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  • Writer's picturePatrick Carroll

12 Months Running Injury Free

Updated: Aug 24, 2023

I hope I’m not tempting fate but I believe hitting 12 months without missing a run due to injury is noteworthy. I know there are people who are on a far longer streak and we could learn from them too but I’m keen to share what I think has helped me reach this point.

To clarify, I’m tracking this from September 2022 to September 2023. This period has seen the largest 12 month volume I have ever covered (3,640km approx) and I have run personal bests in the marathon, 10 mile, 10k and 5k distances. I’m aiming for a half marathon PB in early September 2023 too.

Professionally, I find running injuries fascinating. I spend a lot of time working with injured runners, learning about running injuries and thinking about how to apply this knowledge in the real world. My thoughts here will be inherently shaped by this work but I do want to get across what I experienced rather than write a literature review.

1) Managing Training Load

This has to be top of the list. It’s well established that the leading cause of running related injury is training error. Typically, this means there has been an increase in training distances, intensities or a change in environment (e.g.,hills) that we are not ready for. Depending on what research you look at up to 70% of running related injuries can be attributed to training error.

Without doubt, the last significant injury I had was due to a training error. Considering how I make a living that’s quite hard to swallow but I have to be realistic. I was preparing for a trail race with a lot of elevation. Quite simply, I introduced too much hill work into my training in a short period of time. I was like someone cramming for an exam!

The crux of the problem for runners is that the majority of us want to improve. Challenging yourself with your training is part and parcel of this but it’s a fine line between providing the right stimulus and overdoing it. Unfortunately, I don’t have a perfect solution for this and to the best of my knowledge nobody else does either. Load management strategies are becoming more sophisticated but even in the most well resourced programmes we see athletes struggling to run injury free consistently.

So how do I actually “manage training load?”. I like having a consistent weekly structure. Whether I am working to a formal plan I have written to prepare for a race, or in a period of non-programmed training I stick to a similar routine. On a typical week I aim for five runs. This is Monday to Thursday with a cross training session or recovery day on the Friday, a longer run on the Saturday and I usually don’t train on a Sunday. Two S&C sessions are in the weekly plan also. I have had periods where I’d run on the Friday or Sunday but longer term I think good quality runs on the five days suits me. If I'm hitting 80k I've had a good week. That would increase if there is a longer race in the calendar. The type of run I do each day will be dictated by what stage of my race preparation I’m in. I avoid back to back high intensity days and I like having a day off my feet training wise before the challenging Saturday session. A day to recover after the hardest session of the week sets me up well for the following week too.

Within the higher intensity sessions I err on the side of doing what I think is just enough to get the benefit I’m after rather than hammering myself and hoping I’ll be okay the next day.

Discussing load management typically revolves around training you’re doing. It’s important to note that gaps in training are significant too. I try to avoid very low volume weeks. I hear it a lot in the clinic, someone “goes off” running due to lack of motivation, a spell of bad weather or personal life commitments take over. They try to go back to their regular running routine but can’t tolerate it and pick up an injury.

It’s inevitable I’ll have periods where my running volume dips. I was at a friend’s wedding in Italy in July and over a 7 day period run a total of 18km. One was early morning before the festivities kicked off and the other was in the evening the day before we flew home. It wasn’t much, it didn’t make me fitter but it did provide the type of stress for the soft tissues so that when I got back to regular training it wasn’t a complete shock to the system. These weeks are rare.

In terms of technology support I’m not beholden to anything in particular. I use a GPS watch daily and wear a chest strap most days when training. I use the HRV4 Training app to measure resting heart rate and heart rate variability (HRV) in the morning. I do find the HRV measurements useful, if I see sustained suppression of my baseline score I know it’s not the right time to be ramping up intensities. I largely ignore any advice from Garmin about whether I’m “Productive”, “Maintaining” or whatever else their algorithm spits out.

A combination of easy running, continuous tempo work and faster intervals for shorter duration forms the bulk of my running. I will have strides or sprints in the weekly routine too. In itself, this ensures some variability of the training demands. Not only is this important for improving different components of fitness, it also impacts the type of stresses your bone, tendon and muscle experience. I swap between two different pairs of shoes depending on the session and I try to include training on trails, grass and gravel paths.

2) Race Selection

I see people making a mess of this regularly. I appreciate people wanting different things out of their hobby but an overloaded race schedule with minimal recovery time and insufficient time to prepare for specific events can be a disaster. I’d class myself as being on the conservative side with how many races I enter. Over the 12 month period I’m describing I’ll have raced 10 times. If I do have a couple of races in quick succession I’ll try to pick ones that are complementary. An example being, a 10 mile race in Feb 2022, a marathon in early April 2022 and a half marathon on the trails in late April 2022. There was a good base in place, I worked up to the marathon distance and felt I was recovered enough to run the trail half marathon. I tend to enjoy races more when I feel well prepared too. The thought of banging out 5k races every week over the summer doesn’t really appeal as I don’t see how I’d get much better. I think this helps from an injury perspective, it allows decent recovery and a good preparation period before racing again.

3) Strength Training

No surprises here. I’m not shy about promoting the benefits of strength training for runners. It’s well established that it can boost running performance and despite a lack of resounding research it is well accepted that improving the quality of your bones, cartilage, muscles and tendons makes intuitive sense to help mitigate injury.

We know that physiological components of fitness such as VO2 max, fractional utilisation and running economy are the main determinants of running performance. These are undoubtedly improved most effectively through well programmed running. However, from a biomechanical perspective you need to apply force to the ground to propel yourself forward. Typically, running is a submaximal effort so you’re not looking to generate your maximum force on each foot contact. With that in mind, if you improve the maximal amount of force you can generate through the lower limb the relative percentage of this maximal force you will need to run at the same speed will be lower. This tends to cost us less energy and it also gives you more of a buffer in terms of how much force you have in reserve. Theoretically, if you're closer to your “force ceiling” when running the risk of injury increases.

In practice, I try to strength train twice per week. I chose exercises that target different strength qualities and ensure key body parts are being targeted. A typical strength session will include some jumping or hopping which targets reactive strength qualities. Being able to generate high levels of force quickly is crucial for runners, 250 milliseconds is a typical ground contact time! I use exercises like a deadlift or squat to work on maximal strength. These allow me to try and generate as much force as possible without worrying about balance. Single leg exercises such as hip hinges or step downs challenge muscle coordination and recruit stabilising muscles well. Focused work around the calf is in my weekly routine too. The calf complex, including the achilles tendon, contributes approximately 50% of the force needed to generate forward movement. Having high levels of peak force and local muscular endurance are important here. The clip below outlines what I think is important.

There is far more depth to how strength training can influence running performance but the overview I have given should give a good idea of why I feel it is a worthy inclusion in this article. If you feel like you could do with some help with your strength training check out the resource I have created here.

4) Nutrition

I can summarise my thoughts here in one sentence. Make sure you’re eating enough. Running is an energy intensive activity and if you’re not matching your overall energy expenditure with adequate intake you can get into trouble very quickly.

In the physio clinic I regularly see bone stress responses and the odd established stress fracture. On investigation it usually comes to light that training loads were increased without any consideration of the energy requirements. Overuse injuries to muscles and tendons are also much more likely if you’re in a state of low energy availability.

Bodyweight in running can be a sensitive subject. It’s something I think about quite a lot. I consider myself a healthy bodyweight but for someone eyeing up a sub 2.45 marathon I’d be on the heavy side. My last round of skinfold testing saw my body fat percentage come in at 7.7%. That’s fairly lean and to be honest I think I’d struggle to become much leaner. My weight at that point was 77kg. When you consider VO2 max is related to bodyweight then dropping a couple of kg’s would lead to increased performance. On paper that sounds like a no brainer but there is always a trade off. Dropping into a negative calorie balance while training quite hard impairs the quality of your higher intensity sessions and increases the likelihood of injury. In my case I’d likely be dropping muscle mass, there are implications there for force production too.

