Running Tips: Preventing Injuries and Getting Race Ready

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Article featured on Emory Healthcare

Runners experience all sorts of health benefits, such as better heart health, stronger bones, building muscle and maintaining a healthy weight. But just like in any sport or activity, runners risk getting injured.

Running Tips for Beginners

Never run before? No problem. “Start slow and be patient with your progress,” advises Dr. Mason. “Before starting, talk to your primary care provider to make sure you’re ready to do vigorous exercise like running.”

  • Start with a walk-to-run program: Dr. Mason recommends a program that slowly shifts intervals of walking to running. You can do this by breaking your time into five-minute intervals (for example., a 20-minute workout would have four intervals of five minutes). For the first two weeks, walk for five minutes (a 5:0 walk-run ratio). After that, walk for four minutes and speed walk/jog for one (a 4:1 walk-run ratio). Two weeks later, walk for three minutes and run for two (a 3:2 walk-run ratio). Keep increasing every two weeks until you are running the entire time.
  • Take rest days: Beginning runners can expect soreness as they start their new exercise routine. Start by running every other day or three to four days a week. That way, your body has time to recover between runs.
  • Get good shoes: A specialty running store can analyze your stride (gait) and footfall and help you pick a shoe that’s right for you. Everyone runs in their own unique way, and the shoes your friend wears to run might not be good for you. Finding the right shoes can help prevent injury.
  • Where to run: While running on pavement can be hard on your knees, runners can get injured on any surface. Hard surfaces, like sidewalks, transfer more force to your knees. But softer surfaces, like trails, are less stable and have a higher risk of ankle injury. Dr. Mason suggests mixing up your running surface and routes to strengthen your legs and keep you balanced.
  • Increasing speed and distance: It’s safer to increase how fast or far you run gradually. First, increase your distance, then improve your speed. Start by increasing your distance by a half mile a week. Once you reach five miles a week, you can focus on picking up your pace. You can also add short sprints into the middle of your workout to increase your overall speed.
  • Prevent side stitches: Stay hydrated, avoid large meals a couple of hours before running, avoid sugary training snacks and focus on your breathing. Match your breathing rhythm to your running stride and take periodic deep breaths to keep oxygen flowing and avoid side aches.
  • Eat enough: Make sure you are eating enough and getting all of the macronutrients: protein, fat and carbohydrates. Sometimes the amount of nutrition we need to run can surprise us! Dr. Raiser believes that all runners can benefit from meeting with a sports dietician to help optimize your nutrition. But keep in mind that you should spread your food intake out to 5 to 6 meals throughout the day to optimize the absorption of important nutrients and keep your energy balanced throughout the day. If you regularly eat too little, you may have insufficient nutritional intake, which can lead to low energy availability—and can show up as fatigue, recurrent injuries (especially bone stress injuries), poor performance, and many other medical issues.

Running Advice When Training for a Race

Have your sights set on a race? Setting a goal like this can help structure your training as you work toward race day.

  • Training in the heat: Both doctors emphasize hydration before, during and after you train. When it’s hot outside, water alone may not be enough. Drink electrolytes to replenish what you lose when you sweat. Wicking or dry-fit clothing helps move heat away from your body.
  • Speed work: More experienced runners can use interval training to improve their pace. Add some high-intensity bursts in the middle of your runs.
  • Cross-training and prehab: When training for a race, you may think you should focus all your energy on running. But cross-training can actually help improve your running performance and help prevent injuries. Dr. Raiser emphasizes that “Runners need to train to run; this involves more than just running. This means that strength and agility training, general aerobic training, and mobility work are important for making you a better runner and avoiding injury.” Activities like swimming, cycling, rowing and weightlifting can help you increase your endurance and strength. “Prehab” exercises can help runners strengthen and stabilize their muscles and joints to prevent common running injuries.
  • The day before the race: Wondering if you should train the day before a race? “That depends on the level of runner you are,” says Dr. Mason. “If you’re a beginner, I recommend taking a rest day before a race. If you’re an experienced runner, take the day off or go for a short, easy jog to loosen your muscles and relieve nervousness.”
  • Warm up before a race: To stretch or not to stretch? Some people believe that extensive stretching can impact your performance. And overstretching cold muscles can lead to injury. The doctors suggest runners start with five to 10 minutes of light aerobic activity to warm up the muscles and joints. Then do light stretching, like a simple calf, hamstring or quad stretch.

Prevent and Treat Common Running Injuries

Some soreness and mild discomfort are normal when you start a running routine. But any pain should resolve in a few days or weeks. If pain lingers or gets worse, you might be injured.

