How to Support Joints and Reduce Injuries if You're a Runner

running injury

Story at-a-glance -

  • You enjoy multiple benefits when you exercise consistently, and may increase your risk of chronic illness and disease when you’re inactive
  • Running has been a popular form of exercise for decades, but when your joints are poorly supported you may experience injuries that can sideline you for months
  • Running in minimalist shoes, or barefoot, may reduce vertical force of impact through your knees and hips, but requires a gradual adaptation period to ensure proper form and muscle development
  • Using proper running form will reduce your risk of repetitive stress injury to your hips, knees and feet and will reduce loading rate through your legs and lower back

By Dr. Mercola

The benefits to regular exercise are amazing. Science continues to discover how movement and muscle work affect nearly every system in your body. The opposite is also true. Inactivity is associated with a greater risk for Type 2 diabetes, heart disease, obesity, cancer and depression.

Exercise has far reaching effects on your health, as it helps to normalize your glucose, insulin and leptin levels by optimizing insulin and leptin receptor sensitivity. This reduces the inflammatory response in your body and thus reduces your potential risk for developing a number of chronic illnesses.

The benefits to exercise increase when you are consistent with your workouts. In fact, your body loses muscle tone and conditioning far faster than you may anticipate. Research has demonstrated those who exercise consistently over years may only lose 5 to 10 percent of their aerobic conditioning in a two- to three-month hiatus,1 but those new to a sport may lose up to half of their conditioning2 if they stop for two to three months.3

Injury is one of the reasons you may need to take a break in your routine. If you enjoy jogging and running as I did for many years, you may have already experienced an injury that sidelined you. There are several common running injuries you may prevent by taking care to support your joints.4 Runner's knee, Achilles tendonitis, hamstring injuries and stress fractures are common injuries that may be prevented by supporting your ankles, knees and hips.

The Anatomy of a Joint

A joint is an area in your body where two or more bones meet. Most of your joints are mobile and allow motion and movement. The joints that take the greatest impact while running are located in your feet, knees and hips and have a number of structures that help to support and cushion the joint. Each joint has tough bands of connective tissue providing support and keeping the joint stable as you move forward and side to side.

Ligaments connect one bone to another, while tendons connect your muscle to the bone. Joints also use several mechanisms to reduce friction between the bones. This reduces damage to the head of the bone and enables you to move more freely. Cartilage covers the surface of bones where they meet, helping to reduce resistance.

Your joints also have synovial membranes that secrete a sticky synovial fluid providing lubrication. This membrane lines the joint and seals it into a joint capsule. Between the bones and ligaments are also fluid filled sacs called bursa adding an additional layer of cushion in the joint. These structures are part of the system that protects your joints from injury and overuse.

The Benefits and Risks of Running

Knowing the benefits and risks of any activity helps you take advantage of the first and avoid the second. Like other forms of exercise, running has the potential to help you maintain a healthy weight, balance your insulin and leptin receptors, relieve stress and boost your self-confidence. Running can boost your lung function, reduce your blood pressure and support your immune system.5

Running short distances increases your heart rate and may improve your cognitive performance.6 Cardiovascular fitness in aging adults may reduce the risk of Alzheimer's disease. Regular morning runners also report improvements in sleep quality and concentration during the day.7 A study published in the American Journal of Cardiology demonstrated that running even five to 10 minutes each day at slow speed is enough to reduce your mortality and add up to three years to your life.8

Alongside the long list of benefits are several potential risks. The strategies in this article may help you prevent injuries. Without appropriate support, women run the risk of damaging Cooper's ligament, which supports breast tissue, and ultimately develop sagging breasts.9 This means you should wear an appropriately supportive athletic bra no matter what speed you are running.

