Running by Brian Kitzerow, PT, DPT, OCS, CMPT

Spring is upon us and the rainy weather is calming down.  With more good weather many of us will be subtly tempted to increase our training intensities and want to stay out for that extra mileage.  Though it is a good idea to increase our strength and endurance, doing so in a mindful manner can prevent injuries that can set our training back a month or more.  Proximal hamstring tears, achilles tendinosis, calf lesions, plantar fasciosis, stress fractures, low back pain and patellar femoral syndrome (PFS) are all common running injuries that are more likely to occur when training regiments are progressed too quickly or when tissue damage is happening too consistently for the body to have an opportunity to strengthen the stressed tissues.

Research into running shows that low levels of muscle damage is a regular response to running.  Additionally, muscle damage appears to have to occur in order to progress strength levels.  We know that muscle is very regenerative.  It is one of our body’s most repairable tissues.  The problems arise when the quantity and frequency of healthy injury begins to exceed the body’s ability to repair it.

So, how to balance the natural damage we do to our body’s ability to handle it while progressing a spring/summer running program?  One long-time guideline has been the 10% rule.  Meaning we don’t progress our running distance greater than 10% in one week.  The main problem with this rule is its’ over-simplification, but that is also one of its’ main strengths.  This rule gives you a basic guideline and doesn’t require a great deal of analysis and oversight to ensure that your response to the increased workload isn’t approaching an unhealthy level.

You can pad the 10% rule for a greater probability of success by monitoring your response to exercise.  Muscle pain tends to be healthy, but pain at your tendons, especially where they interface with their bony attachments tends to indicate overuse.  Additionally, pain in the bones of your feet or around the joints of your hips and knees also can show excessive inflammatory responses that may precede more serious injury.   Recovery is essential.  Inflammatory processes typically peak after 48 hours suggesting that taking an extra day of recovery if you start to suspect early injury may be very helpful for extending injury-free long-term training.

Though consistency is important for form and coordination, changing the stresses on your body can help you train harder and longer.  Consider alternating your running shoes between two similar styles or brands to change the distribution of forces through your lower extremities.  Work in progression style runs where your pace increases at different points from beginning to end of your run.  Or work in other forms of aerobic and resistive exercise.

As you increase your runs this year do it safely and with good awareness of your strategies and physical responses to raise the odds of success.


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Lee A, Anderson J, Joya J, Head S, Pather N, Kee A, Gunning P, Hardeman E.  Aged skeletal muscle retains the ability to fully regenerate functional architecture. BioArchitecture. 2013;3(2):25-37
Irintchev A, Wernig A. Muscle damage and repair in voluntarily running mice: strain and muscle differences. Cell and Tissue Research. 1987;249:509-521
Buford T, MacNeil R, Clough L,  Dirain M, Sandesara B, Pahor M, Manini T, Leeuwenburgh C.  Active muscle regeneration following eccentric contraction-induced injury is similar between healthy young and older adults.  Journal of Applied Physiology. 2014;116(11): 1481-1490.

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