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In this episode we talk injury prevention with our friend and physical therapy doctor Ben Shatto. Plus we answer injury related questions from real everyday runners like you. -Glutes, calves, hamstrings, IT Band, foot and knee pain . . . we cover it all!
The Injury Episode
We wanted to make this episode as practical as possible so we start with discussing the prevalence of running injures (as high as 70-80% runners effected according to some sources) then Angie shares some of the biggest mistakes she sees runners make that lead to injuries.
Next, we dive into some excellent questions sent in by email subscribes that deal with specific injuries.
Dr. Ben Shatto, PT, DPT, OCS, CSCS is a physical therapist who specializes in managing orthopedic conditions and strength and conditioning. Ben has been running since 2005. He is co-creator of the Resilient Runner Program for Prevention and Self-Treatment of Injury.
Top Mistakes We See Runners Make
- Only running and neglecting to cross train
- Racing too much
- Not taking time for recovery
- Ignoring smaller issues that may turn into bigger injuries
- Not doing the needed body maintenance (stretching, sleep, foam rolling, massage, chiropractor, etc)
Questions Used in This Episode . . .
Injury Prone Runner
Hi Trevor!! A huge thank you to you and Angie for an excellent podcast. I have two (semi-related) questions. I consider myself an 42 year old injury-prone runner (I’ve have had hip, ITB, plantar issues), although currently I’m healthy. Yes, I’m knocking on wood.
I’m signed up for a challenge race, the Disney Dopey Challenge in January, which I’ve done before. However, I seem to get injured when my long runs get high. I’ve had marathon plans that go beyond 26 miles “to prove that I can do it,” but I’m thinking that’s not the best plan for me. I’ve done 4 marathons, so I know I can do it, so I’m thinking I should do a plan that has a much lower maximum run.
So my first question is, if you are injury-prone runner, what is the maximum suggested long run distance to prepare for a marathon? THANKS! -Katie
Returning to Running After an Injury or Surgery
I’d love to know Ben’s advice on how to return to running after an injury. I’m 4 weeks into a severe ankle sprain. When I’m cleared to run again I want to jump right back where I was pre-injury but don’t want to risk re-injury either. How do I safely return to running after six weeks? (I have continued to do the stationary bike and core work while injured) -Tina K
Feet Hurt All The Time
Hey, Trevor and Angie! I love your podcast, and have been an avid listener for several months now. I’m emailing you today in the hopes of gaining insight on a recurring foot issue. I’ve never had plantar fasciitis or a stress fracture, but myfeet hurt ALL THE TIME. Sometimes it’s just a niggling pain after a day on my feet, and occasionally (although rarely) it hurts to walk for a day or two . . . I can’t seem to overcome the issue. I run an average of 14 miles a week, teach a Zumba class twice a week, and throw in strength training, yoga, and cycling for cross training. Any light you could shed on the matter would be very much appreciated. Thanks in advance! Blessings, -Mariah
I am a Masters runner (53 years of age) and have been running since grade school. I currently run 45-65 miles a week depending on where I am in my training cycle for a marathon. In the past I have had ankle soreness and a heel problem that quickly responded to ART (Active Release Therapy). Over the past couple of months, I have been having issues and have been getting ART treatment for piriformis syndrome . . . it is not responding to ART as quickly as other issues. Because of this I decided to back way off on my miles (once or twice a week and only about 15 miles total) to see if that will help it heal. My question for Dr. Ben: Do you know if there are their other treatments that work better than ART for piriformis syndrome (e.g. dry needling, ultra sound, etc.)? Thanks! -Greg
Running After Pregnancy
Hi Trevor and Angie, I have been listening to your podcast for about a year, when I began training for my first marathon. I ran it 14 months postpartum while still nursing my son. I never in a million years thought I could pull it off, but somehow I did and you two were in my ear for every long run. I am expecting again and would like advice for how to take care of my body while running through pregnancy. Specifically, how to care for my back as my belly starts to bulge. And how to know when enough is enough. It can be difficult to distinguish the general uncomfortableness (is that even a word?) of growing a human from an actual developing injury. Any and all advice from Dr. Shatto would be wonderful. Thanks so much! -Allie
Hi Trevor and Angie, I’m signed up to run my first marathon at the end of May in Traverse City, Michigan. A couple weeks ago my shins started bothering me. Last year I got shin splints in the spring. I tried to treat them the same way as I’d done in the winter (lots of icing, maybe a day or two off, stretching, massages, etc.), but this time they just didn’t go away. Do you have any more suggestions for shin splints? I just bought a pair of compression socks, I ice once a day, and I massage my calves with a lacrosse ball. If I continue to back off on the running, but maintain a high level of cross training, do you think I will still be able to run the marathon on May 27? Thanks, -Kate
I often have tightness in my calves. This can range from being slightly uncomfortable on one day to cramping calves the next. I would say that in about 70% of my runs, I feel the tightness in my calves and have just learnt to run through it. (Which is never really a good thing!!). Any ideas? Thanks for a great podcast. -Wayne
My question has to do with IT Band tightness/irritation. When my IT band (left side) is particularly aggravated, it manifests in extreme pain just under my left ankle-why is that and how can I prevent it? The pain gets so bad that it feels like I’ve broken something! Thanks, -Britt
Hi Angie and Trevor. My name is Clayton and I’m a New Zealander that lives in China. I’ve been listening to your podcasts for about the last couple of years and it has helped me tremendously. Here’s my question. What do you do if you have a running injury and you do not have access to professional help that understands your sport? It is widely said that You should find a doctor or a physiotherapist that is also a runner so that way he or she will understand your injury and assist you in the right way to get you back out training. In my city I have been told that with my knee injury, I should stop running completely and that running is bad for your knees. I know this is untrue. Is it better to take someone’s advice who doesn’t understand your sport and your needs or should you try and find the answer on a website, running blog or YouTube? Are there other options for us runners that aren’t in the most convenient place in the world. Thanks for all you guys have done for me over the years. Your podcasts have been a life saver. Sincerely Clayton B. A Kiwi runner in China.
Also Mentioned in This Episode
We are totally stoked about our new resource that is now available at a special introductory price. This has been a project 1 year in the making and we believe it is the most in-depth resource for preventing and self-training running injuries anywhere on the internet. See what’s inside:
Hi MTA. Started listening a few weeks back now however in the response to Katie, Angie you say slower runners consider 4 hours as a max while also qualifying slower as 6 to 6 and a half hours. Really? a 50% + increase from longest long run to marathon while discussing injury prevention? Did I hear that right? Did you mean to say that?
Thanks for the great question. In the context of slower runners who are either currently struggling with injury or are coming back from injury I totally stand by my statement of capping the longest run at four hours. While a faster runner may be able to run twice the amount of miles as a slower runner in a given time period, one of the things that really matters is the cumulative stress over time. The body doesn’t know how many miles it has covered over a certain time period, it just knows the stress. If a slower runner tries to run as far as a faster runner during training, the extra time it will take increases the amount of stress and therefore puts the slower runner at a greater risk for injury.
To break it down a little more, a runner who does a 20 miler is completing approximately 76% of the total marathon distance. A 6:00 marathoner (13:45 pace) would cover around 17.5 miles in 4 hours for a total of 66% of the total marathon distance. A 6:30 marathoner (14:50 pace) would cover around 16.2 miles in 4 hours for a total of 60% of the total marathon distance. Yes, a slower runner could push through for a 20 miler taking them anywhere from 4:30+ but the benefits of that effort have to be weighed with the extra recovery time it will take for their body. As a coach who has worked with a large variety of marathoners I don’t see a 20 miler as any magic number to prepare for the marathon. It works great for most people, but I also recognize that some older, slower, heavier, or injury prone runners may not benefit from that in training. I hope that helps clarify my thought process.
Hi my name is Margaret One month ago i was diagnostic with gluteal tendinopathy, im very concern about it because even thought im taking physical therapy, it seems that i still have a long way to go. Please help me. The pain has decreased but i really want to go back and run.