Holistic Approach to Running Injury Prevention and Recovery

Deep Dive

Physiotherapist Brodie Sharpe, host of the Run Smarter Podcast and author of "Run Smarter," joins The Strength Running Podcast to discuss how to learn from running injuries. Sharpe, who specializes in endurance runners, emphasizes a holistic approach to injury prevention by examining both training and lifestyle factors.

Sharpe explains that the primary goal of learning from an injury is to identify its cause. He posits that most running-related injuries stem from an imbalance between training load and the body's capacity to recover. This mismatch can manifest as increases in weekly volume, speed work, changes in footwear, or excessive hills. Sharpe stresses the importance of retrospective analysis to avoid repeating the same mistakes and to fortify oneself against future injuries. He also highlights that under-recovery, poor nutrition, and insufficient sleep can contribute to injuries, citing research that indicates a 32% increased likelihood of injury following a week of poor sleep.

The discussion then explores the possibility of not learning from an injury. Sharpe considers this highly uncommon, suggesting it implies a lack of deep investigation or an undetected factor. He uses the example of hormonal changes in females during their menstrual cycle affecting tendon collagen turnover as a factor that might go unnoticed. Sharpe acknowledges that while one can dismiss an injury as random, a deeper dive often reveals crucial information.

Sharpe recounts a personal experience of a fall during a trail run four years prior, which he does not classify as a running injury as it was not a repetitive stress injury. He contrasts this with a tweaked Achilles tendon injury two years ago, which he attributes to a single long run that was dramatically longer than his previous longest runs, clearly identifying it as a training error.

Sharpe reminds listeners that the risk of injury cannot be eliminated entirely, but safeguards can be put in place to minimize it. He advises catching symptoms early and making minor adjustments to avoid significant fitness loss. He also notes that ignoring early signs, such as persistent tightness, can lead to more severe injuries, as demonstrated by his experience with tight calves due to increased muscle mass from High Rocks training.

Lifestyle factors contributing to injury risk are then examined. Sharpe emphasizes adequate calorie intake to match energy output and sufficient protein for rebuilding muscle tissue post-exercise. He reiterates the critical role of sleep, noting that improved sleep can increase the capacity to absorb training load. Sharpe introduces a "cup" analogy, where training fills the cup and recovery empties it; when the cup is close to overflowing due to stress, poor sleep, or nutrition, injury risk increases.

Emotional states and personality traits are also identified as lifestyle factors impacting injury risk. Sharpe discusses how perfectionism and a competitive drive can lead runners to push too hard or take insufficient time off, contributing to injuries. He notes that individuals with Type A personalities may benefit from motivation but can also be prone to overexertion.

The influence of social media on injury risk is considered. Sharpe suggests that while social media can be motivating for some, it can also be unhelpful by fostering comparison and a desire for external validation. He shares his personal decision to leave Strava to avoid focusing on how runs might appear to others, prioritizing personal enjoyment and flexibility.

Training errors are presented as the most common cause of running injuries. Sharpe references the "three twos" principle: too much mileage, too fast a pace, and too soon. He advocates for using a training log, including subjective notes, to track training load by multiplying workout duration by average effort. This metric helps identify significant jumps in training load that could lead to soreness or injury.

Changes in footwear are highlighted as a common training error. Sharpe explains that transitioning to different shoe types, such as zero-drop or minimalist shoes, can redirect load to different parts of the body, potentially leading to overuse injuries if not done gradually. He cites a study where 12 out of 14 athletes attempting to transition to minimalist shoes got injured.

Trail running is discussed as another area requiring gradual introduction. While trails can offer variability and potentially reduce ground reaction forces, abrupt shifts can strain calves, Achilles tendons, and increase the risk of ITB friction syndrome, particularly on downhills.

The density of intensity in training is identified as a risk factor, especially for Type A runners who may condense hard workouts into a few days. Sharpe advises spreading out key sessions like long runs and workouts with adequate recovery days in between. He also refers to the 80/20 intensity distribution rule, suggesting 80% of training should be at low intensity and 20% at higher intensity, and recommends incorporating a deload week every four to five weeks.

When restructuring training after an injury, Sharpe advises making tangible rules based on what caused the injury, such as never increasing long runs by more than 30%. He also suggests identifying and strengthening weak links in the body, which may require professional help.

Sharpe emphasizes the importance of treating injuries and training as experiments to become smarter runners. He advocates for listening to the body over strictly following a training plan, as external factors like illness or stress can impact recovery. Finally, he stresses the importance of appreciating pain-free running moments and practicing gratitude to foster a healthier mindset towards the sport.

Brodie Sharpe's resources include his book "Run Smarter," the Run Smarter Podcast, and his online services at Run Smarter Online.