Running: Why Do People Get Injured?

I often get asked how I can race year after year and stay relatively injury free. They remark that I am 40+ years old and wonder how I can just keep doing this and get faster each time.
It took me 7 years of tinkering with my own body, trying a multitude of advice and training, even trying a bunch of technology from shoes to straps, before I figured out how to keep my body injury free.
Recently, someone tweeted about an article, The painful truth about trainers: Are running shoes a waste of money? from DailyMail, which really disappointed me. It disappointed me in the fact that we often try to simplify things and try to solve our problems with one thing. But it’s not just about one thing, like running shoes as the article suggests, or even the lack of shoes which the article also suggests. Running involves a whole system of muscles, joints, bones, and coordination and how it works during running and over time. You need to address the whole system and not just one thing.
In answering the question of how I stay relatively injury free and race year after year at these long distance events, getting faster every time, I wanted to start with talking about what I have learned in what causes injury. In my next post, I will talk about what I did to address these causes of injury.
Now I will do something that I hate doing, which is to simplify (haha!). I will list a few basic things which I have found cause injury in runners:
Pounding
People talk about how the ground pounds the feet, legs, and body while running. Unfortunately, it’s true. Every step you take puts shock back up into your body, and you have to absorb it somehow through your shoes, feet, legs, muscles, bones – whatever. Over time, exceeding the shock absorption qualities of your body relative to your running style will injure you. The object, then, is to reduce and minimize the shock that your body experiences. A combination of reducing the shock experienced AND increasing your body’s ability to absorb shock will reduce the possibility of injury.
The Build Up of Tightness and Restrictions in Muscles
Muscles get tired and tight after training. It’s natural. Restrictions and adhesions form because the muscle fibers tear during training and they get stronger through this process. Lactate by-products also cause tightness in the muscles and need to get flushed out – the faster they get flushed out, the faster your muscles will recover. Depending on your age and your fitness level, your muscles can loosen up in a few hours, or require days. The intensity of the effort will also affect the amount of tightness experienced and thus also the amount of time to recover.
I have also found that muscles tend to develop a tendency to form certain adhesions or tightness in the same spots until my body adapts to a new training stress. This has happened repeatedly over the course of an entire season; very annoying!
The problem with the buildup of tightness and restrictions is that if they are not removed, they can keep building and building, causing restricted motion and potential strain of the muscles. But there is a more dangerous effect: the tightness in your muscles can seriously reduce their ability to absorb shock, thereby transferring the shock from your muscles to the tendons and ligaments, or ultimately to cartilage and bone, which causes really bad things like fractures.
Cumulative Build-Up of Injury
Related to the previous is actual injury to your body and not letting it heal. You gut your way through pain thinking that is what will build you up, but in actuality you’re just causing more and more injury. Finally, something really bad happens, like a tendon gives way, or a real muscle tear happens, or even a fracture.
Not Enough Recovery Time
A lot of people get really gung-ho about training. They raise the amount they do in trying to attain their goal, whether it’s to lose a certain amount of weight, prepare for a race, or just get to a fitness level that is consistent with their training friends. They may have gotten a coach, who just delivers a plan that is more valid for young athletes or those that are experienced, but unfortunately may not be appropriate for them. The end result is that in the midst of training, athletes’ bodies attempt to keep up but due to some factor(s), they are unable to recover fast enough given their training schedules. The result is a build up of injury and tired muscles which leads to injury.
Many training plans, or following the training plans of others, don’t account for individual needs. Everybody has their own recovery time given certain factors and the best training plans account for this.
Failure to recognize one’s own recovery needs is a common problem. It’s often not clear exactly how much one’s body needs, and sometimes not until you get injured. Factors that influence recovery time are:
1. Length and intensity of workouts
2. Age
3. Sleep, ie. did you get enough sleep?
4. Active recovery sessions and techniques
5. Fitness level, both past and present, ie. did you run track in high school or college, or were you sedentary all the way up to the point at which you started now?
Weak Supporting Muscles, Unbalanced Muscles
I never realized how many small muscles are used in supporting running until these muscles got sore during my training. In the past, I weight trained but the result focused on the big muscle groups and didn’t really build up smaller supporting muscles. Also, being right handed, my right side was used more resulting in an even bigger imbalance between my two sides.
These small muscles are the ones that maintain your form perfectly stride over stride. If these muscles are weak, then over time they will tire and then your form will get sloppy. You subtly adjust your stride to compensate and then problems can occur when your big muscles are taking on the load of moving your body and balancing, not to mention overstraining those supporting muscles in the first place.
The way I discovered my inbalance was twofold. The first was on the Computrainer on the SpinScan where I could see as I pedaled, a graph of my power output. I was clearly dominating the power from my right side! The second way was through racing. Pushing hard through Vineman, my right hip and leg got really sore, tired, and started cramping while my left leg was tired, but relatively cramp free. It became obvious to me that I was just using my right leg more.
Using my right leg more also resulted in more problems for my left leg, showing strain in my calf and IT band, and quads, while my right leg exhibited less issues. It was an issue that has taken a long time to address, and it’s still not fully solved.