There also seems to be a higher potential risk for abuse when running, compared to other cardiovascular activities. This may be related to the stressors on the body and the effect on the endorphins system, leading to addictive running and an increased risk of injury.10

Running compulsively may lead to running longer distances, which may also increase your risk for heart disease. Studies11 have demonstrated extreme endurance may lead to increased oxidative stress, inflammation and damage to your heart muscle that may lead to a cardiac event.12

Choose the Right Foundation

Choosing the right shoe may help you develop the right running form and help develop muscles that support your joints. Wearing shoes changes the way your feet interact with the environment, and often their biomechanical function.13 When you watch a toddler running barefoot you'll notice their toes grab the floor. Wearing shoes changes this function in your feet. The same is true when you wear shoes that have minimal foundation or support, or even when you run barefoot.

In a recent study from the University of Exeter, data revealed those who run without cushioning use their feet to provide the cushion to their joints by landing on the ball of their feet and not their heels.14

The researchers evaluated how the loading rate — force — acts when runner's feet hit the ground. This has been demonstrated as a significant risk in the development of leg and lower back injuries. Running in cushioned shoes encourages a rear foot strike, which increases the vertical forces with each footfall. Dr. Hannah Rice, lead author, commented on the results of this study, saying:15

"So many people use running as a means of reducing the risk of chronic diseases, but about three quarters of runners typically get injured in a year. Footwear is easily modifiable but many runners are misguided when it comes to buying new running shoes.

This research shows that running in minimal shoes and landing on the balls of your feet reduces loading rates and may therefore reduce the risk of injury. Our research tells us that becoming accustomed to running with a forefoot strike in shoes that lack cushioning promotes a landing with the lowest loading rates, and this may be beneficial in reducing the risk of injury."

Another study evaluated the influence of barefoot running on impact force and muscle activation over 16 weeks.16 Tests were done on instrumented treadmills and measured vertical ground reaction force and electromyographic (EMG) signals. Researchers found progressive barefoot training effectively reduced impact force, improved shock and reduced muscle activation intensity.

Barefoot running and using minimalist shoes may also improve your gait efficiency and result in better performance.17 Researchers found that moving from a cushioned shoe to a minimalist shoe requires a gradual adaptation phase to reduce the risk of injuring muscles you might rarely use. Achilles tendonitis or calf strain can occur when you no longer run with a heel lift on a shoe. Running barefoot may also expose you to environmental debris and cuts on your feet.

Strength Train Your Heart and Legs

The large muscles around your knees and hips help support those joints and prevent injury. Research suggests that maintaining strong leg muscles may help prevent the development of osteoarthritis (OA).

In research evaluating the remains of nearly 2,500 people spanning 6,000 years, scientists found the average American is more than twice as likely to develop osteoarthritis (OA) as those born before 1940.18 The researchers theorize one factor increasing your risk may be a reduction in leg muscle strength that support your knees.

Strength training may help to reduce your risk of OA as well as reduce your risk of injury to your knees and hips. However, it's important to not only address the strength and stability of your legs, but also your core muscles that improve your overall balance and strength. A functional personal trainer may help design a program that helps reduce your risk of injury while running.19 Addressing the needs of your whole body may reduce your potential risk for falls, overuse and other types of injuries.

Oftentimes you run at a specific pace for your entire workout. This lowers your heart variability or the function of how well your heart responds to the second-by-second oxygen needs of your body. Heart rate variability has been evaluated as a prognostic factor for individuals with heart disease and diabetes. Research demonstrates an increase in variability improves this population's prognosis, potentially through angiotensin II and nitric oxide mediators.20

In the last 20 years, trainers of elite athletes have been using heart rate variability to determine how well the athlete has recovered from their last workout.21 Consistent high variation in heart rate is a strong indication of recovery. In past years these measurements required expensive equipment, but today many fitness and sleep trackers have this function built in.

High-intensity interval training (HIIT) is a healthy strategy to improve your heart function and strength so heart rate variability increases and your oxygen needs are met consistently throughout your run. HIIT may be performed with your resistance training, cross training on a bike or rowing machine, or during one of your runs during the week.

The benefits of HIIT far exceed heart rate variability and includes an improvement in VO2 max, increased release of nitric oxide, reduced blood pressure and loss of body fat. Read more about HIIT at my previous article, "Can You Really Get Fit in Six Minutes Per Week?"

Your Running Form May Increase Your Risk of Injury and Joint Damage

In this short video, running coaches Sage Canaday and Sandi Nypaver demonstrate correct running form to help reduce your risk of injury and the vertical impact forces on your feet, knees and hips. Running is a repetitive movement, so when you don't have the motions correct you increase the risk of suffering an overuse or repetitive motion injury.

Repeating the same motions thousands of times each week is a recipe for disaster when those motions are not biomechanically correct and place additional stress on your joints. Alternatively, you may increase your risk of repetitive strain when you wear the same shoes each day, run the same route, run at the same pace and never vary your workout.22 There are multiple ways of introducing variety into your routine. You can vary your:

Mileage

Speed

Route

Schedule

Elevation

Shoes

Terrain

Subtle changes impact the distribution of force through your legs. You may try running in minimalist shoes for half your run and barefoot the other half. Reducing repetition may help prevent injury to your joints. Remember, as you vary your mileage, do not increase your distance by more than 10 percent in one week as this one factor may be enough to trigger an injury.23

Overtraining is another factor that often leads to repetitive injuries. Taking at least one day off each week and interspersing light days in the rest of the week helps to reduce the risk of over training. Schedule a light day after hills or interval training, and restrict those heavier workouts to once weekly.

Pay Attention at the Table

What you eat also has an impact on your risk of injury. Cellular nutrition may either increase or decrease inflammation in your body. The greater the inflammatory response in your body, the greater the risk you'll experience pain and discomfort. Lectins-rich foods may increase inflammation, soreness and swelling.24 Wheat and gluten-containing grains also bind with glucosamine, a natural compound found in your cartilage that helps reduce friction between bones inside your joints.

Lectins can also be found in high concentrations in corn, corn-fed meats, peanuts, cashews and soy products. For more information on how to reduce your intake of lectins, see my article "How to Reduce Lectins in Your Diet." Other foods that may increase the inflammatory response in your body include:

Refined sugar

Soda

Carbohydrates

Caffeine

Aspartame

Food additives

Junk foods

Pasteurized dairy

Nightshade vegetables, such as potatoes, tomatoes and eggplant

Avoiding inflammatory foods and eating more anti-inflammatory ones may reduce your inflammatory response even further. Following a low-net-carbohydrate ketogenic diet will literally change the way your body uses energy, allowing it to burn fat for fuel, which creates fewer reactive oxygen species and free radicals that damage your DNA and cellular and mitochondrial membranes. These factors have the effect of a lower inflammatory response and may even slow the aging process.

Don't Forget the Benefits of Collagen and Stretching

Many of the common injuries experienced by runners involve joints and connective tissue, such as ligaments and tendons. Keeping these tissues strong and supple may help to reduce the number of injuries you experience. Collagen is one nutritional substance your connective tissue uses to repair after a hard workout or an injury.

Collagen fibers are the main structural components of connective tissue and made of a large family of proteins.25 Aloe vera gel may increase collagen production when applied topically. Consider an aloe vera massage after a workout to benefit collagen production and reduce muscle soreness.26

Vitamin C is critical in the production of hyaluronic acid, which one study demonstrated may help boost collagen production.27 Hyaluronic acid decreases as you age, so eating foods rich in vitamin C, such as citrus fruit, kale, red peppers, broccoli, kiwi and strawberries, may increase production and support collagen.

Cilantro contains vitamin C, and also linoleic acid that fights free radicals and supports collagen production.28 Ginseng has antiaging effects due to the support of collagen production and protection against UVB rays,29 so consider including ginseng tea in your daily nutritional choices.

Regular stretching will also help reduce overly tight ligaments and tendons and increase the stability of your joints. Yoga practice may assist with flexibility and help improve your athletic performance, improve the utilization of oxygen and improve your lung functions. Each of these factors support the health and stability of your joints.