One of the most researched topics in sports medicine is whether or not injuries can be prevented. Sport is big business these days, so there is a lot of interest in finding ways to ensure star athletes can perform at a high level without suffering injuries. With all this research has anyone found any proven ways to prevent running injuries?

A little over a year ago I spoke at seminar with a Physiotherapist by the name of Toby Watson. We were trying to compare the way Physiotherapists and Osteopaths treat common sporting injuries. It was really interesting to be part of; the osteopaths and physiotherapists who attended were all very experienced in treating sports injuries, I’d worked for the Australian Athletics Team and Toby has been a physiotherapist at the Olympic Games, with a Tour De France team, and for a professional AFL team.

With every injury, we asked two key questions: “Why did it occur now?”, and “Why did it occur here?”. We were looking to identify the factors that caused the injury, in the hope that we could then find ways to prevent them. I’ll take you through some of the findings.

Why did it occur now?

Did you increase your mileage suddenly? Research suggests that increasing your mileage is a good thing, as it helps build your conditioning. But if you make big changes in a short amount of time it can be overwhelming. A 2014 study found that there were more running injuries (such as ITB syndrome, shin splints, patellofemoral pain) in people who increased their mileage by more than 30% over a 2 week period compared with those who increased it by less than 10%.

Did you recently change footwear, or get a new set of orthotics? If not, do you need to change your footwear? Research suggests running shoes last for 800-1000km before they start to lose their cushioning, which means less support for your feet. Another interesting stat is that people who own 2 pairs of shoes and alternate their use suffer less injuries.

Have you changed the type of training you are doing? Or have you changed the surface you are running on? Some surfaces are harder on your legs. Moving from slow jogging to higher intensity sessions like intervals or track sessions can place extra stress on your lower legs. When you walk, you put just your body weight through your joints. Running at 5 min per km pace places about 5 times your body weight through your joints. When you are sprinting and jumping, this increases to around 10 times your body weight.

Are you warming up properly? In a 2014 interview of runners, “not warming up” and “not stretching” were two of the most cited factors for their injuries. A well-structured warm up routine will improve your endurance performance and reduce your risk of injury. For example, studies on the FIFA 11+ soccer warm up routine have shown it reduces the risk of injury by at least 30-35%.

In Part 3 of this series of articles I will outline a warm up protocol based on studies of athletes that will not just reduce risk of injury but also improve endurance performance.

Has your diet changed? Or have you had a recent illness? Perhaps you are nutritionally deficient or your immune system is suppressed, and this could be predisposing you to injury.

Why did it occur there?

Have you had a previous injury in that area? THE NUMBER ONE PREDICTOR OF FUTURE INJURY IS PREVIOUS INJURY. So if you rolled your ankle a while ago on a karaoke night, or strained your hamstring kicking a footy with your mates, and didn’t rehabilitate it properly, you are at risk of re-injuring that area in the future.

Is there a weakness in that area? Staying on the theme of previous injuries for a second, a 2015 study on people who sprained their ankle and didn’t do strengthening have shown they still have functional deficits 6 months later. We see these people in clinic all the time – the people who just seem to roll their ankles again and again and again. Rehabilitation is the key.

There are certain strength exercises that have been shown to reduce the likelihood of re-straining your hamstring. In one study, people who tore their hamstring were divided into 2 groups. In the group who DID the exercises, only 3 re-injured their hamstring.  In the group who DIDN’T do the exercises, 20 re-injured their hamstring, nearly 7 times as many people!

Go see someone after you get injured to get realigned and a list of the best exercises to help prevent recurrence.

Does your technique need a little fine tuning? Runners commonly over-stride, which is both inefficient from a performance perspective, and also puts you at risk of injury. In 2014 researchers put a group of runners on a treadmill and measured their normal stride length. They then asked them to increase their stride length by 10% and watched them for a while, then asked them to decrease their stride length by 10%, and measured what happened there too.

The amount of stress in the knee joint increased 31% in the long step length condition and decreased 22.2% in the short step length condition.

Clearly there are lots of things that can cause injuries and all of the factors listed above are within your control. If you want a more thorough assessment of your risk, ask your health professional. Your health professional can assess your range of motion and strength to check for any imbalances that may predispose you to future injury, and outline exercises to improve your strength and stability.

If you want any of the references for any of the studies cited in this article, shoot me an email chrisjonesosteo@gmail.com . Good luck with your training!

Dr Christopher Jones (Osteopath) has been consulted by World and Olympic champion athletes and worked on the medical staff of national teams for Athletics Australia. Prior to studying to be an Osteopath he completed a Sports Science degree majoring in Exercise Science. As a junior he competed in the 800 and 1500m, gaining selection in the Australian Junior Athletics Team in 1995. He still enjoys running 3 times a week and if you see him training at ES Marks on a Tuesday night feel free to ask him any questions you may have (depending on how much of his session he has done, he may or may not be able to speak).