Running: Knowing the Basics Goes a Long Way
Over the past quarter century, running has become one of the most popular forms of exercise. People of almost any age can do it, it can be done virtually anywhere at minimal cost, and you don't have to be an athletic superstar to participate. Nevertheless, there are some basic guidelines you should know to help keep your running program productive, safe, and injury free.
Although you don't need much equipment to enjoy running, it's almost impossible to enjoy running without proper running shoes. This doesn't mean you have to buy the newest, or the fanciest, or the most expensive shoes. But it does mean buying shoes that fit properly and comfortably, are well cushioned, and give your feet and ankles proper support.
Ask questions of the sales personnel to assure a good fit. Expect to spend between $50 and $200 for proper running shoes. And expect to replace your shoes relatively frequently every six months or 350-500 miles. By that point, the shock absorbing ability of the shoe will become inadequate. But remember, miles logged on planes, trains, and in cars have little effect on your shoes!
Though often overlooked, safety concerns should be a part of your running routine. All runners should follow these basic safety rules:
- Run in familiar neighborhoods close to your home.
- Don't run in dark, secluded areas, especially at night.
- Avoid busy, highly trafficked streets.
- Take responsibility for staying clear of motor vehicles.
- Never assume a driver can see you in his mirrors.
- If you do run at dawn, dusk, or at night, wear bright clothing including at least one piece of clothing with specially designed reflectors.
- Avoid wearing headphones while running, as they decrease your awareness of surroundings.
Running injuries tend to be nagging rather than severe, but still require attention. The best approach is to avoid them. Common runner injuries can be avoided by taking some relatively simple steps. First, don't over-train. When starting your running regimen (or restarting after an injury or illness), start slowly. Never step up your running by more than 5%-10% per week. Vary your regimen by following a long, hard run one day with a short, easier run the next.
Dr. Gary Gibbons, vascular surgeon, director of the foot center at Boston Medical Center, and an experienced runner advises, "Vary the terrain you run on dirt, grass, asphalt, even opposite sides of the street. This will reduce the stress on your entire body." Take at least one or two days off each week to rest and allow your body to strengthen. You should also vary your regimen over a number of weeks, decreasing the difficulty of your training every third week. Finally, cross train. Bike or swim instead of running at least twice a week or, add biking or swimming for 10-15 minutes before running.
Along with a proper training routine, stretching is probably the most important way to prevent running injuries. Although the entire body should be stretched, it's most important to concentrate on the legs and abdominal muscles. Although sports medicine specialists will suggest a variety of stretches, at minimum you need to include an Achilles tendon and calf stretch, a lower back and hamstring stretch, a quadricep stretch, another hamstring stretch, and an abdominal stretch. And, Dr. Gibbons stresses, "It's just as important to stretch after your run as before it, especially as you get older."
Treating the Inevitable
No matter how careful you are, you're likely to eventually suffer some running-related injury. Generally, running injuries can be divided into four levels: (also known as the functional classification of pain)
- Level 1—Minor pain noticed after running
- Level 2—Discomfort or tightness noticed while running, but does not limit activity
- Level 3—Pain felt while running that begins to limit activity
- Level 4—Severe pain while running that forces you to stop
In most instances, running-related injuries begin as a level one or two injury and progress to level three or four if not treated. The key is to treat the injury quickly and properly.
Immediately ice any area that is painful or tight from running. (Ice for 10-20 minutes, let area warm, then repeat.) Ice as many times as possible each day until the symptoms abate. It is important to rest your injury sufficiently. Failing to properly rest a low-level injury can exacerbate the injury. In general:
- Level 1—may requires 1-2 days rest
- Level 2—requires 4-7 days rest
- Level 3—requires 2-4 weeks rest
- Level 4—may need 6 weeks or more of relative rest
Use anti-inflammatory medications strictly according to package instructions or physician guidance, to control inflammation, not pain. Masking pain so that you can continue to exercise after an injury will lead to a more severe injury. If a level three injury doesn't get better after a week of proper treatment, consult with a sports medicine specialist. Level four injuries warrant immediate medical attention.
