Injury-Free Running?

Running is simultaneously the simplest and most complex activity.

Every 2-year old runs, laughing and giggling, with joy and delight (and decent form to boot), but then we get old and screw it all up.

Even among self-proclaimed "runners", few do it well. Many carry some pain or injury, or seem to be constantly fighting upstream. It's rare to see someone float along effortlessly with beauty and grace.

As it becomes more and more apparent how average at this I am, there's only one thing I seem to do well: I run a decent amount with surprisingly few aches and pains.

My take: The two biggest factors in avoiding running injuries are form & attitude.

That may sound simple, but people devote post-graduate careers to the first, and years of therapy to the second (if the running you've done thus far hasn't already lead you to it--or through it).

Form

Many running problems start at either the hips (up top) or the feet/ankles (down low). The key is alignment.

Hips

If anyone has ever suggested you need to work on glute strength to cure your knee pain, what they really mean is that you're dropping the hip over your non-loaded leg. If you're having trouble grasping what that means, stand up, pick up one foot, then relax your hips and settle down into your planted foot. Your belt line probably just took a big dip towards the floor over the foot you just picked up.

When you drop your hip, to stay upright, one or both of the following happen: your weight shifts over your load-bearing foot, drawing your hip outside, putting strain on your IT band; and/or your load-bearing knee buckles inside, making your patella track incorrectly. If the first occurs, hello IT-band pain; if the second, hello patellofemoral pain syndrome ("runner's knee"). If you're really lucky, you'll get both.

To avoid this, pick up one foot, but engage your weighted glute to keep your hips level (keep your belt line even). Keep your hips level through your stride and square, front-to-back.

Ankles

Whereas your hips can screw up your form from the top, your feet and ankles can screw it up from the bottom.

There is such a thing as a neutral ankle position.

• Stand up, shoes off, feet shoulder-width apart and flat on the ground pointing straight ahead.
• Lift your toes up (to engage your arches) while keeping the rest of your forefeet and heels firmly on the ground.
• Keeping your toes lifted, imagine three points of contact with the ground for each foot: inside forefoot, outside forefoot, and heel.
• Equalize the weight on each foot, left-to-right between your inside and outside forefoot, and front-to-back between your forefoot and heel. 
• Now, without moving your ankles or shifting your weight, put your toes down. That's the neutral ankle position.

Now (and this is fun): relax.

When I relax from this position, my arches collapse down, and my ankles drop to the inside. If I run like this, my collapsed arches and dropped ankles buckle my knees in, and my patella tracks incorrectly and increases the strain on my IT band.

The solution: Don't relax your feet/ankles. Ever.

Find that neutral ankle position, equalize the weight inside-out on each foot for each foot strike, and never let that ankle or foot relax. Just like you can't let your weighted glute relax and drop your hips, you can't let your arches relax and drop your ankle. Keep your loaded feet coiled, always resisting. Never settle or relax into the ground. You are not one with the earth while running. The ground is your enemy that you have to fight off 2,000 times per mile. Treat it as such.

One of the problems with a prominent heel-strike is that it's difficult to tell if your ankle is aligned or judge that whole inside/outside weight balance with only one point of contact on the ground. Whereas a forefoot or whole-foot strike let's you feel and equalize the weight across your loaded foot, left-to-right.

Often, while running, I'll lift my toes before/at ground contact to better feel that weight distribution, recalibrating/balancing on the move.

Heal, then change something

Alignment and balance helps with everything, but it can't always speak to tendon injuries, stress fractures, etc. Things happen. I have a saying, "If you want to be disappointed, make a plan." Take things as they come. 

Don't train through pains or injuries. If it hurts, stop and let it heal. Something's wrong, and doing the same thing you've been doing and expecting it not to happen again is madness. Heal, rest, change something, then try again. If the change works, keep it. If it doesn't, try something else.

Always tinker (one thing at a time), but never so far at each go that you can't retrace your steps to get back where you were.

Attitude

One characteristic of people with healthy staying power in the "running" crowd is that the competition is more internal with themselves than anything external or with others. They're just striving to find the edge of what they thought possible, then pushing past that a bit.

If you don't want to run, don't run. This is supposed to be fun, not a punishment. If you're doing it as rehabilitation for some perceived wrong, you're never going to enjoy it--for that reason, it can only get you back to zero. Done for the right reasons, it can be so much more.

That said, others take it too far. Don't ever let this sport become a chore or add stress to your days. Don't ever let it single-handedly define who you are, because when it will be taken from you, and it will be taken from you, is completely out of your control.

But above all, remember to giggle every now and then. We're all human, struggling to figure out what that means. Be kind to yourself and others. Offer encouragement to everyone. Toss random high-fives and compliments to strangers. You're allowed to be proud of yourself. Take delight in puddles and falling leaves, in sunrises and sunsets, and in rain showers and rainbows.

This is our only life. May as well take full advantage.