Achilles tendonitis

Your Achilles tendon connects your calf muscles (in your lower leg) to your heel bone. Runners can experience tendonitis in their Achilles if they increase distance or speed too quickly or if they have abnormal running mechanics. Tight calf muscles or excessive pronation (foot rolling inward) can also cause tendonitis.

To prevent Achilles tendonitis, increase your distance and speed gradually. Stretch and strengthen your calves after each run. And select the right running shoes for your gait. A specialist running shoe store can analyze your stride, determine if you pronate, and suggest a shoe that will help.

If the pain and tightness in your Achilles tendon persists, Dr. Mason recommends seeing a sports medicine physician. Achilles injuries generally heal when the runner takes time off from running and does specific stretches and strengthening exercises. Runners may be able to cross-train with swimming, rowing or cycling while they wait for their Achilles to heal as long as those activities are pain-free.

Runner’s knee

Runner’s knee refers to many different knee issues, including patellofemoral syndrome and patellar tendonitis. If you’re having knee pain, the first step is to diagnose the specific cause so you can treat it. Both physicians recommend scheduling an appointment with a sports medicine physician.

Plantar fasciitis

If you have pain in the bottom of your heel when standing or walking, it could be plantar fasciitis. This condition happens when the thick band of tissue across the bottom of your foot becomes inflamed and painful. Wearing the wrong type of shoe or worn-out shoes, excessive running volume or increasing your distance too quickly can all cause plantar fasciitis.

Wearing good shoes with arch support when you’re running and in your daily life can help. Focus on stretching exercises for your calf and the bottom of your foot and strengthening the small muscles of your foot with “toe yoga” exercises. If the pain persists, you may need to decrease your running and be aware that stress fractures in the heel may sometimes mimic plantar fasciitis. If you start feeling pain in your heel, Drs. Mason and Raiser suggest you see a physician to discuss the appropriate treatment plan.

Shin splint

If you increase your running volume too quickly, you may experience painful shin splints. They should go away with rest, and you may want to decrease your running distance before you slowly work back up again. Shin splints usually aren’t serious. But if you don’t rest so they can heal, they could turn into a stress fracture.

Stress fracture

Runners can get stress fractures — tiny, hairline cracks in a bone — from the repetitive impact of their sport. They may notice pain in the shin, foot or heel that gets worse over time. The only way to know if you have a stress fracture is to get an X-ray, so talk to your doctor if you think you may have one. Runners usually need to rest for six to eight weeks as the stress fracture heals. Some stress fractures can require surgery if they worsen, so don’t ignore the symptoms!

Sprained ankle

Ligaments support your ankle and keep it in the right position. But when those ligaments stretch too far, usually from rolling an ankle, it can cause an ankle sprain. A sprained ankle can swell, bruise and be painful. It gets better with rest, ice, elevation and the help of physical therapy, though it can take weeks to months to heal.

No Pain, All Gain

While you may have heard of the adage “no pain, no gain” in sport, both physicians share the advice that “Running shouldn’t hurt!” So if you have pain that sticks around or gets worse, don’t push through it or write it off as normal.

Top 10 Tips for Preventing & Treating Ankle Sprains

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Article featured on Martin Foot and Ankle

Did you know that most ankle sprains account for nearly 15% to 17% of all sports injuries? These common injuries can affect anyone, from athletes to those simply enjoying an active lifestyle. Recognizing their prevalence is vital for promoting effective prevention and treatment strategies.

Now, let’s explore the importance of effectively preventing and treating ankle sprains.

Understanding Ankle Sprains

A sprained ankle is an injury that occurs when the ligaments supporting the ankle joint are stretched beyond their limits or torn, resulting in pain, swelling, and limited mobility. This injury often happens during activities that involve sudden changes in direction, making the ankle joint prone to instability. Sports like basketball, soccer, and running frequently contribute to this risk due to their quick movements.

Additionally, wearing improper footwear without adequate support, navigating uneven surfaces, and encountering obstacles can increase the likelihood of a sprained ankle. Factors such as past ankle injuries, insufficient strength or flexibility, and inadequate training or warm-up routines also elevate the risk of sprains. Understanding these factors is essential for both preventing sprained ankles and ensuring effective recovery.

Tip 1: Strengthening Exercises

Strengthening the muscles around the ankle is crucial for preventing chronic ankle sprains and improving stability. Strong muscles support ankle ligaments, which reduces the risk of injury during sudden movements. A well-conditioned ankle can absorb impacts better and adapt to various terrains, making it essential for athletes and active individuals.
Here are some effective exercises to strengthen your ankles:

  • Calf Raises: Stand with your feet shoulder-width apart and raise your heels off the ground, then lower them back down.
  • Ankle Alphabet: Sit and lift one foot, tracing the alphabet in the air with your big toe to enhance flexibility.
  • Resistance Band Exercises: Use a band for movements like pulling the foot upward, pointing the toes, and rotating the sole inward and outward.
  • Single-Leg Balance: Stand on one leg and maintain your balance, gradually increasing the duration as you improve.

