OT: Avoiding running injuries

[dgauthier]

I've noticed a few threads on running the last little while, so I thought I'd pick the brains here.

I *love* running, but for the past couple of decades every time I attempt to start any regular running regimen after a couple of weeks I end up with a painful calf strain that takes 4 weeks to heal. I got into cycling because of this, but just because I enjoy riding a bike doesn't mean I still wouldn't love to be able to run injury-free.

For those of you who bike and run, how do you avoid injury like calf strains? I've googled the topic, but the info I've found so far only contains vague recommendations to stretch and warm up. Hey, I stretch, I warm up, I still get injured. Does the smart, educated, athletic crowd here have some more specific advice?

[cnighbor1]

running over extends the muscles and tendons while cycling does the opposite
i.e you don't fully bring your leg into its full length while cucling
Need to see trainer who knows how to be prepared to do both

[false_Aest]

You should make an appointment with a PT or trainer instead of hitting up the forum.

Here's my recommendation: Matt Stodolsky (http://www.yelp.com/biz/orthopedic-and-physical-therapy-specialists-los-angeles)

[beercan]

Run really slowly for awhile and eventually the rest should follow. People tend to overboard too quickly and end up with injuries. Maybe pick up a jumprope to strengthen your calves.

[Dead Man]

I easily avoid running injuries by avoiding running.

[mhespenheide]

D,

As someone who's relatively in shape from cycling, you're probably going too hard/too fast/too long for someone starting out running. Try to dig up a training schedule that's targeted towards a complete beginner and use that as guideline for your running -- while continuing your cycling as appropriate.

I know that I've done similar things and that I have to be more careful than I would figure when I get back into running again.

Good luck,
Mark.

[mgm777]

dgauthier,

I have been an avid runner my entire life. It has been my experience, every time I suddenly increase either the distance, frequency, or speed of my running workouts, I will suffer from an injury. Usually, the onset of the injury lags 2-3 weeks after the sudden ramp-up of my running load. I suspect the reason you keep getting injured is that you never fully acclimate your body to running and gradually build-up your running fitness. You get motivated, begin an aggressive running program, increase the distance, frequency, or speed of your runs too suddenly, and then you get injured. Stop, rinse, repeat. This cycle is very common for new runners. I humbly suggest you build up your running fitness gradually. Slowly increase your distance, frequency of runs, and speed. Let your body adapt to running, very slowly. You want to build a solid foundation. In the long term, you will be a much stronger runner, with less injuries, with this approach. Just my two cents.

[holliscx]

You're getting golden advice here.

A common problem with cyclists starting running is that their cardiovascular condition exceeds their specific tendon/muscular condition. The good news is that the main thing you have to do is get this specific capacity up to par, i.e. your calves. Luckily this build up of specicfic capacity is relatively fast as long as you keep running, at least that is my experience. As others have said you need to build up slowly, decrease your pace, and also consider running on forgiving surfaces such as trails vs asphalt which can exacerbate injury.

[rockdoc]

If the strains are usually on the same side, you have some imbalance causing muscle hypertonicity. It is really easy to strain muscles that are already tight for some reason. In my applied kinesiology chiropractic practice I see this every day. Leg muscle imbalances almost always come from one or a combination of factors, including instability of the ankle; instability of the tibia/fibula, which stretches the sciatic nerve shutting off various big important muscles like hamstrings and glutes; instability of the sacroiliac joint which inhibits gluteus maximus, causing atrophy there and further destabilizing the SI joint, a vicious cycle and which leads to overcontraction of piriformis, aggravating the sciatic nerve and all the muscles of the leg; and a big often undiagnosed one, iliopsoas tightness, which upsets pelvic girdle balance as well as compressing the lumbar spine causing lumbar irritation, leading to leg imbalances. All these usually lead to chronic calf muscle tightness, making them very easy to strain.

The key is regaining and maintaining stability of the various joints, regaining muscle balance, and removing nerve irritation where it exists. The instabilities I find are very often from old injuries years or decades ago that never really healed; but just stopped hurting. Broken bones heal to as strong as before the break; sprained joints just stay unstable. And muscles develop adhesions when they're hypertonic for even a couple of weeks. So in addition to finding and fixing the reasons for muscle imbalances, the muscles need massage and myofascial work to erase some or most of the adhesions and trigger points.