I’m sure if I worked with a sports dietician and measured what I’m eating closely I might come down in weight a bit. It would likely require a lot of planning, headspace and potentially sacrificing social events or meals out. I’m just not up for that. There are other ways to get fitter!

The key things I focus on are the right types of carbohydrates at the right time and ensuring I get enough protein throughout the day. In marathon blocks it’s easy to be too low on the carbohydrate front. Generally, anyone training should be looking into their protein intake. I’d recommend anyone to use a tracking app like MyFitnessPal for a week to see what your typical intake is like. If you’re running high volumes and strength training then a protein intake of up to 2g/kg of bodyweight can be advisable. I regularly refer clients to a sports dietician named Evan Lynch. If you think you would benefit from more individualised help his team can help.

In summary, I’d rather stay a stable bodyweight and be consistent with training compared to under-eating, dropping weight and becoming more susceptible to injury.

5) Lifestyle Management

I feel like this is the bit that everyone knows but finds the most difficult to implement. Running places stress on the body. That’s a good thing in the right amount. If we’re able to recover from the training stimulus / stress then we improve. If we can consistently do this over a prolonged period (years) we can improve a huge amount. Unfortunately, life throws stress at us in many forms!

Poor sleep, pressure in work or relationship issues are all stressors to some extent. Excessive alcohol or caffeine intake coupled with poor dietary choices can be detrimental. Constantly comparing yourself to others on Strava can be stressful!

The complexities of people’s circumstances limit how useful generic advice is here. Running sits in different places on people’s priority lists too, I appreciate that. In saying that, I’m happy to share some of the principles I use.

Protect your sleep. There is no substitute for it. General wellbeing and physical performance rely on the body and brain repairing itself and developing overnight. I try to keep 10.30pm to 6.30am as my “sleep window”. That means trying to be in bed for 10ish with my phone in another room. When I’m in a good routine I usually wake before my alarm and feel pretty good. I know this is idealistic, I don’t work shifts or have young children. If my scenario changed and I was faced with longer periods of disturbed sleep it’s likely I’d change my expectations of what I’d be getting from my training.

Alcohol is another area I’ve definitely changed over this 12 month period. I’ve had plenty of periods in my life where I’d drink a fair amount most weekends. That just doesn’t lend itself to getting fitter or staying generally healthy. Training well for the majority of the week but overdoing the alcohol on a Saturday after a hard run on a Saturday morning sets me back a few days. Being more mindful with alcohol consumption is how I approach it now. I’ve no issue with having a couple of drinks now and then but I’ve also got better at going to social events or meeting friends and not drinking at all. It surprised me how much effort it took at the start but the rewards were huge.

Work related stress is something most of us encounter. It’s fairly normal to have periods where work ramps up and takes more of our focus from time to time. What I stay vigilant for is work related issues that nag me for prolonged periods. Low level stress for long periods is not good for us. Identifying the root cause of these issues and setting time aside to try and deal with them is time well spent. I have often blocked slots in the physio clinic to fix problems with booking systems or cancelation policies. I lose out on the few quid from the slot but I sort something that will reduce stress longer term.

Lastly, I’m a firm believer that if you schedule something for the first thing in a day you’re hugely increasing the likelihood of completing that task. I have flexibility with my work diary and have experimented with training at different times. Without doubt, my training is most consistent if I run early before work. There’s an accountability element too. I start my work day later so I need to justify taking that time in the morning.

Hopefully that gives an idea of how I can explain 12 months without an injury. There are certainly no secrets and I don’t see any groundbreaking changes popping up over the next 12 months. I will keep training and racing and I would like to be updating this to a “24 Months Without an Injury” article next year!

Thanks for reading and all the best with your training.

If you would like to learn more about the Running Buddy strength training app I have designed specifically for runners you can check it out here.

Do you have a running related injury you’d like help with? This is a link to my physiotherapy practice.



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