Incorporating these exercises into your routine can enhance ankle strength and stability, reduce the risk of sprains, and promote joint health.

Tip 2: Proper Footwear

Wearing the right shoes is crucial for preventing severe ankle sprains and maintaining foot health. Proper footwear provides essential support, cushioning, and stability during physical activities. Here are some helpful tips for choosing the right shoes:

  • Activity-Specific: Select shoes tailored to your activity. For instance, running shoes are ideal for forward motion, while cross-training shoes offer support for side-to-side movements.
  • Proper Fit: Make sure the shoes fit well with sufficient room in the toe box. It’s best to try them on at the end of the day when your feet are slightly swollen for the most accurate fit.
  • Support: Seek shoes that offer good arch support and stability, especially if you have flat feet or high arches.
  • Cushioning: Opt for shoes with ample cushioning to absorb shock, particularly during high-impact activities.
  • Replace Worn Shoes: Regularly check for wear and tear, and replace your shoes when necessary to ensure ongoing support and cushioning.

By choosing the right footwear, you can enhance your performance, reduce the risk of injuries like severe ankle sprains, and enjoy your favorite activities with confidence.

Tip 3: Warm-ups and Stretching

Warming up and stretching are essential for preventing acute ankle sprains and promoting overall joint health. A good warm-up enhances blood circulation and muscle elasticity, while targeted ankle stretches improve flexibility and strengthen the surrounding tendons and ligaments. Here are some effective ankle stretches to include in your routine:

  • Heel-to-Toe Rock: Stand with your feet hip-width apart, rock back on your heels, then forward onto your toes. Repeat 10-15 times.
  • Ankle Circles: Lift one foot and rotate your ankle 10 times clockwise and 10 times counterclockwise to boost mobility.
  • Calf Stretch: Face a wall, step one foot back while keeping it straight, and bend the front knee. Hold for 20-30 seconds to stretch your calf muscles.
  • Supine Foot Flexes: Lie on your back, pull one knee to your chest, flex your foot, and alternate pointing your toes away and back. Repeat 10-15 times on each foot.

Incorporating these stretches into your routine can significantly reduce the risk of ankle sprains and help you perform your best in sports and exercise.

Tip 4: Use of Ankle Braces

Ankle braces are crucial for individuals currently experiencing pain, particularly those with a history of ankle fractures or engaged in high-risk activities. They offer support and stability, protect the ankle, reduce pain and swelling, and promote healing by restricting excessive movement.

It’s recommended to wear ankle braces during activities such as running on uneven surfaces or playing sports like basketball and soccer, as well as during warm-ups to improve stability. Here are some tips for effective use:

  • Correct Fit: Ensure the brace is snug but not too tight to avoid restricting blood flow.
  • Proper Application: Always adhere to the manufacturer’s instructions for the correct positioning and adjustments.
  • Monitor Comfort: Make sure you feel comfortable; any discomfort could mean the brace is too tight.
  • Gradual Weaning: If recovering from an injury, begin with the brace and slowly reduce its use as your strength improves.

Tip 5: Be Mindful of Terrain

Being aware of your surroundings is crucial for preventing injuries, particularly chronic ankle sprains. Different terrains pose unique risks: rocky ground can lead to missteps, while wet surfaces can be slippery. To navigate uneven terrain safely, keep these tips in mind:

  • Foot Placement: Always look ahead and place your foot on stable ground before shifting your weight.
  • Maintain Balance: Keep your center of gravity low by slightly bending your knees and engaging your core.
  • Proper Footwear: Choose shoes with excellent traction and ankle support.
  • Take Smaller Steps: Opt for shorter, deliberate steps to improve your balance.
  • Stay Focused: Keep your attention on the ground ahead to avoid distractions.

By being mindful of the terrain and applying these techniques, you can lower your risk of chronic ankle sprains and enjoy outdoor activities with more confidence.

Tip 6: Ice and Elevation Post-Injury

Prompt and effective management of a lateral ankle sprain is essential for reducing pain and accelerating recovery. Utilize the R.I.C.E. method: Rest, Ice, Compression, and Elevation.

  • Icing: For the first 48 hours, apply ice or a cold pack wrapped in a cloth to the ankle for 15-20 minutes every 1-2 hours to minimize swelling and numb pain. Be sure to avoid direct contact with the skin to prevent ice burns.
  • Elevation: Keep the injured ankle elevated above heart level to reduce swelling and enhance blood flow. Use pillows or cushions for support while resting, and ice it if possible. Elevating the ankle as much as possible in the initial days will promote recovery.

By adhering to these steps, you can effectively manage a lateral ankle sprain and prepare for rehabilitation.

Tip 7: Seek Professional Help

A professional evaluation helps determine the injury’s extent, often using X-rays or MRIs to identify any underlying issues like fractures or ligament damage. They can also create a personalized rehabilitation program with suitable exercises and therapies.

Remember, seeking medical advice is not a sign of weakness. The sooner you consult a professional, the better your chances of a full recovery and returning to your activities. Don’t hesitate to reach out for help—it’s an important step toward regaining confidence in your movements and ensuring your long-term well-being.

Tip 8: Gradual Return to Activity

Allowing adequate recovery time is crucial for healing a severe sprain and preventing reinjury. Rushing back into physical activity can worsen the injury and extend the recovery period. Here are some tips for a safe return to your activities:

  • Listen to Your Body: Pay close attention to your pain levels; if you feel discomfort, it’s a sign that you may need more rest.
  • Start Slowly: Begin with low-impact activities like walking or swimming to ease back into movement without putting too much strain on your ankle.
  • Progress Gradually: Once you feel ready, slowly increase the intensity and duration of your workouts.
  • Incorporate Strengthening Exercises: Focus on exercises that enhance ankle strength and stability before jumping back into high-impact activities.
  • Consult a Professional: If you’re uncertain about when to return or which exercises are appropriate, seek advice from a healthcare provider or physical therapist.

By prioritizing recovery and following these guidelines, you’ll support your ankle’s healing process and minimize the risk of future injuries.

Tip 9: Maintain a Healthy Weight

Weight management plays a significant role in ankle health, as excess body weight can increase the stress placed on the joints and surrounding ligaments, raising the likelihood of injuries such as sprains. Maintaining a healthy weight helps to alleviate this strain, promoting overall joint health and reducing the risk of discomfort. Here are some practical tips for effective weight management:

  • Balanced Diet: Focus on a diet rich in fruits, vegetables, whole grains, and lean proteins to support a healthy weight. Avoid excessive sugar and processed foods.
  • Regular Exercise: Incorporate a mix of cardiovascular, strength, and flexibility exercises into your routine to burn calories and build muscle, which can support joint stability.
  • Stay Hydrated: Drinking adequate water helps regulate metabolism and can prevent overeating, as thirst is sometimes mistaken for hunger.
  • Mindful Eating: Pay attention to portion sizes and eat slowly to better recognise hunger and fullness cues.
  • Set Realistic Goals: Aim for gradual changes rather than drastic weight loss, promoting sustainable habits that benefit your overall health.

By managing your weight effectively, you can reduce undue stress on your ankles and lower the risk of injuries during physical activity.

Tip 10: Know Your Body’s Limits

Listening to your body is one of the most important practices for preventing injuries during physical activities. Our bodies often give subtle signals when they’re under strain or nearing their limits. Recognizing these cues is essential for effective self-care and injury prevention.

Signs You Need to Rest:

  • Persistent Pain: If you experience ongoing pain, especially sharp or severe discomfort in your ankles or joints, this is a clear signal that your body is asking for a break. Ignoring pain can worsen injuries, including issues with the lateral ankle ligaments, and lead to long-term damage.
  • Swelling or Inflammation: Noticeable swelling around your ankle or joints may indicate overuse or stress. This is a sign to stop the activity and allow your body to recover.
  • Fatigue: Unusual fatigue or a lack of energy during activities might mean it’s time to take a break. Fatigue can impair coordination and increase the risk of accidents.
  • Decreased Performance: A marked decline in your performance, such as slower reaction times or difficulty maintaining balance, often indicates that your body requires rest and recovery.

By listening to these signals and possibly incorporating physical therapy, you can make informed choices about when to take a step back or modify your activities, ultimately helping to protect your ankle health and enhance your overall well-being.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
17355 Lower Boones Ferry Rd Suite 100A
Lake Oswego, OR 97035

Hours
Monday–Friday
8:00am – 4:30pm

Kinds of Ankle Sprains and Common Treatments

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Article featured on HSS

A sprained ankle is the most common athletic injury and the number one reason people go to see an orthopedist. There are an estimated 30,000 ankle sprains per day in the United States alone. They are more prevalent in certain sports – such as basketball, where in one study they accounted for 13% of all musculoskeletal injuries. (A high ankle sprain, which affects a different set of ligaments, is less common.) Despite such a high frequency of injury, conventional wisdom has led most physicians to recommend various forms of conservative treatment, with the adage “all these injuries get better.”