Trying to run with a set of leg muscle imbalances is risky. Especially as we age. I am a big proponent of walking. A lot of what I do is get patients stable and balanced so they can walk properly, and that means with long enough strides to activate the glutes and stretch the iliopsoas and hamstring muscles, as well as with upper body rotation during the stride bringing the opposite shoulder forward to twist the spine and ribcage with each step. Walking like this re-integrates the entire neuro-musculoskeletal system. Walking without the upper body rotation leads to further imbalances. I have a bunch of older runners who have benefited quite a bit by walking properly before and after their runs; sometimes during for marathons.

A couple of key signs to look for are pronation in one or both feet, where the ankle falls inward; one butt cheek smaller than the other indicating atrophied glutes on that side; tightness in one or both sides low back muscles-quadratus lumborum.


Steve

[verticaldoug]

Is your preferred running route hilly? If so, try to pick a flatter route or run the hills more slowly. The hills (up and down) will put a lot more strain on the calf.

Walk on your toes forward and backwards to strengthen the calf. Try 10 or 15 yards.

Heel drops on a stairs to stretch out the achilles.

Get a shoe with a little more heel. The barefoot style shoes are not for everyone. You might want to try a ASICs KAYANO with 9mm. The shoe seems a bit clunky, but is robust.

[old2new]

Definitely stretch out the achilles on stairs. Make sure you hold on to railings so no chance of slipping and cause an injury.
I would also see a good sports Podiatrist or Chiropractor who could evaluate you for orthotics. If you are a severe pronator or have an extremely high arch you will continue to battle calf injuries.
Upon heel strike the foot needs to go into a natural movement where it transfers the impact across the metatarsals for push off. With pronators the weight is all concentrated to the 1st metatarsal so the foot arches collapse, causing the achilles to bow pulling the gastocs (calf) with it. A good indicator if you are a pronator is a callous formation under the ball of the big toe.
This injury is less of a problem on the bike because you are not weight bearing and their is no impact.

[Climb01742]

If the strains are usually on the same side, you have some imbalance causing muscle hypertonicity. It is really easy to strain muscles that are already tight for some reason. In my applied kinesiology chiropractic practice I see this every day. Leg muscle imbalances almost always come from one or a combination of factors, including instability of the ankle; instability of the tibia/fibula, which stretches the sciatic nerve shutting off various big important muscles like hamstrings and glutes; instability of the sacroiliac joint which inhibits gluteus maximus, causing atrophy there and further destabilizing the SI joint, a vicious cycle and which leads to overcontraction of piriformis, aggravating the sciatic nerve and all the muscles of the leg; and a big often undiagnosed one, iliopsoas tightness, which upsets pelvic girdle balance as well as compressing the lumbar spine causing lumbar irritation, leading to leg imbalances. All these usually lead to chronic calf muscle tightness, making them very easy to strain.

The key is regaining and maintaining stability of the various joints, regaining muscle balance, and removing nerve irritation where it exists. The instabilities I find are very often from old injuries years or decades ago that never really healed; but just stopped hurting. Broken bones heal to as strong as before the break; sprained joints just stay unstable. And muscles develop adhesions when they're hypertonic for even a couple of weeks. So in addition to finding and fixing the reasons for muscle imbalances, the muscles need massage and myofascial work to erase some or most of the adhesions and trigger points.

Trying to run with a set of leg muscle imbalances is risky. Especially as we age. I am a big proponent of walking. A lot of what I do is get patients stable and balanced so they can walk properly, and that means with long enough strides to activate the glutes and stretch the iliopsoas and hamstring muscles, as well as with upper body rotation during the stride bringing the opposite shoulder forward to twist the spine and ribcage with each step. Walking like this re-integrates the entire neuro-musculoskeletal system. Walking without the upper body rotation leads to further imbalances. I have a bunch of older runners who have benefited quite a bit by walking properly before and after their runs; sometimes during for marathons.

