A study in 2021 found four main psychological factors that increase injury risk in running – and they are quite shockingly absolutely nothing to do with your shoes, gait or terrain or anything you may guess straightaway.
The research showed them to be:
Identity –meaning identifying as a serious athlete can lead to risk taking or what we would maybe call pushing ourselves.
Perfectionism – our self-criticism and competitiveness made longer harder training more likely, leading again to more risk exposure.
Stress – we know that both normal negative life stresses and bigger events affect everybodys pain perception and in an activity can cause us to be distracted and make less rational choices.
And finally Relationships – now all our relationships can be a source of worry, stress or concern but a poor coach relationship or indeed no coach relationship can loop us back to the previous issues of Identity, Perfectionism and Stress.
Now to keep things in perspective the more we expose ourselves to anything in life, the risk increases. For example, I have a disproportionate amount of car issues from punctures to problems BUT I also do four times the mileage of most people due to living more remotely. So my exposure ( road use, mileage, car wear) is greater therefore the odds of an incident are higher. Exactly the same if we are lifting regularly, running or practicing yoga. But the increase in exposure through activity is preferable to less risk and less activity.
When we learn about injury, let’s talk in terms of reduction not prevention. However, stretching or yoga often comes up in conversation about preventing injury in runners. A perspective to consider is that there simply isn’t enough evidence to support the claim that stretching prevents injury.
Running is similar to yoga in that there is a tendency to chase shapes or mileage. Ideally, for both we would see mixed cross training as part of the picture of injury mitigation and understand that it is still only part of the puzzle.
Yoga can still play a good role in rest and recovery skills by dialling down the nervous system and exploring nasal breathing and lung capacity and many sporty people like introducing yoga for its elements of focus and self awareness.
Worry less about fixing or replicating things like stride gate or terrain and more about working WITH the variables rather than against them. Research shows time and time again that these things do not matter as much as we think they do.
Instead tolerance, variety and adaptability are all good training exposures.
For injury reduction, consider less peaks and troughs in all elements including:
Hydration
Nutrition
Mileage
Intensity.
Rest
Recovery.
You may be very consistent in running regularly but lack consistency in the basic key pillars of health for everyone. This can be such a useful reflection and a healthy one as it focuses neither on increasing or denying yourself anything but simply smoothing out the bumps of pits and peaks.
Recovery and running sees foam rollers, tennis, balls, peanuts, massage guns etc getting pushed on us – but are we doing what we think we are doing?
Can we use these products to deform the tissues or change your internal architecture?
Is myofascial release biologically implausible? If it takes around 9000 N to change our IT band by around 1% and 4500 N to change your planter, fasciitis by around 1% this is a strong chance that massage therapy and all the tricks and tools we buy has very little effect on changing the length or tension of our tissues at all. Just like stretching your hamstrings doesn’t make them biologically longer at all.
So is there still of value in self massage? The answer is a strong yes!
If it feels good do it. A massage can make you feel great and give you positive mental feel good change for the nervous system so it definitely has value for your health and well-being.
Massage also provides good sensory feedback and when we deal with pain and injury our proprioception and pain perception becomes a bit skewed.
We hear phrases like ‘releasing’, ‘ironing out the kinks’, ‘working a knot out of a muscle’– when we look at cadaver work, however, we cannot see tense shoulders or knots in the muscles, these are nervous system responses.
Ultimately, if these techniques help you feel better do it. Manual therapy like many types of yoga is about into playing with the nervous system rather than actually changing the structure of the body. Interplaying with the nervous system and its tolerance are what creates a change rather than physically being able to manipulate tissue properties to create a biological change
A happy nervous system is key to creating balance in all of the systems of the body, including a perception of pain. After all, the vast majority of pain doesn’t come from damage but heightened systems.
But it’s hard to feel energised or enjoy your sport when you are in pain or injured. In fact could pain and injury be included in the top most common barrier to enjoying our sweaty pursuits?
There’s NOTHING good about feeling benched from what you love doing. Currently there just isn’t enough evidence to support stretching as a method to prevent pain and injury But it can still have pleasant and beneficial interaction with the nervous system as part of your rest programming.
If increasing flexibility, stamina, range of motion is the goal then strength training is ideal for runners. Start to load your muscles, tendons andligaments.
Know your sport and strengthen accordingly.
We think nowadays not of injury prevention but of injury reduction and strength training is an excellent starting point.
Here are some tips to help you feel closer to your run. They are built on increasing a wider awareness to life, mood, food and more and it’s something I often use with private clients who are passionate about there pursuits but are stuck in recurring pain and problem loops.
Create a training diary that keeps a weekly account not only of your mileage but pace, strength, training, movement skills, how you are sleeping, how are you feeling generally, nutrition, and take into account your work and home life stresses. This will help you with your own patterns and also create and build a valuable resource to show your coach if you are struggling with training progression or your physio should you be struggling with injury.
A simple emoji scale of happy, ill, sad or neutral faces and a few honest answers around external factors, nutrition and hydration can often help with the bigger picture more than numbers on the fit bit.
We know without shadow of a doubt that pain is not an isolated mechanical problem and in pain research and coaching we look at the whole bio psycho social and emotion person so why should running or indeed training be reduced to the approach of this bit of my machine is broken in isolation, this bit needs fixing.
Nowadays, most sports are multifactoral in their training approaches but running can still tend be a little narrow focusing on only mileage and speed.
Not all miles are created equal … and miles, speed and distance do not give us the whole picture. Milage alone isn’t a reliable predictor for pain or injury, just like pain isn’t a reliable predictor of damage.
Variables in human movement is normal and unavoidable so instead of trying to replicate the latest ideas around gait that popped up on YouTube, try working WITH your variables, rather than against them.
Tolerance, variety and adaptability are great training exposures.
Commit to a consistent program, so avoiding the big peaks and troughs in all elements from hydration to mileage, nutrition to intensity and of course, rest and recovery.
Aim for smooth transitions in any of these areas if you need to meet life changes such as holidays, illness, scheduling etc – it’s those rapid increase and decrease that can cause problems.
In summary think less of how running keeps you fit and more about keeping your body fit to run.