comprehensive than the standard bloodwork you get at the doctor. Then, based on your results, they provide dietary recommendations to optimize your health.
Ideally, you’ll use InsideTracker a few times a year so you can compare your results and track progress on certain biomarkers, especially as you age, have major life changes, or change your training load. Biomarkers to pay attention to in your InsideTracker dashboard include Vitamin D, hsCRP, creatine kinase, testosterone, ALT, and AST as those can often indicate an injury.
10. Fuel 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 also research that also shows that endurance athletes are more prone tp injuries if they are under-fueled. 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 can help identify red flags, like under-fueling, through certain biomarkers including Vitamin D, cortisol, testosterone, DHEAS, and iron. (Learn more here.)
Use this link to save 25% on your InsideTracker test.
More tips to avoid 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!
- 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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