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Injuries and Treatment

The 10 Commandments of Healthy Running

How to stay happy and injury-free on the trails

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Preventing major injuries is essential for reaching your adventure potential. 

Some people think trail-running training is about running the fastest time on the local climb. Other people think it’s about running the most miles on the most epic trails. And for all their differences, those people share one thing in common: they are probably injured all the time.

What is trail-running training actually about? It is not a competition to see who can run the fastest or the farthest, but who can stay the healthiest while running the most consistently.

It took me many years of comical failures to realize this. Have I tried to get my race weight down to that of the ectomorphic half-person, half-praying-mantis who just won an Olympic gold? Why yes, I have (and got a torn labrum to prove it). Did I forsake the foam roller to get to the post-race “shower beer” five minutes sooner? You bet (metatarsal stress fracture). I’ve made every mistake in the book and had countless, increasingly exotic injuries to show for it. Simply put, if you stay healthy, you’ll reach your potential. If you don’t, you may always wonder, “What if?”

Fortunately, I learned some helpful tips from my own mistakes and by talking to many of the world’s best trail runners. Here are 10 things you need to know to stay healthy and happy on the trails.

1. Thou shalt foam roll.

I legitimately believe that they should teach foam rolling to school children. It is beneficial not just to runners, but to anyone who does any repetitive motion in their everyday lives. Essentially a self-massage, foam rolling releases tightness in sore, overtaxed muscles.

It’s tough to overstate the relationship you should have with foam rolling. Here’s a try: if they say dogs are a man’s best friend, and diamonds are a woman’s best friend, then for trail runners, foam rolling is like a diamond-encrusted cocker spaniel.

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Clockwise from top left: Quads, back, calves, and shins. Also, it is recommended that you do not foam roll in a parking lot. Photo by David Roche

Each day, using the firmest foam roller you can find, roll your IT band/quads/hip flexors, butt/lower back, shins and calves for 30 seconds on each group.

RELATED: A Beginner’s Guide to Foam Rolling

2. Thou shalt not start a run with cold feet.

While your feet may be figuratively cold before starting a tough run, they should never be literally cold. Pitting stiff metatarsals and Achilles tendons against the hard ground is a recipe for pain and injury. Because every part of the lower leg is intricately connected, it only takes a bit of instability to cause the entire system to crumble. To visualize what can happen on a cold, stiff morning, imagine a tree branch covered in ice hitting the ground with a couple hundred pounds of force, and you’ll get the idea.

Before you run, warm up your feet, if needed, by putting your little piggies in a blanket or giving them a warm soak under the showerhead (no need to get the rest of your body wet). Just don’t stick them in the oven.

3. Thou shalt stretch thy calves.

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A basic calf stretch (left) and eccentric heel drops (right). Photo by David Roche

At the risk of sounding overly fixated: As a runner, you should cherish your feet. They determine everything—how you hit the ground, how impact is distributed and whether your wife lets you into the house before spraying them with Odor Eaters (OK, that last one may just be me).

So many foot-related injuries (including plantar fasciitis, Achilles tendinitis and stress fractures) come from tight calves. Every day, stretch each calf muscle for two one-minute durations. If you have a history of Achilles or plantar issues, go a step further and do eccentric calf drops (Google it!). Quick, daily calf stretching has saved many running careers.

4. Thou shalt not wake up hungry during hard training weeks.

Eat enough, every day. Runners who restrict calories during intense training are more at risk for injury, and it goes beyond healthy body composition. Even one day of calorie deficit can leave a person vulnerable to small injuries that only worsen over time. Moreover, overtraining is most common in athletes with deficient diets.

So if you’re losing weight, awesome! Just don’t do it during a big training block for your next race. Instead, focus on body composition in the off-season and during times when you are not building training volume. And no matter what, always drink lots of water.

5. Thou shalt move thy legs in all directions.

Running is bad dance practice. We trail runners become experts at one not-very-slick move: running man, which makes sense. But we often are really bad at the electric slide, the dougie and the nae nae.

Why is that? It’s not just our need to leave the club at 8 p.m. so we’re rested enough for a Saturday long run. It’s because running is almost purely forward motion. Moving in one direction all the time leaves one open to overuse injuries, including torn labrums and IT band tendinitis.

