• Prevention and Treatment of Walking and Running Injuries

    August 26, 2016
  • For health and well-being, few things can beat exercise, and one of the best ways to stay or get in shape is walking or running. It requires very little in the way of equipment or cost and is accessible to anyone able to walk or run. No initial training is required and it gets you outdoors and in touch with the natural elements.

    Unfortunately, nothing is without risk and many develop walking and running injuries. Luckily, there are a few things you can do to maximize the benefits of these activities and reduce your risk of walking and running injuries. The following, while not an exhaustive list, provides some tips I’ve gleaned from my decades of practice as a physical therapist as well as a survey of the scientific literature.

    Through treating hundreds of people with injuries related to walking and running, three themes have emerged that underlie the majority of injuries I’ve seen: building up too fast (overload); inadequate footwear (poor biomechanics); the wrong flexibility – strength (muscle imbalance).

    Prevent Walking and Running Injuries by Being Aware of Overload

    Overload in and of itself is not necessarily a bad thing. When trying to get stronger by building muscle, weight lifters will overload the muscles by lifting heavy weights. This causes the body to react by putting more protein into the muscle cells, making them bigger and able to generate more force (stronger). However, a weight lifter that lifts too much weight before they are strong enough will encounter injury – potentially muscle tears – resulting in pain, loss of ability to exercise and ironically, loss of strength. This is why weight lifters should gradually build up the amount of weight they lift over a period of time.

    The same can be said of any form of exercise, including walking and running. Whether you are a novice or an experienced athlete, your body will only tolerate a certain level of activity before an injury occurs. Trying to walk or run a marathon if you’ve only been clocking up a few miles a week is a recipe for walking and running injuries. Anecdotally, I’ve noticed that, of people training for distances of 10K (6 miles) or more, this is often when under-training (building up too fast) can result in injury.

    When you are exercising, try to be aware of how your body feels. If you are experiencing any pain of more than a mild nature, there is probably a problem and you should stop and address it. Think about your level of exertion or how hard you are working. If you’re going over a moderate level of exertion for long periods of time (whatever that means to you) then that is likely too much.

    Footwear to Minimize Walking and Running Injuries

    Your feet are the foundation of your body and the point of interaction with the ground. The footwear you use should be suited to the activity, the shape of your feet and the individual way that your feet move in order to prevent walking and running injuries. In theory, our bodies are designed to absorb shock experienced during foot strike. We do this by adjusting the amount of muscle activity and the position of our joints. How we move on sand will be very different from when walking or running on concrete. Unfortunately, as we age, our bodies become less able to adapt adequately to the surface and the shock to the body (ground reaction forces) will potentially become damaging.

    Footwear can mitigate the forces on the body either by absorbing shock or by altering the mechanics of how the feet move. So-called ‘low profile’ shoes will offer little shock absorption or motion control, making your body do the work. This can be a good thing in controlled doses but can lead to injury if your body is not able to cope with the demand. Motion control shoes will either slow down or reduce the motion of the shoe through the placement of various density foams at different points in the sole, as well as through wedging the heel of the shoe to change the angle of foot strike. Insoles or orthotics can help as well by further correcting the position of the feet in the shoes.

    Muscle Balance

    Strengthening the muscles around the hips, in particular the ‘glutes’ (muscles which comprises the buttocks), is important for all athletes and non-athletes alike and will, in turn, help prevent walking and running injuries. Many of the patients I treat who have lower back pain also have very weak gluteal muscles. At the same time, due to our sedentary lifestyles, it’s very easy to lose flexibility in the legs. Sitting in a chair generally results in weakness in the back of the hips and lack of flexibility in the front of the hips where the muscles are in a shortened position. Simple stretches performed after walking or running when the muscles are still warm are the most effective way of stretching. Strengthening and stretching, even for a few minutes, 3 – 4 days per week, will help with the glutes and to prevent walking and running injuries.

    Walking or running is a great form of exercise that can be enjoyed throughout your life. With a few simple precautions, you can avoid injury and stay healthy. If you do encounter an injury, a brief period of rest and use of ice to reduce inflammation often takes care of the problem. Pain that persists for more than a few days should be seen to by a physician or physical therapist in case a more serious injury is present.

    For specific exercises you can try, there are many resources on the internet or in the public library. Use a trusted source to get the safest information.

    About the author: Local resident, Joshua Wies, has been a physical therapist since 1993 and currently owns and operates Mount Washington Physical Therapy.