A couple of key signs to look for are pronation in one or both feet, where the ankle falls inward; one butt cheek smaller than the other indicating atrophied glutes on that side; tightness in one or both sides low back muscles-quadratus lumborum.


Steve

This^^

There is a great deal of very good info from rockdoc. His explanation closely matches my experience. Odds are, there are underlying imbalances and restrictions in your body. If you can find a good, holistic chiro, PT or massage therapist near you who really understands athletes, get thee to them. I'd bet they could help a lot. As athletes we tend to believe our willpower can overcome anything. But our bodies, and old injuries, often disagree. Good luck!;)

[mecse]

I've noticed a few threads on running the last little while, so I thought I'd pick the brains here.

I *love* running, but for the past couple of decades every time I attempt to start any regular running regimen after a couple of weeks I end up with a painful calf strain that takes 4 weeks to heal. I got into cycling because of this, but just because I enjoy riding a bike doesn't mean I still wouldn't love to be able to run injury-free.

For those of you who bike and run, how do you avoid injury like calf strains? I've googled the topic, but the info I've found so far only contains vague recommendations to stretch and warm up. Hey, I stretch, I warm up, I still get injured. Does the smart, educated, athletic crowd here have some more specific advice?

Go and see a pro about this before you start. Running is great, but has lots of variables too: shoes, running surface, your body.

[coffeecake]

Lots of good advice here. I agree that the most important thing is to avoid going overboard. The rule of thumb I hear thrown around is to increase your distance by no more than 10% each week. Doing so requires discipline because after participating in cycling, 4 or 5 miles seems short. You must start slowly in order to build up muscle strength and prevent injuries.

[Chris]

I've started running this year for a few different reasons. It was a tough transition and continues to pose some challenges. I have a plantar fibroma that I am trying to work around at the same time, so I have spent some time with the podiatrist and a pretty knowledgeable guy at the running store. What I have noticed most is what has been alluded to earlier. I need to spend a lot of time focusing on stretching, primarily my calves and a slow methodical build was important. I started running really slow. Breathe through the nose slow and am just starting to up the tempo to a more rhythmic pace. The guy at the running store and my wife who is a runner also emphasized running form. I was running really up and down in this plodding type manner when I should have been running lower to the ground and more elliptical in nature. That has helped with the impact of running. The experiment continues.

[dgauthier]

Well, this is about 100,000 times better info than I've seen elsewhere. Thanks!

False_Aest, thanks for the recommendation. It has occurred to me to consult with a sports medicine specialist.

Rockdoc, my calf strains happen on both calves. I supinate rather than pronate while both walking and running. My running style is almost entirely on the forefoot, with little to no heel strike, which is probably why my calves take the brunt of the load. It all worked fine when I was 18 . . .

mgm777, your experience sounds the most like mine, right down to the 2-3 week lag.

Last time I tried to run was about 2 years ago, so I'm currently uninjured (and untrained). What would be a reasonable distance to limit myself to when starting from zero?

[tmf]

As someone who has been down this road a few times (former runner, start back running to have injuries as I ramp up), here are some tips that have helped me.

- start really slowly. At first, think of it as jogging/walking more than running. Stop every few minutes and walk for a minute or two.

- do some initial running/walking on a treadmill if possible. For me, the treadmill is more forgiving on my legs. I still like to warm up for 10-20 minutes on the treadmill before going out to run. I usually start with a brisk walk up to moderate jog pace for at least 10 minutes.

- plan to ride at least a little after you run - either on the road or on a trainer. This has been probably the best way to help my legs stay in good condition. I can tell a big difference if I don't ride even a little after a run

- run on dirt or crushed gravel trails when possible. It's easier on the legs, and I enjoy the scenery.

- as you ramp up more running time/distance, continue to incorporate some short segments of walking (1-2 minutes at a time).

- go to a good running-specific store to have your stride/gait analyzed either by video or by a trained eye. Make sure you have the proper shoes. I like having 2-3 pairs of good shoes that I rotate between during the week. For years I thought I overpronated. After two gait analyses at two different stores, I found out my stride is neutral. I think things have been a lot better since shifting to "neutral" shoes.

