Strength training to prevent running injuries
September 18, 2019 4:35 PM   Subscribe

I'm an solidly mid-pack trail and ultra runner who's been running for about 10 years. In the last couple years, I've started to struggle with a series of overuse injuries. I'm fairly sure they all share the same root cause: insufficient strength work, especially in my core, glutes, and hips. I really hate strength work, don't love gyms, but want to do a better job staying injury-free. Please help me figure out how to more seriously engage in strength work and stay injury-free! Specific questions inside:

My injuries have all been in my lower legs: ITBS, peroneal tendonitis, hamstring tendonitis, and now this weekend's race brought another soon-to-be-diagnosed ankle tendon injury. Hence the hypothesis (supported by several PTs I've seen) about the root cause being core/glute/hip strength. When I do PT focused on those areas, I can heal, at least until I injure myself again.

My goals are to continue to run ultras (mostly 50k, but a couple longer distance runs per year) but to stay injury-free while doing so.

I'm a 38-year-old cis man, in case that shapes folks advice.

Sme specific questions:

1. Other endurance athletes: how have you find the time/energy/willpower to engage in cross-training? I love running (and hiking), and enjoy biking and swimming. So I spend all my time doing those things. I really hate strength work and tend to only do it when a PT directs it. I know it's good for me, but how the heck do I make it happen more consistently?

2. I'm thinking I should get a personal trainer. I worked with a (running) coach several years ago and found the external accountability helpful. Does this seem like a good idea? What should I look for in a trainer?

3. If not a trainer: are there other self-guided resources that'll help? Please assume I know next to nothing about strength work. For example: I tried Starting Strength several years ago and even though it's supposed to be for beginners I couldn't figure out how to use it effectively.

And, of course, I would love any general advice from fellow endurance athletes about how to keep spending all day in the mountains without getting hurt so much.
posted by jacobian to Health & Fitness (12 answers total) 23 users marked this as a favorite
(I know I give this answer anytime something about core strength or hip injuries comes up....) