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April 2012: Prevention of Running Injuries

31 Mar 2012

Dr. Charlotte Covello is a board certified podiatrist affiliated with Vanguard Weiss Memorial Hospital. Her specialties include sports injuries, preventive care and diabetic foot care. She has special expertise in treating runners’ injuries.

Charlotte M. Covello, D.P.M.
Michigan Avenue Podiatry
(312) 701-0770 

As sure as the longer days and warmer temperatures are harbingers of springtime in Chicago, so is the sight of runners coming out of winter hibernation. Unfortunately, after a few months of diminished winter activity, springtime enthusiasm can often lead to injuries. Whether you’re a seasoned marathoner or a beginning runner, adding on the miles too quickly can lead to injury.

The vast majority of running injuries are a result of overuse—specifically, too much running too soon. Despite investments in high-tech gear or winter cross-training programs, your body needs time to adjust to the increased load placed on bones, joints, tendons and ligaments that occur with the impact of running. Even if you’ve maintained your fitness on a treadmill, your body will still need time to adjust to the more rigorous demands of outdoor running on a harder surface.

The following guidelines and resources can help you avoid and recognize common running injuries:

The 10 percent rule: your mileage should not increase by more than 10 percent a week.
If you’re a beginning runner, there are some great resources available online to help you work toward your goals. These include “The Couch-to-5K” plan ( and the training programs offered by Jeff Galloway. The Galloway plans are helpful for beginners, as his training regimens implement a walk/run method. This is a good way to gradually build a strong base (

More advanced runners with a goal of completing a half or a full marathon may prefer the Hal Higdon ( training series. Each of these programs includes appropriate weekly mileage increases.

Invest in your footwear
There is a dizzying array of gadgets and gear available for runners offering benefits in hydration, nutrition, and pace and distance monitoring. These purchases should come only after you ensure that your feet are properly outfitted; those high-tech GPS watches are useless if you can’t train due to injury. Proper shoes and socks should take priority in your gear budget.

Visiting a running specialty shoe store is important particularly for beginners. This is true because of the importance of fit; your training shoes should be a half size to a full size larger than your regular shoe size to allow for the spaying of the foot that occurs on impact. Guidance from an experienced sales person is important in selecting the appropriate shoe in the correct size. Technical wool or other moisture-wicking socks are also a good investment to help prevent blistering.

The barefoot running craze
“Barefoot running,” oddly enough, is hardly synonymous with “shoeless” running. The recent trend toward shoes that emulate barefoot running come with many claims of improvement in form and decreased incidence of injury. These claims have not yet been proven by a definitive study, and, so far, are largely anecdotal. There is factual evidence, however, that human beings have been wearing shoes for upward of 10,000 years, and subsequently our feet have evolved to reflect the different forces on bones in shod feet. Over time, weight-bearing bones in the forefoot have become slimmer. A sudden change in the biomechanics of the foot can easily overload these bones and lead to stress fractures. If you wish to experiment with these types of shoes, it is crucial to do so in very small increments and on a soft surface, such as a padded track or on grass.

Listen to your body!
Some aches and pains are inevitable when you’re a runner. It’s important to recognize which of these are telling you that you need a bit of a rest, and which ones indicate you may require medical attention.

As you begin adding miles and increasing the intensity of your runs, you can expect symmetrical muscle soreness in both legs. You should allow these muscles to recover before doing another hard run. Cross training or shorter, slower runs are recommended while this muscular healing occurs. Pushing yourself too hard when you’re still aching from yesterday’s run can increase the risk of injury.

When to seek medical attention
Prompt diagnosis and treatment of injuries can lessen the impact and downtime associated with an injury. Knowing when to take a break and when to see a doctor is important:

  • You should seek medical attention if you experience pain that is sudden and severe in nature, as this can be an indication of a fracture or tear.
  • Swelling and bruising over a sore spot can also be suggestive of serious injury.
  • Pain during running that does not resolve after two weeks or worsens gradually should be evaluated.
  • If there is a biomechanical imbalance causing pain or discomfort, this can often be treated via physical therapy without requiring downtime.
  • Any pain that causes a limp or change in your running form should be evaluated.
  • Trying to relieve pressure on one area can cause secondary injury due to compensation—something as minor as a blister can lead to something as serious as a stress fracture. 

Enjoy your run while you take care
Running is a fun, inexpensive, healthy and a readily available activity. If it is what you chose to do for cardiovascular health, weight management or competition, make sure to maintain healthy running habits so that you can continue to participate for many years.

For more information
If you would like more information about preventing injuries while running or other podiatric concerns, or would like an appointment, please contact Dr. Charlotte Covello at (312) 701-0770.