As the weather gets colder and colder, my goal is to start running more as I ride less.

[Daveyk]

I went through the same cycle for over a year before my calves could last as long as my lungs. I tried many things so not sure which ones worked.

Running form - more striding and less up and down trotting. Keep good posture and don't lean forward.

Shoes - Find right pair of running shoes and stick with the same model. Proper arch support helped.

Massage - deep, deep tissue massage to get rid of the knots, others referred to adhesions.

Regular stretching - against wall first with legs straight, then with knees bent to get Achilles area also. There is a blue plastic thing that seemed helpful, but not necessary.

Strengthening - high volume, lower weight calf presses on a Pilates or leg press machine. 8 to 10 sets working way down from 20 reps to 8.

Don't overdue it - it got to a point where I could feel the spasm coming. Stop then before you lose another 2 weeks to recover.

Search "calf heart attack" - I used that method of run/walk to recover. Not sure if it helped, but at least there was a method to getting better.

[jmoore]

I easily avoid running injuries by avoiding running.

this



running suck, hth

[guido]

Get this book:
http://www.amazon.com/Anatomy-Runners-Unlocking-Potential-Prevention/dp/1620871599/ref=tmm_pap_title_0?ie=UTF8&qid=1414679085&sr=1-3

Do the exercises carefully and regularly every day.

Start slowly on trails or grass using run/walk approach.

Enjoy!

[rockdoc]

Rockdoc, my calf strains happen on both calves. I supinate rather than pronate while both walking and running. My running style is almost entirely on the forefoot, with little to no heel strike, which is probably why my calves take the brunt of the load. It all worked fine when I was 18 . . .


running is best with heel strike, rolling through the foot arch, and pushing off with the big toe. Forefoot strike does put a lot of stress on the feet, and the gastrocnemius and soleus muscles as well as the Achilles tendon and the calcaneus. Good habit to change.

[jpw]

run on a sandy beach.

[twangston73]

I recently managed to complete a marathon after a couple of prior unsuccessful attempts that ended in injury. I used a training system that called for lots of slow running before getting too aggressive with pace - it seemed almost painfully slow at times - but it was a good way to build strength without injury. The other thing I came to discover was that increased cadence is your friend. Quicker shorter strides are more efficient, result in less energy wasted on bouncing up and down, and keep you from decelerating with each overlong stride. Have fun and good luck!

[mecse]

I've noticed a few threads on running the last little while, so I thought I'd pick the brains here.

I *love* running, but for the past couple of decades every time I attempt to start any regular running regimen after a couple of weeks I end up with a painful calf strain that takes 4 weeks to heal. I got into cycling because of this, but just because I enjoy riding a bike doesn't mean I still wouldn't love to be able to run injury-free.

For those of you who bike and run, how do you avoid injury like calf strains? I've googled the topic, but the info I've found so far only contains vague recommendations to stretch and warm up. Hey, I stretch, I warm up, I still get injured. Does the smart, educated, athletic crowd here have some more specific advice?

Actually, a fun question, what kind of running shoes do you wear? Do you wear inserts?

[harryblack]

I've noticed a few threads on running the last little while, so I thought I'd pick the brains here.

I *love* running, but for the past couple of decades every time I attempt to start any regular running regimen after a couple of weeks I end up with a painful calf strain that takes 4 weeks to heal. I got into cycling because of this, but just because I enjoy riding a bike doesn't mean I still wouldn't love to be able to run injury-free.

For those of you who bike and run, how do you avoid injury like calf strains? I've googled the topic, but the info I've found so far only contains vague recommendations to stretch and warm up. Hey, I stretch, I warm up, I still get injured. Does the smart, educated, athletic crowd here have some more specific advice?

this question, not criticism, because I used to say same thing but what do you mean by "calf strain"?

that could be a # of different things: gastroc, soleus, posterior tib etc. smart podiatrist or sports chiro can have very educated guess though ultra-sound takes most guesswork out.

in any event, it's a strength, flexibility &/or possible structural imbalance issue, you just gotta figure out which!

what kind of miles, frequency, long runs are getting you into this trouble?

meantime, for basic maintenance i'd recommend keeping a lacrosse ball, a 5" styrofoam ball and the sprinter model of "The Stick" (or similar) around.

if you can afford it, regular massage is great complement though the more you can take care of yourself the better in terms of future prevention.