To decrease injury risk, do side lunges, side-to-side leg swings, and hurdle drills (see our five-minute strengthening plan). And you might just improve your ability to do the twist, along with your running.

6. Thou shalt not run with any pain from the knee down.

It’s the age-old dilemma—should I stay (at home) or go (on a training run)? As runners, we face that conundrum every time we feel a minor niggle of hurt when we get out of bed. The number-one rule to remember is to never run with lower-leg pain.

Numerous season-derailing injuries can happen in the shins, calves, Achilles and feet. If any of those areas are in pain, it’s always worth taking an extra day off, rather than exacerbating a potential injury. Instead, stretch, foam roll and live to run another day.

RELATED: When Should You Skip A Run?

7. Thou shalt use painkillers wisely.

Non-steroidal anti-inflammatory drugs (NSAIDs)—pain relievers like Advil and Aleve—are a blessing and a curse. Bad news first: you should not take them before or during runs. The risks to your kidneys and stomach lining are too high. If you can’t run without drugs, then don’t run until you can.

Now for the good news: NSAIDs can be great injury-fighting tools. When you are frustrated by a soft-tissue injury and set on not running for a few days, try NSAID therapy. (Disclaimer: after consulting with your doctor.) Take two NSAIDs in the morning, again at midday and again in the evening, with water and a meal, for three days. The reduction in inflammation will help cure whatever it is that was ailing you—or, if the pain doesn’t subside, let you know that something more serious is going on.

Be careful when you return to running, and never go hard within 48 hours of your last pill, to avoid potentially harmful complications.

8. Thou shalt not run in shoes for more than a few hundred miles.

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The best thing to do with a new pair of trail shoes is get them dirty immediately. Photo by David Roche

“What harm could running in my 1932 Converse sneakers possibly do? If they were good enough for Grampy, they’re good enough for me!”

That sounds ridiculous, right? Well, that is effectively what people are doing when they put many months and 400-plus miles on their favorite running shoes. As a shoe gets pounded over more and more miles, the midsole compresses and stability decreases, causing increased impact forces in the joints and reduced energy return. When your shoes begin to show substantial wrinkle lines in the midsole and have an inefficient, “spongy” feel, replace them.

Saving a few bucks is never worth the pain (and performance decreases) that come with prolonging shoe life for a few extra runs.

RELATED: How and Why To Run Strides

9. Thou shalt do strides.

People often think injuries come from running fast, and that is partially true. Too many interval workouts can increase injury risk over time. But injuries can also be caused by running the same pace almost all of the time.

Varying speed in training recruits different muscle fibers and improves running efficiency, increasing strength and improving running biomechanics, which in turn lead to more efficient and less injury-prone running.

To reap the benefits of changing pace, add strides to your runs for the ultimate bang for your buck. At the end of a normal run two times a week (or sprinkled throughout a run if you’re feeling frisky), do four to eight repetitions of 15-second accelerations. Start relaxed and build speed, finishing at the fastest pace you can go while maintaining running form (and not sprinting). It will mix things up and prevent injuries while simultaneously improving running efficiency and speed across all distances.

10. Thou shalt elevate thy legs.

We treat our legs pretty horribly. We pound them against the ground, put them under stuffy desks, wear uncomfortable work shoes and generally don’t pay our most important running appendages the respect they deserve.

Show your legs some R-E-S-P-E-C-T by taking at least five minutes every evening to elevate them and relax. While lying on the floor, put your legs straight up against a wall. This simple, passive exercise will decrease inflammation and help you be ready to run the next day. Take it to the next level by finding another five minutes at work—just make sure the boss doesn’t walk into the conference room while you are respecting your legs.

Most importantly, with all these tips, listen to your body (and your doctor). Every runner is different, and self-discovery is one of the joys of trail running. Happy (and healthy and fast) running!

David Roche is a two-time USATF trail national champion, the 2014 U.S. Sub-Ultra Trail Runner of the Year and a member of Nike Trail Elite and Team Clif Bar. When not frolicking on single-track or working as a public-interest attorney for the Environmental Law Institute, he enjoys spending time with his wife and puppy, both of whom are substantially better at running than he is. He works with runners of all abilities through his coaching service, Some Work, All Play. Follow David’s daily training on Strava here, and follow him on Twitter here.