More recently, however, studies of these injuries have shown that 10% to 40% of them result in persistent symptoms after the initial injury. These studies show that this can be due to a number of problems, including:

  • Torn or dislocated tendons
  • Underlying cartilage damage
  • Recurring (chronic) ankle sprains

It is not clear how many cases of chronic ankle sprain result from a single, initial ankle sprain. However, many doctors report that damage to the nerve receptors around the ankle and the weakening of the lateral (outside) ankle ligaments are likely to cause additional ankle sprains.

Types of Ankle Sprains

There are two different basic classifications of ankle sprains: Anatomic (the level severity of damage to tissues in the ankle) and functional (the level an injury affects a patient’s ability to walk or put weight on the ankle).

Anatomic Classifications

  • Grade I ankle sprain – lateral ligaments are strained (overstretched)
  • Grade II ankle sprain – partial tearing of one or several of these ligaments
  • Grade III ankle sprain – complete rupture (tear) one or more of the lateral ligaments

Functional Classifications

  • Grade I injury – the patient is able to fully weight bear and walk
  • Grade II injury – the patient walks with a noticeable limp
  • Grade III – the patient is unable to walk

These grading systems can also predict timelines for recovery, which range from 1 to 2 weeks (Grade I) to 6 to 8 weeks (Grade III).

Treatments

It is very important to reduce swelling in the immediate post-injury period. This can be accomplished by a compressive wrap, icing for 20 minutes at least twice a day and wearing a CAM walker boot or ankle brace to provide protected weightbearing. This will expedite healing and protect the ankle while it is still vulnerable. More importantly, reducing the swelling will help the ankle ligaments heal in their natural position. If the ankle remains swollen for longer periods, the ligaments may heal in a stretched-out position, which makes them less functional.

The time-tested gold standard in treatment of ankle sprains is non-operative management, which remains a well-accepted and typically successful treatment choice for most patients. Several prospective studies have compared non-operative and operative treatment for Grade III sprains, and have failed to demonstrate a difference in outcomes.

Early functional rehabilitation, therefore, remains the cornerstone of conservative management. This includes:

  • The RICE protocol (Rest, Ice, Compression and Elevation)
  • Early range of motion exercises progressive weightbearing guided by level of pain
  • Physical therapy, which includes proprioceptive training (balance exercises), is also beneficial for some patients. Several studies have shown that patients may develop proprioceptive deficits. This means that the body loses some of its ability to localize the position of the ankle in space and fire the ankle muscles accordingly. What this means is that the muscles that protect the ankle from rolling over may not protect patients as well when they are walking on uneven ground. Functional rehabilitation should focus on identifying and restoring these deficits, as well as overall limb strengthening.

The vast majority of patients who undergo conservative, non-operative management will have an uneventful post-injury course and return to sports and/or routine activity within six weeks. Despite these encouraging data, however, 10% to 40% of patients will go on to develop persistent symptoms, including recurrent sprains and pain.

In athletes with a history of prior sprains, bracing or taping the ankle has been shown to decrease the frequency and severity of ankle sprains.

These above non-operative methods should always be considered the first-line treatment in any patient with recurrent ankle sprains. Improved proprioception and muscle strengthening can be very successful in managing these patients, and current data do not support using surgical treatments unless a full course of physical therapy has failed to bring the patient back to full strength and mobility.

Patients with recurrent sprains can benefit significantly from a guided therapy program focusing on strengthening the peroneal muscles (the muscles on the outside of the calf), which can improve dynamic ankle stability. Patients usually reach a maximum benefit at 6 to12 weeks. Any patient who exhibits recurrent sprains, ankle rolling or other ankle instability after that time or has associated injuries such as swelling, locking or catching may be a candidate for surgery. These patients should be evaluated by an orthopedist to discuss optimal management to decrease the risk for future ankle problems such as arthritis.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
17355 Lower Boones Ferry Rd Suite 100A
Lake Oswego, OR 97035

Hours
Monday–Friday
8:00am – 4:30pm

Ankle sprains: What's normal and What's not?

Ankle sprains: What’s normal and What’s not?

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Article Featured on AAOS

Ankle sprains are the most common sports injuries, with an estimated 25,000 occurring every day in the US. Sprains can happen with any sport, including just walking across the yard! Ankle sprains are most common in ball sports such as basketball, soccer, volleyball and others.

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