Doctor shares how to prevent and treat running injuries

Nothing stops a runner in their tracks like a throbbing knee or a sore foot.

Most runners have experienced soreness at one time or another, usually from trying to do too much without a proper training foundation.

On the eve of the TCS City Marathon in New York on November 3, we spoke with Dr. Mark Grossman, a sports orthopedist at NYU Langone Hospital-Long Island, on how to prevent and treat common running injuries.

How do I start an exercise routine?

People ask me, “How do I start an exercise routine?” The first thing you should do is consult your primary care physician to make sure you are healthy enough. You really want to take things easy and gradually build.

Fit it into your weekly schedule as best you can. This way you develop a routine. Listen to your body – any aches or pains, take a break. Be ready to rest at any moment to avoid injury and see a doctor if the pain persists.

What kind of shoes should I wear and how often should I replace them?

There are many different types of running shoes. However, good cushioning is essential and will facilitate gentle foot strikes for lower impact on bones, joints and soft tissues.

Running shoes should be replaced every 300 to 500 miles.

What are the most common injuries you see?

The most common injuries I see are bunions, which is pain and inflammation around the inside of the leg bone. Another would be iliotibial band syndrome, which is pain on the outside of the knee. The last thing we tend to see is Achilles tendonitis – this is inflammation just above the heel bone in the Achilles tendon itself, which can be painful with excessive running. Fortunately, many of these running injuries can be treated at home.

What should you do if your feet hurt?

When you’re injured, it’s good to take a break, rest, and ice. Any nagging pain that affects your stride for at least two weeks should be evaluated. Rest is critical so you can rebuild yourself. The rule of thumb is to not increase your mileage by more than 10% each week.

How can a runner avoid injury?

The most important thing for a runner to avoid injury is to stretch forward, ensure adequate hydration during the run, allow a five-minute cooldown and allow your heart rate to decrease, and then stretch again to avoid tight muscles. This will help you avoid injury.

What stretches should runners do and when should they do them?

Running involves a variety of muscles. There are many stretches you can do. The main thing is not to stretch for two minutes, but 10-15 minutes or more. This will also put you in the right mindset to run. Here are the stretches I like:

• Side shot
• Piraformis stretch
• Arm swings for your upper body
• Standing quad stretch
• Seated thigh stretch
• Pushing the wall
• Ankle mobility heel lift

If I get hurt once, will I get hurt again?

Hopefully not, but you need to analyze what caused the damage and adapt. Here are some tips:

• Exercise properly: Stick to the 10% rule – increase your activity by no more than 10% per week
• Avoid hard surfaces: Use a soft track or dirt track sometimes
• Maintain proper form: Don’t overdo it, which can increase impact
• Cross train: Rotate swimming, cycling or even elliptical work to train and avoid the impact of contact
• Stretch, stretch, stretch
• Strength training: Use weights to improve body mass and balance
• Eat healthy
• Use heat before and ice after: Joint and muscle pain can be treated with heat before a workout or race to get the blood flowing and ready for activity. Muscles and joints can be swollen after a run, so soothe them by applying cream afterwards.
• Listen to your body! Runners with pain or swelling should seek appropriate medical attention with a physician’s evaluation. Rest and physical therapy may be in order.

How does diet play a role in running injuries and recovery?

Focus on berries, soy products, canola and olive oils, green tea, and foods rich in omega-3 fatty acids, which have anti-inflammatory properties beneficial for joints.

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Mark G. GrossmanMD, is clinical associate professor in the Department of Orthopedic Surgery at NYU Grossman Long Island School of Medicine and chief of sports medicine and arthroscopy in the Department of Orthopedic Surgery at NYU Langone Hospital-Long Island. He specializes in treating patients with orthopedic sports injuries and helping patients return to their previous level of sport.