In the mid-1970s, Runner's World medical editor George Sheehan, M.D., confirmed that he was hardly the only runner beset by injuries: A poll of the magazine's readers revealed that 60 percent reported chronic problems. "One person in 100 is a motor genius," who doesn't have injuries, concluded the often-sidelined Sheehan.
To describe himself and the rest of us, he turned to Ralph Waldo Emerson: "There is a crack in everything God has made." With all the amazing advancements in sports medicine, you'd think that our rates of shinsplints and stress fractures would have dropped since Sheehan's era. But 30 years after running's first Big Boom, we continue to get hurt. A recent runnersworld.com poll revealed that 66 percent of respondents had suffered an injury in 2009.
Still, I figured medical science must have uncovered lots of little-known prevention secrets. So I went searching for them. After reviewing hundreds of published papers, I was surprised to find few answers. Most of the studies are retrospective, looking back. A few are prospective, looking forward. Even then, they're not the gold standard, which are randomized, controlled, double blind experiments. And conflicting results make it difficult to draw meaningful conclusions.
I learned, for example, that running injuries can be caused by being female, being male, being old, being young, pronating too much, pronating too little, training too much, and training too little. Studies also indicate that the "wet test" doesn't help shoe selection, old shoes don't offer less cushioning than newer shoes, and leg-length discrepancies don't cause injuries (but too-little sleep does). Oh, here's good news: To get rid of blisters, you should drink less and smoke more.
Clearly, the medical studies wouldn't offer much help. So I switched to Plan B: I interviewed nearly a dozen of the best running-injury experts in the world. They come from the fields of biomechanics, sports podiatry, and physical therapy. Like the medical studies, these experts didn't always agree. But the more I talked with them, the more certain principles began to emerge. From these, I developed the following 10 laws of injury prevention. I can't guarantee that these rules will prevent you from ever getting hurt. But if you incorporate these guidelines into your training, I'm confident you'll be more likely to enjoy a long and healthy running life.
I. Know Your Limits
It's easy to get injured; anyone can do it. Just run too much. "I firmly believe that every runner has an injury threshold," says physical therapist and biomechanist Irene Davis, Ph.D., from the University of Delaware's Running Injury Clinic. "Your threshold could be at 10 miles a week, or 100, but once you exceed it, you get injured." Various studies have identified injury-thresholds at 11, 25, and 40 miles per week. Your threshold is waiting for you to discover it.
Of course, your goal is to avoid injury. Runner and sports podiatrist Stephen Pribut, D.P.M., warns runners to beware the "terrible toos" — doing too much, too soon, too fast. Every research paper and every expert agrees that this — "training errors" — is the number one cause of self-inflicted running injuries. The body needs time to adapt from training changes and jumps in mileage or intensity. Muscles and joints need recovery time so they can recover and handle more training demands. If you rush that process, you could break down rather than build up.
Running experts have recognized this problem, and long ago devised an easy-to-use 10-percent rule: Build your weekly training mileage by no more than 10 percent per week. If you run 10 miles the first week, do just 11 miles the second week, 12 miles the third week, and so on.
Yet, there may be times when even a modest 10 percent increase proves too much. Biomechanist Reed Ferber, Ph.D., an assistant professor in the faculty of kinesiology and head of the Running Injury Clinic at the University of Calgary says that he sees a lot of newly injured runners during that third month of marathon training, when a popular 16-week Canadian program pushes the mileage hard. Meanwhile, his clinic's nine-month marathon program for first-timers increases mileage by just three percent per week. "We have a 97 percent success rate getting people through the entire program and to the marathon finish line," Ferber says.