Come back very slowly from an injury. Recognize that it will generally take at least as long as the time you took off due to the injury to work back to the training level you were at prior to the injury.
Unless you have access to an indoor track or live in a very temperate climate, you will have to deal with extremes of heat and/or cold. However, if you take the proper precautions, neither temperature extreme should curtail your running regimen.
Running in extreme heat poses the danger of heat exhaustion (severe dehydration) or the sometimes fatal danger of heat stroke (a failure of the body to regulate heat level). To avoid heat-related injury from running, take the following precautions:
- Stay well hydrated but avoid over-hydration.
- Drink fluids 30-45 minutes prior to running, and a cupful every 10-15 minutes while running depending upon your individual needs.
- The American College of Sports Medicine recommends drinking at intervals, to match fluid loss, along with intake of electrolytes to prevent hyponatremia (a dangerously low level of sodium in the blood).
- Build slowly, gradually increasing your running in hot weather, so as to give your system time to acclimate itself. And take into account your fitness level, since the less fit you are, the more susceptible you are to heat-related injury.
- Pay attention to humidity. Recognize that the combination of heat and humidity affects your system. For example, 85-degree heat with very high humidity puts more strain on your system than 95-degree heat with very low humidity.
- Recognize that many health conditions including diabetes, high blood pressure, the flu, and obesity, as well as many medications, can lower your heat tolerance. If you are uncertain about a condition or medication, check with your physician.
- Wear sunblock and UV-protective sunglasses when running during the day to protect against skin and eye damage.
Running in cold, wintry weather can lead to injury from slips and falls, strains or pulls due to cold muscles, and frostbite. To avoid these injuries, take the following precautions:
- Warm up well before you begin each run.
- Avoid icy areas and snowy areas. But if you must choose, remember that snow gives you much more traction than ice.
- Recognize that not just cold, but cold plus wind (the so-called wind chill factor) causes cold-related injuries, including frostbite.
- To help maintain warmth throughout your run, begin your run heading into the wind and return with the wind at your back.
- Make sure your entire body is protected. Pay special attention to your extremities head, ears, hands, and feet which are most susceptible to frostbite. Since a great deal of heat is lost through your head, be sure to wear a warm hat, and in extreme wind and cold, wear a ski mask or other protection for your face.
- Wear proper clothing. Wool is warm and helps whisk moisture away from your skin, but it can be heavy. Polypropylene and Gortex™ clothing are warm, allow evaporation of sweat, and have the benefit of being lightweight. A layer of nylon can also help lessen the effect of wind. On your feet, try a thick sock over a thinner sock as long as this does not make your foot fit too tightly in your shoe.
Finally, as with any training regimen, before you begin, it is best to get a check up with your physician. Let your health care provider know of your plans and seek their advice.
Georgia State University
Canadian Society of Exercise Physiology
ACSM Recommendations for Endurance Athletes. Am Fam Physician. February 1, 2006; 73(3); 547.
Early detection and treatment of running injuries. Team Oregon website. Available at: http://www.teamoregon.com.
Georgia State University website. Available at: http://www.gsu.edu/webprj01/coe/wwwfit/public_html/running.html.
How to avoid injuries. Dr. Pribut's Running Injuries website. Available at: http://www.drpribut.com/sports/sportframe.html.
Johnson JA. The Running Shoe. In: O’Connor FG, Wilder RP, ed. Textbook of Running Medicine. New York: McGraw Hill; 2001:589-594.
Wilder RP, O’Connor FG. Evaluation of the Injured Runner. In: O’Connor FG, Wilder RP, ed. Textbook of Running Medicine. New York: McGraw Hill; 2001:51.
Last reviewed February 2008 by John C. Keel, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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