Inconsistency in Training
In observing friends who train, I find there is a huge inconsistency in their training. They all say they go out and run, but when you ask them daily if they ran, you start to realize that they train only intermittently. Some weeks they’ll run 3 times. The next week they run once. Then the week after they don’t run at all. The week after that they’ll run 2 times. And then it’s two weeks of no running. And so on.
Consistency is key in training. Your body does not adapt to something by doing it occasionally. You need to do it regularly such that the body will recognize it needs to adapt to a new level of activity and stress and will do so accordingly.
If you are inconsistent, then you’ll inevitably set yourself up for pain and injury as you’ll constantly think that you can do more, but in actuality your body hasn’t even adapted to what your mind thinks your body can do.
Bad Running Form
I watched my kid run and she has perfect running form. Great body lean forward, arms pumping, barely a thump on the ground for every step, floating on the balls of their feet.
Then we get older and something changes. We get heavier so it takes more effort to run. We don’t run constantly enough any more and enjoy sitting in front of the TV or computer screen more than going out and running. We drive cars and take elevators. Our bodies forget how to run efficiently and either we go out for track and train during high school, or we spend those years in high school letting our bodies forget how to run well.
Go out and watch other people run. You’ll see people leaning or hunched over. They swing their arms back and forth across their bodies. They pound down the pavement and you wince with every thump on the ground as you imagine the stress their bodies are absorbing. Some lean back while they run, resisting the pull of gravity backward as they try to move forward!
Bad form means body parts don’t align when you run. You’re putting stress not along the strongest muscles, but against the weaker muscles of the sides of your legs. If you’re heel striking, you send the maximal shock up into your leg bones. If you wave your arms across your body, you’re not taking advantage of the balancing movement that swinging arms forward and back brings. If you’re hunched over, then you’re adding stress to your shoulders and back and you can’t move efficiently if you’re all stiffened up!
All this leads to wasted effort and energy, and can lead to pulled/strained muscles because you’re not relaxed and not running efficiently.
Doing Too Much Too Soon
Enthusiasm in runners is great. But many don’t listen to their bodies and just do too much too soon. It is often hard to know exactly what our bodies can take before we try. But sometimes, we just exceed what our bodies can do or recover from and that’s where injury occurs. We go for a marathon when we should have trained for a 10K and a half marathon first, and over a period of years.
Or, in our competitive zeal, we go out and try to become the fastest humans we can first time out and we get hurt because we didn’t get our bodies up to adapting to the stresses yet.
Or we have someone driving us too hard, like an army sargeant coach, or friends who are more faster and experienced who egg you onwards when you go out and run with them. These are people who make you feel bad for going too slow, and you try to rise up to their challenge. Don’t get me wrong; some people need this kind of motivation. But it’s bad when you try and you don’t listen to or know your body and you hurt yourself simply to save face.
Doing Something New
Related to doing too much too soon, doing something new that your body is not adapted to can also lead to injury. Suppose you’ve never run before. Then your friends tell you it’s great and they run, and they want you to go out and run with them. So you do it. Then after a few times, your legs are aching. Now why is that?
Probably because in your desire to keep up with your friends, you go out and try to keep up with people who are used to running more than you. Then your body protests because you’re trying to do something that your body is not used to. If you continue to gut your way through it, you might make it to adapting, or you might go downward into injury.
My Painful Path to Ironman
On my path to Ironman, I chose to start with an Olympic triathlon first, working with Team in Training. Then I raced a half ironman, swam the Waikiki Rough Water Swim (2.5 miles), and also ran the NYC Marathon. I did each stage of the full ironman before I did the full thing. But still, it was too much too soon.
Before my first Olympic tri, I had not done any running at all. I cycled intermittently and didn’t really know how to swim. My body was not damaged from a previous injury thankfully, but my lack of a history of athletic pursuits, and adding in my age of 37, and the fact that my body adapts to physical stress at a certain rate, all meant that as I built up towards my first triathlon, my body was just not able to keep up.
I was constantly getting too tight and stretching could not alleviate the tightness. I tried to keep up with my Team in Training buddies on the training schedule but that was even too much for me. I kept getting sore legs and my IT bands were really sore. My knees were also getting sore from all the tightness in the surrounding muscles and the shock of my poor heel striking running form. I just thought that I would follow the plan and everything would be all right. It was definitely not, but I did make it through my first triathlon although I thought it really sucked.
After this episode, I resolved to figure this whole thing out. I tried everything and read up on everything I could get my hands on. I found out that most doctors don’t know anything about running. I found out that a lot of research has been done, but a lot of it has turned out to be false. I tried technology and that worked sometimes but not all the time. I went for another 2 years of training, gutting through my first half ironman and other Olympic triathlons until 2004 when I left my company and could spend a lot more time trying to figure this out and how to remove all these nagging aches and pains that I experienced.
The journey I went on to solve all this is my next blog post – stay tuned!

  • keith

    Good article, but I think one MAJOR concept was left out and that is Stretching. A good warmup followed by stretching before running, then a cooldown and stretch after the run. I am in the 40+ age range and have found that to be one of the most important ways to prevent injuries.