Understanding and Reducing Mountain Running Injuries
The Rut Mountain Runs are five months away, but now is the time to establish effective training practices to maximize success on race day. The complex terrain, altitude, and race venue pose unique training challenges. In this month’s article, Colleen Shields of The Mountain Project and I will discuss four common running injuries mountain runners face and how to reduce injury risk through proper training. Photos were created with assistance from Sarah Boughner, SPT. A YouTube video demonstration of the exercises described below can be found at the following link: *click here for YouTube video*
Achilles Tendinopathy:
Preparing for the steep, scree-covered climbs requires lots of vertical. Increasing training volume and vertical too rapidly places stress on the Achilles tendon. Decreased calf strength, insufficient Achilles tendon tensile strength, and excessive pronation all place higher stress on the Achilles tendon which may result in Achilles tendinopathy.
Calf Raises
Standing up on a box, place the ball of your foot on the edge. Dorsiflex at your ankle (let your toes come up and your heel go down to the ground, like you were stretching your calf) then plantarflex (point your toes down toward the ground) all the way up and squeeze your calf. Keep your leg straight (don’t bend at the knee). Feel free to hold onto the wall or another structure to keep your balance. You can do these double leg, single leg, or with weight to make them more difficult.
Single Leg Hops
Grab a single weight plate (or anything low and sturdy that you can jump on). As quickly as you can, hop on and off the plate, trying to keep your balance on your one leg. Use your calf to propel up. These are difficult on balance and take a lot of ankle stability. Start off double leg, at a lower height, or use a ski pole for more support to make these easier.
Patellofemoral Pain (runners knee):
Mountain running requires strong quadriceps to power you up the climbs and control your descent at speed. Inadequate quadriceps strength (especially in a downhill, lengthened or eccentric contraction) places increased load through the patella and the patellar tendon. Over-striding, excessive heel striking and a low step rate all contribute to the onset of patellofemoral pain. A step rate of 160-180 steps per minute will reduce knee impact loading and reduce your step length as well. A phone metronome app can be downloaded to provide an auditory reminder of your target step rate goal.
Single Leg Squats
Grab a dumbbell or kettlebell and hold it in your opposite hand of the leg you’re working. Hinge at the hips and bend at the knee, focusing on simultaneously driving your hips back behind you and down toward the ground. Keep the weight back in your heel and focus on keeping your knee behind your toes and tracking straight forward. Keep your torso tall and core engaged. Make sure you’re comfortable and have the strength to perform a regular squat (body weight or with a barbell/dumbbell) before doing single leg.
Jump Squats or Split Squat Jumps
A favorite staple at The Mountain Project. Like John mentions above, downhill running is all eccentric muscle contractions. Jump squats and split squat jumps are great eccentric plyometric exercises. Jump squats – starting in a squat position, explode and jump up, land in a soft knee position by automatically sinking back into a squat with the weight traveling back toward your heels. Split squat jumps– starting in a static lunge position, explode and jump up, switching legs mid-air and landing with your opposite leg in the front/back. Keep your front knee behind your toe and your back leg bent right below your hip. Start off with body weight resistance and add weight for challenge.
Iliotibial Band Syndrome:
Iliotibial band (ITB) syndrome tends to strike when a person is running fast and running often. The gluteus medius muscle (back pocket hip muscle) stabilizes the pelvis at foot strike. If the gluteus medius is functionally weak, then runners compensate unknowingly with the lateral quad and hip musculature which increases ITB tension. Similarly, fast running increases a narrower running stride known as cross-over. Cross over running stride increases lateral hip and ITB tension as well. Combine cross-over, gluteus medius weakness and you have the perfect recipe for ITB syndrome.
Lateral Abduction Band Walks
Place a resistance band/Thera-band up above your ankles/below the meaty part of your calf. Sink into a squat position and side step, pulling lateral tension on the band. Keep your knees tracking out over toes (don’t let them extend or collapse in) and keep your hips at the same level (don’t hike them up as you step). You should feel this in your glutes and hips pretty quickly. Make it more difficult by increasing the tension of the band or by holding a weight at your chest.
Plantar Fasciopathy:
While proper trail running shoes with a rock plate are a wise choice, footwear alone will not prevent plantar fasciopathy (plantar fasciitis). Symptoms include sharp pain in the arch and-or heel of the foot which is worse descending stairs and first thing in the morning upon rising. Once again, a sudden increase in training volume is the leading cause of plantar fasciopathy. Underlying causes include calf stiffness or weakness, decreased intrinsic foot muscle strength, and running on rocky, unforgiving terrain. Releasing tension in the foot and calf and providing additional foot-ankle support will ease symptoms, but prevention is the ideal approach.
Single Leg Balance on a BOSU (or Balance Disc)
Sometimes just standing single leg on a BOSU or smaller balance disc is difficult enough. Standing on an unsteady surface like a BOSU is great for firing all of those stabilizing muscles in our ankles that help keep us steady on rocky, unsteady, and uneven trail. To make it more difficult add in any kind of motion, like a single leg squat or deadlift (with or without weight). You can do this with the unsteady side down to make it easer (blue side of BOSU on the ground) or with it up to make it more difficult.
Foam Roll Calves & Arch
To decrease any kind of tightness after a day on the trails, we recommend using the foam roller on your calves. Roll it out for a good minute plus on each leg, starting with big long sweeping motions and narrowing it down if you find a super tight spot. Add active ankle and toe movement for more lasting relief.
Sapphire Physical Therapy and The Mountain Project will collectively provide monthly training tips leading up to The Rut weekend.
John Fiore, PT
Sapphire Physical Therapy
Sara Boughner, SPT
Colleen Shields
The Mountain Project