Head of Arcadia’s Running Injury Clinic Offers Tips on Risk Factor, Foundation Building for Runners

By Purnell T. Cropper | May 1, 2014

Dr. Brian Eckenrode, assistant professor of physical therapy at Arcadia University and director of the Arcadia University Running Injury Clinic, offers tips for runners—just in time for Sunday’s Broad Street Run.

Running Injury Risk Factors

On Sunday, May 4, an expected 40,000 runners will participate in the annual 10-mile Broad Street Run. Participation in running has seen exponential growth over the past two decades with the number of individuals participating at the competitive and recreational levels at an all time high.  Injuries are common in runners, with some studies noting 46-65 percent of runners experiencing an injury yearly. Runners training for a marathon have a reported incidence of injury as high as 90 percent. Also, runners who ignore the early signs of pain and discomfort can put themselves at risk.

Several risk factors for developing a running injury have been identified, with current evidence suggesting that a history of a previous injury is a primary factor. This may be from an incomplete recovery or from a pre-existing muscular or structural imbalance. Potential compensations in running form and technique can manifest themselves as pain symptoms. Muscular imbalances in strength and flexibility, in addition to structural issues, can alter one’s biomechanics when running. Recovery from injury should address all of these components including temporary rest from running (which is often the most difficult change to incorporate for runners). Injury prevention techniques can also be beneficial for the runner to address any impairments in strength, flexibility, or running form to meet their running goals.

Building a Better Foundation for Running

Running is a vital component of all types of athletic competition. There is great variety in how individuals run. Biomechanical and physical therapy research has begun to look at the effects of changing running gait variables, such as cadence and joint positioning, through verbal and visual feedback. Studies have shown short-term improvements in running gait efficiency in addition to less lower extremity pain in runners with an injury.

One important factor to note is that changing running mechanics may benefit some individuals, but it may not benefit all. Muscular weakness of the core (especially the hip abductors) is a common finding in runners and athletes with an overuse injury of the lower extremity. If the core or ‘foundation’ is unable to stabilize effectively during running, this can lead to suboptimal alignment of the hip, knee, ankle, and foot.

When running, individuals often take between 160 and 180 steps per minute. Over the course of a several-mile long run, a runner can take thousands of steps. Each step requires adequate muscular strength and timing to keep moving forward (and avoid falling). With an imbalance or weakness to the foundation, runners and athletes may be forced to compensate, leading to an overuse injury. Research on runners with a variety of overuse injuries (anterior knee pain, iliotibial band syndrome, Achilles tendinopathy) have shown positive benefits with core and hip abductor strengthening on decreasing pain and improving function.  Having a strong foundation is important for keeping runners and athletes in the game.

The Arcadia University Running Injury Clinic is designed for runners and athletes recovering from an injury, seeking injury prevention, or looking to improve their performance.  The session consists of a thorough musculoskeletal examination and video running analysis. A treatment plan recommendation is developed to address any strength or flexibility imbalances, running form, or training technique.

Eckenrode, PT, DPT, OCS is former 4-year collegiate cross-country runner with more than 12 years of clinical experience treating runners and sports-related injuries in his hometown of Philadelphia.