IV. Use Strength Training To Balance Your Body
You need something — and what better than muscle? — to keep your body properly aligned while you're running down the road at 450 pounds of crunching, twisting-in, and torquing-out force per stride. According to Ferber, it's particularly important to strengthen the hip muscles. He claims his clinic has cured 92 percent of knee injuries with a hip regimen. "Strengthening the hips is optimal for effective rehabilitation, as opposed to treating the area where the pain is located (e.g., your knee)," he says. "When you strengthen the hips — the abductors, adductors, and gluteus maximus — you increase your leg stability all the way down to the ankle."
You don't want to train for bulging muscles. You need just enough core, hip, and lower-leg strength training to keep your pelvis and lower-extremity joints properly positioned. "Healthy running should be as symmetrical and fluid as possible," says Michael Fredericson, M.D., associate professor of sports medicine at Stanford University School of Medicine. "If you don't have muscle balance, then you lose the symmetry, and that's when you start having problems." For a strength-training routine, visit runnersworld.com/injuries.
V. RICE Works
When you've got muscle aches or joint pains, there's nothing better than rest, ice, compression, and elevation for immediate treatment. These measures can relieve pain, reduce swelling, and protect damaged tissues, all of which speed healing. The only problem with RICE is that too many runners focus on the "I" while ignoring the "RCE." Ice reduces inflammation, but to ice-and-run, ice-and-run, without giving the tissues enough time to heal, is a little like dieting every day until 6 p.m. and then pigging out. And so Bruce Wilk, an orthopedic rehabilitation specialist in Miami, has added another letter to the acronym, spelling out PRICE. The P stands for "protection," which means don't run until the injury is better.
RICE is most effective when done immediately following an injury. If you twist your ankle or strain your hamstring, plan to take a few days off from running (see Law II). Apply ice — for 10 to 15 minutes at a time, several times a day. A homemade ice pack — a baggie filled with ice cubes and water — is best. A bag of frozen vegetables is also effective. If you can, elevate the area (easy for foot and ankle injuries, not so much for hip or hamstring issues) to limit swelling. Compression can also further reduce inflammation and can provide pain relief, especially when you first return to running. An ACE bandage is the simplest way to wrap a swollen area, but Amol Saxena, a sports podiatrist in Palo Alto, California, uses a compression dressing with 3M Coban, a self-adherent over-the-counter product. He then uses Kinesio Tex Tape or a Darco Body Armor Walker for when the swelling goes down. "The tape pulls up the skin slightly, allowing more blood to flow to the injured area," he says. He teaches runners, including 2008 Olympic bronze medalist Shalane Flanagan, how to put it on themselves.
VI. Run on a Level Surface
Here's another factor that could have a significant impact on running injuries, but has been rarely studied: road camber. No doubt you always run on the left side of the road facing traffic. That's good for safety reasons. But it also gives you a functional leg-length discrepancy, since your left foot hits the road lower on the slope than your right foot. You're also placing your left foot on a slant that tends to limit healthy pronation, and your right foot in a position that encourages overpronation. And you're doing this — running in an unbalanced way — 160 to 180 strides a minute for mile after mile, day after day, week after week. Clint Verran, a physical therapist in Lake Orion, Michigan, sees the results of this cambered running in his clinic, where he treats a higher incidence of left-hip injuries in runners than right-hip injuries.
Follow these expert tips and rules for safer road running.
True, it's not easy to escape cambered asphalt. And safety concerns demand that you run on the left side of the road. So now you've already got two strikes against you. To avoid strike three, remember that road camber can cause problems. If you're increasing your mileage, feel an injury coming on, or are returning from injury, try to do some of your training runs on a level surface like a bike path or dirt trail. The local track also provides a firm, essentially flat surface that's great for slow-paced running. (When you do faster interval training on a track, you put unequal torque on your feet and legs due to the need to keep turning left, so be careful if you are injury prone.) Also consider the treadmill. It's hard to imagine a better surface for balanced running. At the very least, a treadmill provides a great surface for beginning runners, runners who are recovering from an injury, and perhaps even marathoners aiming to increase mileage without increasing their injury risk.