Tips to Live By

10 Strength Training Exercises for Runners to Avoid Injury

Oct. 23, 2024 - Josh Davis

Running is one of those sports people either love or hate — and those who love it, can't seem to get enough of it. Unless, of course, even with proper shoes and form, they overuse muscles that tend to tire after miles and miles of pounding pavement.

When that happens, pain can set in, worsen over time and even travel from the foot to higher up the leg as other muscles are strained.

The solution is strength training and stretches, says Dr. Scott Rand, a primary care sports medicine physician at Houston Methodist who's supported runners' health in Houston for more than 20 years.

"If you're a runner and all you do is run, you tend to overuse muscles that you don't really strengthen as well as you should," says Dr. Rand. "As that happens, people get very predictable patterns of injury that typically start at the ankle and work their way up around the knees and into the hips."

"By strengthening the muscles you use when running, you can decrease the likelihood of overuse injuries and have more long-term success," he adds.

Even better, you don't need a gym membership or fancy equipment to condition the appropriate muscles. Most exercises can be performed at home using your body weight and common items around the house. The others just require resistance bands and dumbbells.

Whether it's your first 5K or you have a marathon or more under your belt, Dr. Rand's guidance should benefit all runners for better endurance, fewer injuries and greater long-term success.

What injuries are runners more likely to develop?

As Dr. Rand emphasizes, runners — especially newcomers — will often develop very predictable patterns of injury: they start at the ankle and work their way up to the hip. However, experienced distance runners are susceptible too, suffering some injuries that, though typically milder, can last longer — for weeks, months or chronically.

Starting at the ankle, says Dr. Rand, runners will often get posterior tibial tendon dysfunction, or PTTD, a condition that causes pain just behind the inside ankle bone. The muscle connected to this tendon (the tibialis posterior) is key for maintaining stability, especially during running. Every time your foot strikes the ground, this muscle has to "fire" or activate to keep your foot stabilized, says Dr. Rand.

As you can imagine, since every time you step this muscle has to activate, overuse is all too common, especially as your mileage increases.

Around the knee, Dr. Rand says two of the most common running injuries are IT band syndrome and patellar tendonitis. Both mostly occur due to overuse.

The IT band runs down the outside of the thigh from the hip to the shinbone to help keep the knee stabilized. Every time your foot strikes the ground — even when just walking — the IT band is constantly being used. As runners strain this tissue, pain can develop on the outside of the knee, Dr. Rand says, but is easily treatable with stretches and anti-inflammatory medication, among other methods.

Patellar tendonitis, or jumper's knee, occurs when the tendon just below your kneecap becomes inflamed from overuse, causing pain in that area. Like the IT band, the patellar tendon helps with joint stability but also aids in decelerating. It's a very common injury in sports like volleyball and basketball, but it can also occur in runners (mostly men).

Further up, hamstring injuries can begin to develop. Hamstrings are the muscles that run along the backside of your thigh and help with balance, posture and stability. Dr. Rand says runners tend to neglect these muscles, which are vital to endurance but tend not to strengthen just from running like some other muscles do.

"If you don't specifically exercise your hamstring muscles, they won't get strong, will become more fatigued toward the end of a run, and will be more susceptible to injury," he says.

Finally, at the hip, there's the piriformis, a small but important muscle that crosses over the sciatic nerve and keeps the hip rotated outward. Like the others, says Dr. Rand, it's very commonly overused and can become "very tight" if not stretched and strengthened. As it crosses over the sciatic nerve, this strained muscle can sometimes cause pain that radiates down the leg.

When is a running injury serious?

"The pains that runners should worry about are what feel like bony pains at foot strike," says Dr. Rand. "If runners have pain that's in front of the shinbone, in their groin, in the forefoot area right behind their toes or midfoot, then we worry about stress fractures."

Unfortunately, stress fractures are very common in runners, Dr. Rand notes. He adds that they're also among the only injury types that warrant stopping running.

"If you keep running, you will break that bone," Dr. Rand says. "For most other pains, runners will push through, and we can do things to help them with that, but for those specific bony pains at foot strike, you need to see a doctor."

What muscles should runners strengthen to avoid injury?

Runners all have very strong quadricep muscles, or "quads," in the front of the thigh, but Dr. Rand says they tend to neglect the muscles that are more easily overused. Those are the more central, core muscles around the pelvis in addition to the ones mentioned above, which include the hamstrings, piriformis and calves.

"What we find is that runners strongest in their core, including the muscles around the pelvis, lower abdominal muscles, gluteus medius and hip flexors, tend to get injured less and run faster," says Dr. Rand. "They run with their glutes and hip flexors more than the rest of their leg muscles."

The stronger you are in those, he says, the more you will naturally become a runner who runs from their core.

So how can you strengthen those core muscles and support others more prone to injury? Dr. Rand suggests 10 exercises — both strengthening and stretching — that runners can begin to incorporate into their exercise regimen.

How often should runners be strength training?

According to Dr. Rand, two days of strength training and stretching per week is "plenty" to target those muscles that runners often neglect and overuse. Three sets of 10 to 15 repetitions for each muscle group is standard, but feel free to adjust to your specific workout needs.

If you're a runner, don't stop; keep going

"Running is the sport that other sports do for punishment," says Dr. Rand. "But it can be a source of pride for many and a big therapeutic release."

While many people ultimately wish to run a marathon, any running goal can be a great source of pride and self-achievement. Every runner starts with their first mile or kilometer.

Plus, in addition to our cardiovascular health, running can greatly benefit our mental health, whether it's chasing that euphoric state following intense exercise known colloquially as "runner's high," joining a running club to develop relationships and build community or simply spending time inside your head away from the hustle and bustle of life.

"The phrase I always tell my runners is that nobody finishes a marathon pain-free," he adds. "Don't expect to run pain-free, but know the pain usually isn't dangerous and solvable with a little bit of help."

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Categories: Tips to Live By