Running Related Injuries amid COVID-19
You may be sitting at home during these uncertain times wondering, "how am I going to maintain my fitness?" or "how am I going to exercise?". We are limiting our time outdoors, gyms are closed and your favourite group class, which is now on Instagram Live, is not cutting it.
You look towards your back door which leads you to the great outdoors and next to the crown-moulding is a pair of running shoes. You, like many people during these crazy times, are thinking the same thing - "I am going to start running during the pandemic!"
This is a great idea. Running is one of the most simple forms of physical activity with the best return on investment (ie. benefits) and the least start-up cost (ie. getting ready to start exercising).
However, running related injuries are very common in new runners and people deciding to return to running. Most commonly, knee pain, ankle pain, hip pain and back pain.
The root cause? More often than not, progressing too much, too fast or too soon.
A study by Damsted et al. (2019) showed significantly more acute and chronic injuries occurred 21 days into running when the participants increased weekly total running distances by 20%-60% compared to the group that increased distances by less than 20%.
Slowly progressing volume (ie. distance per week) is one of the best ways to prevent injury. This ensures that the musculoskeletal system has recovered enough from previous runs to be able to handle, and recover from, the next. It is a fine balance of load (stress on the body from exercise) and capacity (how much stress the body can handle). I invite you to watch this short video on Load vs. Capacity: https://www.youtube.com/watch?v=H1rp_v4Dr3g
As a Physiotherapist, I usually recommend a slightly more conservative rule, "The 10% rule" -increase successive runs by no more than 10% in volume or intensity where, volume is distance (km) and intensity is the pace or speed (often measured in minutes per km).
For example, if you run 5km at a 5'/km pace. Your next run could be 5.5km at a 5'/km pace or 5km at a 4'30sec/km pace. Never 5.5km at a 4'30sec/km pace.
This is a good framework but unfortunately, it is not that simple. A runner needs to look further. Other metrics include, distance per week, number of runs per week, distance per month and even other stresses to the musculoskeletal system such as cross-training (ex. your other forms of exercise), nutrition, stress and sleep.
Determining what a good starting volume for each individual is another tough consideration. This is mostly determined by the person's capacity. What is your current fitness level? Do you do similar activities to running already (ie. hiking, speed walking)? I suggest starting conservative. Following the 10% rule in the beginning will not seem like very big progressions (ie. 5km to 5.5km = 10% increase) but once you reach longer runs, the marginal increase per run is larger (ie. 10km to 11km = 10% increase). As well, if you are a new runner, 2-3 runs per week is appropriate.
Most importantly, listen to your body and never let a running program override that. If your body is asking for a day off due to fatigue or muscle soreness, give it the day off. A good chef never follows a recipe exactly; a good athlete never follows a program exactly.
If you have questions on any of these topics or need help with things such as running mechanics which can also decrease overall load (ie. stress), please contact InReach Physio.
Aaron Dobie, Registered Physiotherapist
InReach Physio - online physiotherapy (telephysio / telerehab) services via teleconference.
Damsted et al. (2019). The Association Between Changes in the Weekly Running Distance and Running-Related Injury: Preparing for a Half Marathon. JOSPT. 230 238, 49(4).⠀