Advice on Injury Free

Russ Toronto, M.D.

Most injuries in endurance sports such as running are overuse injuries.

Overuse injuries are results of repetitive stress or strain on skeletal tissues and include tendonitis, bursitis, stress fractures and synovitis (inflamed joints).

General-factors that can help prevent injury are:

Adequate nutrition to fuel the activity and help the tissues rebuild themselves;

Adequate fluid intake before, during and after activity;

Adequate rest from activity to allow healing and rebuilding after breaking down from the activity.

Some general quidelines to prevent iniuries:

Don’t increase mileage by more than 15% per week.

Avoid back to back days of running until you can run the distance you want to go every other day.

Don’t run through pain in a joint if the pain continues to increase through a run.

Specific -factors

Most runner injuries result from one of the following:

Training error -increasing miles too fast, adding speed when not trained to, too much back to back running without rest.

Equipment failure: shoes -either the wrong kind for your foot or wearing them too long (> 300-400 miles); know what kind of shoe you need -motion control or cushion.

Anatomical problems such as inadequate strength in quads, degenerative joint disease, imbalance in flexibility or alignment.

What is OK to train through?

Most overuse injuries will start with a pattern of pain after workout then proceed to cause some pain early in the workout that goes away during workout and then comes back to the end of the workout. If activity is modified with more rest, shoes are changed if needed and utilizing an anti inflammatory such as naproxen (Aleve) or Ibuprofen (Advil) and ice can alleviate the symptoms. It’s ok to work through the pain as long as it doesn’t alter gait and last for more than an hour after workout.

Don’t run through pain. lf something starts to hurt stop and walk for 3-5 minutes, then try to run again. lf the pain comes right back finish by walking. lf the pain goes away and then is sore after but goes away within 1-2hours its ok to run again after a day off.

lf a pain occurs earlier and earlier in your runs either rest for a week and cross train on a bike or walk, then try again. lf it reoccurs again at the same time in your run get it checked.

Taking Medication

Tylenol is for pain only and is not an anti inflammatory

Ibuprofen can be used as a pain reliever and anti inflammatory: to have anti inflammatory effect one must take 3xday at 600-800 mg for 3 days to receive maximum effect. Aleve or Naproxen would be (2) twice a day for 3 days.

If taking for more than 7 -10 days should have injury checked.

Ice can be helpful to alleviate inflammation if used 20-40 minutes after activity

Remember -long term goal is participation. Sometimes short term training changes and aggressive inflammation control can allow continued participation in your long term goal.

Fluid/Nutrition Support

For runs up to 30 minutes: 12-16 oz of fluid ½ hour before run with electrolytes (Gatorade).

Replacement for more than ½ hour: 8 oz fluid for every ½ hour of activity. lf sweating replacement with electrolyte (PowerAde, Gatorade, etc).

For marathon length: Add sugar containing candy Jolly ranchers, gummy bears, etc) continually through race to replace energy stores in muscles.

To “carbo load”: Eat highest carbohydrate containing meal (bread, pasta, etc) within 2 hours of exercise for 3-5 days before event.

Distances to train:

Can run 5K with 3-4 miles long run.
Can run 10K with 5-7 mile long run.
Can run ½ marathon with 10-12 mile long run.
Can run marathon with 18-20 mile long run.