Fact Buster

Q: Do runners risk injuring their knees and ankles?

A: They can, but there are simple measures they can take to reduce their injury risk.

Our expert: Sebastian Buccheri



[Image source: Sergey Ivanov/iStockPhoto ]

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It's well known that running has many health benefits. It increases fitness, keeps you lean and doesn't cost a cent.

But would-be runners are often discouraged when they hear tales of the aches and pains that come with the territory of being a regular pavement pounder.

The most common injuries include shin splints, jogger's heel, Achilles tendinopathy and knee (or iliotibial band  ITB) strain.

Not only are these painful, but they can cost a small fortune in physiotheraphy bills and sideline you for weeks.

But experts say running itself doesn't cause injuries; it's that many casual runners don't wear appropriate shoes or don't do resistance training to keep their leg muscles strong.

Luckily, with a bit of knowledge of your foot biomechanics and ensuring you look after yourself, running can be a life-long form of exercise for pretty much everyone.

If the shoe fits

Sebastian Buccheri, exercise physiologist and board director of Exercise and Sports Science Australia, says most people wear the wrong shoes because they don't know what their natural foot alignment is.

"Some people have an excessive foot pronation, which is a very flat foot and can result in internal rotation of the leg," he explains. "This overloads the knee joint and hip and puts pressure on your pelvis.

"If you're an excessive foot supinator, which means you have a high foot arch, you can get stress fractures in the leg and foot."

He strongly recommends having a podiatrist assess your feet and stride, so you can be fitted with appropriate running shoes.

While there's debate over whether forefoot or rearfoot striking (that is which part of your foot lands first) is better for speed and injury prevention, Buccheri says amateur runners are better to stick with what feels natural.

If fact, a study from the University of Western Australia found trying to change your foot strike can do more harm than good. The researchers determined that rearfoot strikers (about 75 per cent of people) who change their technique increase their risk of injury and will most likely end up becoming slower.

Starting off slowly

If you're new to running, another way to protect your bones and joints is by easing into it, Buccheri says. Rather than running for 20 minutes straight, you should start out by alternating between walking and running to give your muscles and joints a chance to get stronger.

"Start out on grass instead of the pavement," he suggests. "Shin splints often occur when you're just starting out and immediately run on hard surfaces like concrete."

Always stand tall, relax your arms and don't tighten your shoulders. Otherwise you'll begin to hunch forward when you fatigue and that will restrict your breathing.

Preparation is key

When you're short on time and keen to get into your exercise it's easy to skip the warm-up and cool down to save time. However these steps help you to avoid injury, and are essential regardless of the exercise you do.

A good warm-up should last for at least five minutes and increase your heart rate enough to make you break a sweat. This stops unnecessary stress being placed on your heart and lungs and also prepares your muscles by boosting blood flow to them.

"The best warm-up for any sport is to use the muscles you're about to use in a less intense way," explains geriatrician Professor Maria Fiatarone Singh from the University of Sydney.

"So for runners that's walking, jogging, then building up to your normal running pace."

Equally important is having an active recovery (cool down), Buccheri says.

"Don't just stop your run, jump in the car and get back to your day," he stresses.

"An active recovery means walking for an extra five or 10 minutes at the end."

This will bring your heart rate back to normal and removes the build-up of waste products in your muscles that occur during exercise.

If time really is an issue, then don't worry so much about your pre-run stretch. Recent studies show stretching before and after exercise has little impact on muscle soreness.

It's still important to stretch for flexibility because running puts pressure on the major muscles in your lower body, causing them to become tight. Without regular stretching, tight muscles impact your range of movement and can make everyday things like squatting and straightening your legs more difficult.

Buccheri recommends using a massage ball or foam roller for 10-20 minutes on your non-running days. The best time to do it is while you're watching TV.

"Do your calves, but also your hamstrings, lower back and glutes, which are our biggest muscles and cop a lot of pounding whether we sit, stand, walk or run," he says.

Keep your muscles strong

Even the most seasoned runners should do regular strength training, two or three times a week, to further reduce their chances of injuries such as muscle tears.

"If you strengthen the muscle, then the tendon that attaches it to the bone is also stronger," she explains.

"The best exercises are moves like squats, calf raises or leg presses, which all involve the muscles used when running."

Regular strength training becomes even more important as you age, as your muscle mass starts to decline and your risk of osteoarthritis increases after age 50.

Singh suggests alternating running and strength training days. If you're trying to get fitter, run for shorter distances at a faster pace; if your goal is endurance, you'll need to run longer distances at a pace you can comfortably maintain.

"There are lots of ways to do it but having regular rest days is important for recovery," she says.

"You can certainly increase your fitness without having to train every single day."

Sebastian Buccheri is an exercise physiologist and board director of Exercise and Sports Science Australia; Professor Maria Fiatarone Singh is a fellow of the Royal Australasian College of Physicians and works with Sydney University's Exercise, Health and Performance Research Group. They spoke to Cassie White.