Injury Prevention & Treatment

Video: Blister Prevention | Athlete Tip - Injury Prevention | Athlete Tip - Injury Recovery

Nikki Kimball Video: Tackling the Downhills

Injury Prevention

The North FaceŽ Athlete Tip - NIkki Kimball
Every year one of every three serious runners will incur a running-related injury. Two thirds of these injuries result from training errors (J Am Acad Orthop Surg 1995;3:309-318). Dr. Stan James, MD paraphrases a colleague’s "rule of too’s" stating "athletes court disaster when they exercise too often, too hard, and too soon and too much after injury and attempt remediation too little and too late," (JAAOS 1995;3:309). The "rule of too’s" summarizes most controllable factors in avoidance of injury. Of course there are other factors such as trauma, intrinsic biomechanical problems and possibly age. But I’d like to focus on the most common risk factors, as these training errors are also avoidable.

Unfortunately, what constitutes "too much" varies according to individual athletes as well as their chosen activities. Some people are more susceptible to injury when they increase hill work while others are more at risk from increasing speed work. Athletes need to learn to listen to their bodies, as most overuse injuries develop slowly over time and can be successfully dealt with if caught early. If you have difficulty deciding what discomfort feels like injury and what is just benign muscle soreness or fatigue, consider working with an experienced coach (preferably one with an athletic training, physiology or physical therapy background) until you learn to read your body well.

There are some general guidelines in avoiding the trap of the "rule of too’s." Do not increase weekly mileage by greater than 5-10% per week. Do not add or i ncrease your speed or hill work while your are increasing mileage. Do not add speed work concurrently with hill work additions. Be extremely careful in returning to previous levels of running following lay-offs due to injury, pregnancy or simply time away from the sport.

In addition to following the general rules above, I schedule time away from training. I usually take one day off a week, and always take at least two weeks (yes, 14 day in a row) off from training each year. Following these two weeks of no training, I take an additional 4 weeks off from running. During this time I ski a lot, use cardio machines at my office (mostly elliptical), hunt, hike, snowshoe and generally explore non-running fitness options. I feel guilty and lazy when I’m not training, but really enjoy the following 4 weeks of alternative sports. And when I return to my regular program, I’m physically recovered from a long year of training and racing, and, perhaps more importantly, I am mentally fresh, alert and in love with running once again.

Please note that I do not believe everyone needs to take a full 6 weeks off from running each year. It is just what I do. It works particularly well as I spend my winter ski racing. Some runners don’t have the luxury of loving a non-impact sport. And some of these people may do well with 2-4 weeks a year off from running. But I do credit my longevity as a very competitive, frequently-racing ultrarunner to my low winter mileage and love alternate sports.

Injury Recovery

The North FaceŽ Athlete Tip - Nikki Kimball
Once injured, runners need appropriate rest, which usually doesn’t mean a complete layoff from running. They also generally need skilled care and/or advice as to specific musculature which needs strengthening or stretching in order to remediate the current problem and avoid its future recurrence. As mentioned above, the return to running often needs to be slow and calculated. There are exceptions to this, but generally one benefits from a measured return to full function. As there is so much variability in running injuries and there causes, I will recommend here that people seek care soon after recognizing injury. Be sure your provider experienced in treating runners. I have known massage therapists, trainers, physicians, chiropractors and physical therapists with passions for treating runners. Seek these people out. Find one with whom you work well and develop and maintain a relationship with this health care professional. He or she will get to know the needs of your body (and mind) and can be invaluable in the treatment and prevention of injury.