[Louis]

run on a sandy beach.

Running down these was really fun. (Great Sand Dunes National Park, in SE CO)

http://media-cdn.tripadvisor.com/media/photo-s/03/3e/13/5e/great-sand-dunes-national.jpg

[Daveyk]

^^^^ Looking at this makes my calves hurt.

[Dave Ferris]

More or less copy & pasting a post I did last year. Added some additional thoughts and had to replace all the bad links.

Been at this running thing for 33 years. Probably close to 65,000 miles covered. I used to race a ton, all distances, but now just run simply because I have an intense passion for it.

I'm 61 and while I'm still running at a pretty high level for my age group, at around age 58 , I had to force myself to get on the bike once or twice a week. The bike is not enjoyable for me, more like a chore, but I think it will prolong my running and keep me at a good quality level. I don't wanna be that old guy plodder you see out on the road and wonder if he's going to freeze up at any second. If I ever lose that semblance of turnover, then it will be time to retire to all bike-like a lot of my friends-- who all wish they were still running..lol

All good advice given here. Just to echo some of the things mentioned already and maybe throw in a few other suggestions for the long run--

Even if it means driving a bit to a park, or track at a school, try and stay on even soft surfaces with no hills. As much as I love running on the trails here in LA , they are very hilly, rutted, uneven and rocky. This can play havoc on ankles, shins, feet and even balance. Dirt roads are great. Unfortunately we don't have such an animal here in LA. It's either fireroads, single track trails or roads (where all the cars are :crap: ) .

Don't underestimate the value of going into a legit running store and having them watch your form in relation to pronation, supination. I've worn orthotics off and on most of my running career. I'm back on them again and they are helping with my stage 4 Hallux Rigidus condition (stiffening of the big toe joint ).

Nothing wrong with alternating walking breaks in there when starting out or up again. Always do less and finish feeling like you could have done more. Save it for another day. Run by time not miles. Ice and rest are your best friends. After every run that ends at my house...within one minute I have the high pressure hose in front of my house spraying my legs, calves, quads, hamstrings down with cold water. Takes a lot of the lactate acid buildup out. Your legs feel immediately lighter.

The trigger point massage thing with the rollers are very important in flushing out the lactate acid from your quads. I've found this one to be outstanding
http://www.tptherapy.com/Shop/Product-Viewer/The-GRID-Foam-Roller

I've fought chronic hip pain for over 20 years. The culprit is the sacrotuberous ligament in the hip. This little ball saved my running.
http://www.tptherapy.com/Shop/Product-Viewer/TP-Factor-Massage-Ball

I use this everyday .For the achilles, calf, arch, plantar :
http://www.roadrunnersports.com/rrs/products/PTU100/prism-step-stretch/

Also stand on my slant board
http://www.fitter1.com/Fitterfirst-Slant-Board_p_169.html

and use the aforementioned "stick" everyday
https://www.thestick.com/cgi-bin/commerce.cgi?preadd=action&key=HW-2300

Even short intervals of one leg standing/strengthening at home, gym or office on balance or wobble boards will pay off huge dividends in preventing injuries. This company is the best resource for balance/wobble/rocker boards. Pricey for sure but high quality stuff.
http://www.fitter1.com/Professional-Rocker-Board_p_21.html
http://www.fitter1.com/Professional-Balance-Boards_p_20.html

Just standing on one leg on these Bosu Balls is great for balance and addressing muscle imbalances. Sorry for the lame video but you get the idea.
https://www.youtube.com/watch?v=ePMMTnEfixw

Incorporate one leg regular and half squats, lunges and step ups. All done with very light weights or just body weight. I started doing all of this balance/core/trigger point massage stuff in my early 40s and without a doubt it has been crucial to keeping me in the ballgame while all my high mileage friends, who would laugh at me when I would take a day off from running and go to the gym, had to retire or go strictly to the bike.

