Overuse injuries are common to distance runners, especially if they are involved in intense, long-term or high-mileage training programs. Overuse injuries can be related to the following factors:

• Equipment (shoes)
• Physical condition (weight, fitness level)
• Training surface
• Biomechanics (bone alignment in the body)
• Training program
• Rest

Equipment
Equipment is the easiest factor to address. Footwear can make a noticeable difference in preventing injury. Different shoe styles are designed for different feet; a properly fitted running shoe will help keep your foot in proper position while running. Shoes should be replaced every 300-400 miles. Once your shoes have broken down, the likelihood of injury increases. After purchasing your shoes, wear them prior to running to properly break them in. Doing so will also help avoid blisters, ingrown toenails and potential foot problems.

Physical Condition
Check first with your personal physician before beginning any fitness regime. First-time marathon runners are advised to work into a rigorous training program slowly. Injury is more likely for those who are overweight, de-conditioned, or have preexisting medical problems.
Excessive weight contributes to knee, lower leg and foot distress. De-conditioned athletes engaging in intense training programs may over stress bones, joints, ligaments and muscles, causing inflammation that can lead to a cycle of inflammation and pain. The same may apply to those who have been inactive. Avoid tendonitis and the inflammatory process by working into the conditioning program slowly, gradually increasing the stress on your body.

Training Surface
Training surface may affect runners. Begin running on a soft (not bouncy) surface, gradually progressing to pavement. If running on a track, be sure to switch directions so that joints on one side of the body are not stressed more than the other. If running on a city street, be sure to change directions as streets are slanted and can increase stress to one side
of the body.

Biomechanics
Runners who are knock-kneed, bowlegged or have high arches are predisposed to knee, shin and foot problems. The way in which bone, cartilage, ligaments, tendons and muscles work together is greatly affected by their alignment. Muscle imbalance, bone malalignments, tight muscles or a combination of these may cause a joint to move improperly. If you have problems, check with your personal physician or visit a sports medicine physician who works with runners.

Training Program
When training for a marathon, there is a greater chance of developing an overuse injury. The longer period of time athletes train, the greater the risk of overuse injuries. A frequent result of overtraining is inflammation, which if prolonged, can begin a cycle that can lead to a debilitating injury. Rest should be a key component of your training program. Every time you exercise, your body breaks down both bone and muscle. If you continue to run 20 miles per day, the likelihood of causing disruption in bone or muscle tissue increases greatly. Days of rest and varied levels of intensity are very important.

Avoiding Overuse Injuries
• Pay attention to your body
• Use proper equipment
• Allow your body to recover

Signs of Overuse Injuries
•  Post-activity pain or pain later in activity participation that progresses to before, during and after each activity
• Swelling in a joint accompanied by a rise in tissue temperature in the area

Treating an Overuse Injury
Don’t try to run through the pain. Think about the term “overuse;” the more you run the worse it will become. Have your injury evaluated by the proper medical professional team, which may include a running specialist. Medical professionals can help rule out alignment problems you may have, provide simple warm-up and cool-down activities or prescribe custom orthotic supports.

Helpful Resources
Minnesota Sports Medicine: 612-273-4800
Institute for Athletic Medicine Runner’s Program Hotline: 612-672-2722
Athletic Medicine Hotline: 612-920-8850