Rules of the Road for Preventing Running Injuries

Expertise in injury prevention, rehabilitation, sports medicine and athletic conditioning from John Gallucci, Jr., Founder/President of JAG Physical Therapy.


Running is one of the most effective ways to maintain good cardiovascular health, low body fat, and optimal overall tone and condition…but it is also a physically demanding activity that can cause injuries and pain. There are 4 general rules you can use to help keep yourself injury free if you are a runner:

1. Know your limits and “listen” to your body; don’t over-train or race too often

2. Cross-train and strength-train in addition to running

3. Warm up and then, stretch before you run

4. Run on level surfaces and wear the proper sneakers

The most common injuries suffered by runners are patellofemoral pain syndrome, also known as “runner’s knee,” iliotibial band (ITB) friction syndrome, shin splints, plantar fasciitis, achilles tendonitis, stress fractures, and hamstring strains.

Patellofemoral pain syndrome, “runner’s knee,” occurs when the cartilage on the inside surface of the patella (kneecap) rubs against the inner joint of the knee and thigh bone causing chondromalacia, a blistering of the cartilage. The pain experienced with runner’s knee is increased with walking down stairs or after sitting for a long period of time.

The iliotibial band is the large band of fascia that goes from your hip to your knee.  Iliotibial band syndrome is typically indicated by a band of pain on the outside of the knee or lower thigh, and usually includes a clicking with bending, on stairs, and on hills. The condition is often due to over-training.

Shin splints, or medial tibial stress syndrome, occur when the muscles of the shin become overstretched, weakened, and inflamed. Excessive uphill or downhill running, running on tilted/uneven or hard surfaces or with worn out or improper running shoes can cause shin splints. Runners who overstride and land heavily on their heels increase the chance of shin splints.

Plantar fasciitis is indicated by pain and inflammation of the thick band of tissue running across the bottom of your foot and/or sharp heel pain, usually worst with the first steps in the morning and more common among heavier runners and those with improper footwear.

Achilles tendonitis, pain and inflammation of the tendon that attaches the calf to the heel, accounts for some 11% of all running injuries. Among the causes are excessive uphill running, tight calf muscles, and the wearing of high heels.

Stress fractures occur when muscles become too fatigued from overuse and can’t absorb the shock of repeated pounding on hard surfaces. The shock is transferred to tibia and the bones of the foot.

Hamstring strains usually are the result of an overextension of the leg caused by running too fast down hills, or muscle imbalances caused by running on sloped roads. Pain in the posterior mid-thigh region, behind the knee, or below the buttocks may indicate a hamstring strain.

Preventing these common injuries begins with proper warm ups and, then, stretching of the calves, hamstrings, quadriceps, hip flexors, ITB, gluteus, and priformis. The right footwear is extremely important, too, and so are strength-training and cross-training. Above all, if you experience the pain indicating any of these injuries, the best thing you can do is allow your body to rest and heal. Pain is a clear sign you are doing something wrong or overdoing it.

Quite simply, don’t disregard what your body is trying to tell you.

John Gallucci, Jr., MS, PT, ATC, DPT, is the Founder/President of JAG Physical Therapy with renowned expertise in injury prevention, rehabilitation, sports medicine and athletic conditioning.  JAG Physical Therapy facilities in New Jersey are located in West Orange, Warren, Hackensack, Cedar Knolls, Union and soon to be opened in Woodbridge.

This post is contributed by a community member. The views expressed in this blog are those of the author and do not necessarily reflect those of Patch Media Corporation. Everyone is welcome to submit a post to Patch. If you'd like to post a blog, go here to get started.

peg rosen May 19, 2012 at 02:02 PM
While dynamic warm up is certainly a good idea, I'm somewhat surprised that you are still recommending that people stretch before they run, considering the growing body of scientific data showing that stretching before exercise does little if anything to reduce incidence of injury or muscle soreness among most individuals. There is even evidence that static stretching before exercise may increase injury risk. Could you possibly have meant dynamic stretching? I refer anyone who is interested, to the following reviews of literature on the subject: http://summaries.cochrane.org/CD004577/stretching-to-prevent-or-reduce-muscle-soreness-after-exercise; http://www.ncbi.nlm.nih.gov/pubmed/15076777; http://www.ncbi.nlm.nih.gov/pubmed/10593217
Monk May 19, 2012 at 07:49 PM
My old cross-country and track coach thought it was enough to run slowly at first before accelerating to training pace. Stretching seems geared more to increasing or maintaining range of motion. What is most important of all in my opinion is good running form. I see (and hear) runners slapping the ground with their feet, taking too long, loping strides and other jarring and inefficient things. I think a lot of those scary sounding ailments Mr. Gallucci names can be avoid by running with the proper form.
Andrew May 21, 2012 at 02:29 PM
"Run on level surfaces and wear the proper sneakers". - 1. I don't believe you're a runner. Runners don't call their shoes "sneakers" first of all, they are running shoes....please, respect the game. 2. Run on level surfaces? Now I know you are not a runner. If you want to prevent injuries you are better off running on rolling hills along the lines of what you see on a Golf course. This way you're varying different muscles constantly and not falling into muscle motion pattern. Injuries come out of repetitive motion. The idea is to run on gradually varying mixed grades, inclines and declines. In a similar regard, you don't want to run on road surface in an ideal world. Why? Flat road surface running = repeated motion for the muscles in your feet, ankles, and legs. Run on trails wherein with each strike, there is slight variation with the surface you're striking on. This will keep you from repetitive motions and strengthen and build muscles in your feet and ankles nicely. If you want to be running when you're 50?, 60?, 70+? Stay off the roads, find trails with rolling hills, stay away from repetitive motions.
John Gallucci, Jr. May 21, 2012 at 09:13 PM
Hello Peg, As prefaced, I discussed a warm up and stretching component. Dynamic stretching has been found to be more advantageous for runners than static stretching, as evidence has shown. To confirm, when referring to the warm up component, increased heart rate and perspiration are to occur before any stretching. Thank you for pointing out relevant articles, your feedback is appreciated. Best, John Gallucci, Jr.


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