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What every runner needs to know…how to avoid injury

I love running. I love the freedom of being outside, the ongoing improvements and the wonderful running community. However, like many runners, when injury strikes it’s miserable and you can become isolated from your passion and your community. Astonishingly, 50% of runners get injured each year and if you are training for a marathon this increases to 55% (Van Middlekoop et al, 2008).

Running has become increasingly popular, no doubt due to it’s convenience, it’s relative low cost and amazing events like Park Run. Parkrun alone saw 147,986 runner in June and it is estimated that 10.5 million people in UK now regularly run (Sports Marketing, 2014).

Women running

While the nation’s new passion is great for weight loss, reducing blood pressure and improving fitness, it is not without risk. Running puts a lot of strain through the knees, ankles and the lower leg biomechanics. At it’s maximum impact the internal compressive force on the lower limb can be 10-14 times your body weight, and the impact on the knee can be 4 times your body weight. If you factor in that many people start running to lose weight, and are therefore likely to be carrying excess pounds, you can see how this extra strain can lead to injury.

But don’t let the fear of injury put you off! If you are sensible with your training and ensure you are wearing the right shoes, you can reduce your risk of injury dramatically. Injury usually comes about due to a combination of several factors.These include;

Running injury risk factors

  • High training volume. Personally, I found my body can not cope with much more than 40 miles per week and 40-50 miles per week seems to be the cut-off point for your average runner.

  • A change in training. Gradual changes in training are necessary to see progress, but the body struggles with too much too soon. A dramatic change in training volume, terrain or drills can all put the lower limbs under excess strain. It is advised that you increase your training volume by no more than 10% per week and cut back your volume every 3rd or 4th week.

  • A history of previous injuries puts you more at risk of future injury

  • Weakness through the hips also indicates injury risk. It’s important to strengthen the hips through all planes of movement, not just forward and back, in order to keep alignment through the pelvis.

  • Tight hamstrings. This can also cause the pelvis to go out of alignment causing all kinds of biomechanical issues.

  • Running with a heel strike rather than a mid-foot or a front-foot strike. People who strike with their heel first are 2.5 more likely to have injuries, in particular at the knee, hip, lower back and plantar fascitis. The pose method of running suggests that the most efficient way to run with the least risk of injury is a mid-sole strike and a slight lean forward so that the shoulders, hips and ankles vertically align with the support leg.

Thankfully there are ways to improve your running form with these 4 simple steps.

  1. Posture. Think tall, toes pointing forward and keep your head up and gaze to the horizon.

  2. Run on your mid-foot. Running on forefoot can cause Achilles or calf issue, and, as mentioned, heel strikes can increase injury risk.

  3. Aim for a cadence of 180. Some apps or watches measure cadence as you run, but you can count the number of times your right foot strikes the ground in 20 seconds and multiply it by 6 to find your running cadence. If you’re really keen on getting the cadence right try downloading a metronome app and set it to 160-180

  4. Lean from the ankles without bending at the waist. This reduces unnecessary strain in the muscles and takes advantage of gravity

The key component to your running training schedule

Runners doing Pilates

For most runners training consists of running. Tempo runs, long runs, steady runs and other variations of running are the mainstay and strength training or cross training rarely feature. However, world renowned coaches such as Alberto Salazar, Mo Farrah’s previous coach, always include strength and conditioning work. Salazar says that the pelvis is king and that keeping the pelvis in alignment while running is key to an efficient performance. Having strong, steady hips will drive a runner forward and ensures the glutes are in the best position to propel you along.

One of the best exercises runners can incorporate in their schedule is Pilates. Pilates can improve the efficiency of your running and reduce the risk of injuries. It trains the body to keep the pelvis in line, engage the glute muscles and helps you run more efficiently. This will mean less injuries, improved flexibility and less fatigue due to increased running efficiency. One study (Laws, Williams and Wilson 2017) found that a six-week course of Clinical Pilates significantly improves the functional movement of recreational runners and that this reduced the risk of running related injuries. Not only that, it can improve performance so that you run more efficiently.

Pilates exercises to include in your training schedule

Here are a couple of Pilates exercises to help prevent runners getting injured.

Calf raises A great exercise to build up all the stabilising muscles of the foot and ankle and strengthen the calf muscles. Essential for preventing Achilles issues.

Standing clam This is a function adaptation of the classic clam exercise. It activates the Gluteus Medius, such an important muscle in injury prevention for runners.

Carol is a Clinical Exercise Specialist who has completed 12 marathons, with a best time of 3:38:40. She currently teaches Pilates for runners in north east Hertfordshire and 1-2-1 clinical exercise.

Carol Clark Clinical Exercise Specialist logo


Laws, A., Williams, S. and Wilson, C. (2017). The Effect of Clinical Pilates on Functional Movement in Recreational Runners. International Journal of Sports Medicine, 38(10), pp.776-780.

Van Middelkoop, M., Kolkman, J., Van Ochten, J., Bierma-Zeinstra, S. and Koes, B. (2008). Risk factors for lower extremity injuries among male marathon runners. Scandinavian Journal of Medicine & Science in Sports, 18(6), pp.691-697.

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