Good luck with it. A lot of it is really common sense and not doing too much too soon and too frequently.

[dgauthier]

this question, not criticism, because I used to say same thing but what do you mean by "calf strain"?

A tear in the muscle fibres. Right in the center of the calf, midway between the heel and knee. You can hear it when it happens: sounds like canvas tearing.

what kind of miles, frequency, long runs are getting you into this trouble? ( . . .) meantime, for basic maintenance i'd recommend keeping a lacrosse ball, a 5" styrofoam ball and the sprinter model of "The Stick" (or similar) around.

Practically nothing, since I'm always starting from zero: brisk walking for 20 minutes to warm up; sprint until tired (1-2 minutes); walk until recovered (5-10 minutes); repeat for about 60-90 minutes. Do every other day for 2-3 weeks until injured, then stop. Resume in 2 years. ;) Thanks for the tips!

[mecse]

Practically nothing, since I'm always starting from zero: brisk walking for 20 minutes to warm up; sprint until tired (1-2 minutes); walk until recovered (5-10 minutes); repeat for about 60-90 minutes. Do every other day for 2-3 weeks until injured, then stop. Resume in 2 years. ;) Thanks for the tips!

Sprints are the most challenging on your body. What are your goals with running?

See if you can get a coach / training plan for a goal of some sort. You'll probably (I'm guessing!) be told to do less sprinting.

[oldpotatoe]

I easily avoid running injuries by avoiding running.

glad somebody said it.and I loved to run before I got hurt, running.

[verticaldoug]

A tear in the muscle fibres. Right in the center of the calf, midway between the heel and knee. You can hear it when it happens: sounds like canvas tearing.



Practically nothing, since I'm always starting from zero: brisk walking for 20 minutes to warm up; sprint until tired (1-2 minutes); walk until recovered (5-10 minutes); repeat for about 60-90 minutes. Do every other day for 2-3 weeks until injured, then stop. Resume in 2 years. ;) Thanks for the tips!

I hope this is a sarcastic comment, because doing this will probably result in almost everyone on this forum to get injured unless you are already a track runner.

You can't possibly have the elasticity to take this pounding. Essentially, it is going to a high school track and doing a 10x400. You need a high level of fitness to do this.

Periodicity in running is more important than cycling because the cumulative pounding will eventually result in injury. You need to build into the sprinting.
Insanity is doing the same thing over and over again and expecting a different result.

The advice on this board is mostly if you want to go out and run 5k/10ks at a reasonable clip and stay healthy. Sprinting is a different kettle of fish.

[laupsi]

saw this in the wsj yesterday. while I no longer do any running whatsoever I've often experienced the "stitch" when I did run and often wondered what caused it. since becomming a cyclist over 30 years ago I've never experienced the "stitch" while on a bike.

[dgauthier]

I hope this is a sarcastic comment, because doing this will probably result in almost everyone on this forum to get injured unless you are already a track runner.

Not sarcastic, just a bit tongue in cheek, but essentially accurate. I must admit, when I posted that, the word "sprint" jumped out at me.

You ever have a problem you can't figure out and when you explain it to someone else all of a sudden the solution is clear? That's kind of what happened here. As many of you have already pointed out, I'm just going too hard. (I'm sure what I call sprinting looks more like your grandmother sprinting, but still, too hard is too hard . . . )

Thanks for all the terrific information! I'll use it, coupled with toning it waaaaaayyy down.

[mecse]

Not sarcastic, just a bit tongue in cheek, but essentially accurate. I must admit, when I posted that, the word "sprint" jumped out at me.

You ever have a problem you can't figure out and when you explain it to someone else all of a sudden the solution is clear? That's kind of what happened here. As many of you have already pointed out, I'm just going too hard. (I'm sure what I call sprinting looks more like your grandmother sprinting, but still, too hard is too hard . . . )

Thanks for all the terrific information! I'll use it, coupled with toning it waaaaaayyy down.

Woohoo! Go slow. The other thing: shoes make a big difference.