Overuse Injuries: shoes, running surface, recovery, and diet

May 26

Overuse injuries are commonplace in the competitive running world. The more you know about these injuries, the better you can help your athletes get back on their feet.

By Elisha Cusumano (Elisha Cusumano, MS, ATC, is an Assistant Athletic Trainer at the University of Oregon, where she works with the men’s and women’s track and field and cross country teams.)

A lot of competitive runners and their coaches have come to believe that if 40 miles per week is good, then 80 miles per week must be better. Many more are of the mindset that a day off is a bad thing. Put those two issues together, and it’s easy to see why overuse injuries have become commonplace in the world of competitive track and field.

And unfortunately, those runners don’t always stop when an overuse injury is sustained. One of the mantras being hammered into the minds of distance runners is that second place hurts more than a stress fracture–a statement any athletic trainer would find wince-worthy.

When an athlete comes into the athletic training room with an overuse injury, it’s important to talk to them about factors beyond biomechanical influences. These can include (but are not limited to) shoes, running surface, recovery, and diet.

Shoes: Runners should pay close attention to the type of shoes they wear and how often they replace them. However, while some shoes reach their structural limit at about 200 miles, others can push over 300 miles before breaking down, so there is no steadfast rule to tell all the runners on the team–each athlete will have to figure this out individually. Also note that excessive wear patterns can cause a runner to replace a pair of shoes sooner than normal since a wear pattern can lead to biomechanical deficits and injuries.

Running Surface: Keeping the majority of a runner’s mileage on softer surfaces like grass and trails can help reduce overuse injuries by lessening daily impact forces. When a distance runner is training on paved surfaces day after day, cumulative impacts can take a toll on the body.

Recovery: Another consideration is the amount of recovery time the runner is taking. At the college level, it’s not abnormal for a competitive distance runner to train for three weeks without taking a complete day of rest. While this may work for some, the majority of runners will need a rest day more often–weekly to every 10 days.

The ratio of training load to recovery time can be vastly different for each runner. Thus, keeping detailed training logs (which include mileage, fatigue level, perceived stress, and any injuries) over the period of a season or two can help prevent future problems by comparing injury, stress, and fatigue levels during high and low mileage periods.

Logs can also be used to guide future training plans and mileage goals. Some runners can be very successful at 30 miles per week of land running and supplementing with swimming, while others are successful at 80 miles per week of land running and no low-impact work. It truly varies based on the individual body’s needs for optimal adaptation gains.

Diet: One last tip would be to recommend runners speak with a dietitian about caloric needs. When runners are increasing their mileage week after week, even slightly, their caloric intake and output ratio is impacted. Without enough calories to support their training load, the body will not be able to recover between runs. Appropriate type and timing of recovery foods after a run can greatly influence the body’s ability to make optimal gains from the training session.

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