As an orthopaedic sports medicine surgeon, I am fortunate to treat athletes of many skill levels across many disciplines. Unfortunately, the nature of my practice means I regularly see patients struggling with broken dreams and changed race plans as a result of an injury. In fact, I was one of these individuals in 2012. I can speak as a physician and an athlete because my 2012 season was derailed by a femoral stress fracture. My plans of competing in the Boston Marathon and Ironman Lake Placid were cancelled because of preventable mistakes. Fortunately, most overuse injuries can be avoided by following a few simple guidelines.
The best injury treatment is prevention.
These simple guidelines can be used to build toward a successful race regardless of the distance or your expected finish time.
Phase One: Prepare to Train
Before you begin a specific training program, focus your efforts on establishing a realistic race goal and developing core strength. The time period required to train for and achieve your goal will depend largely on your beginning fitness level.
Many injuries occur because the start of training and the goal race are simply too close together. A shorter preparation time requires both the volume and intensity to be advanced quickly.
Necessary core strength can be developed from three to four quality sessions of core strengthening per week. This can include the exercises discussed in this article by coach Ryan Warrrenburg of ZAP Fitness, as well as planks, reverse planks, sit-ups, back extensions, box jumps, etc.
If you are a runner with poor flexibility, this can be addressed with yoga or focused stretching sessions; however, not all runners will need this flexibility focus. If a muscle is tight, then the tendon and its insertion to bone are at risk during the repetitive load of running. The glutes, piriformis, quads (as they cross the hips) and the gastroc-soleus complex are common areas of injury resulting from poor flexibility.
Establishing a realistic goal and developing core strength to train for your goal will help you prevent injuries.
Phase Two: The Build
This phase should include steady state and easier running. If you are returning from injury or an extended time away, use a run/walk progression. This program will allow for sequential gains in run volume in a safe manner. Please note that your core program should continue at a frequency of two to three sessions per week.
Evaluation of appropriate shoes and gait is also crucial. A high-quality gait analysis can demonstrate weaknesses or overload issues. If you are going to run in a minimalist shoe, please educate yourself and be aware of the possible complications.
Phase Three: Training
This phase assumes that you have already established excellent core strength, built up a solid run/walk volume, and have a gait and shoes that are adequate. Intensity and volume should be advanced in a safe and sequential manner.
Avoid "running off" stresses of your work or home life. Be careful of loading up your weekends with back-to-back long runs because that is the only time you have to run longer. A plan written by a coach and by you, if you have the experience, several weeks in advance is helpful to prevent overtraining. Your plan should account for your ultimate race goal, monthly gains in intensity and volume, and weekly and daily run volume.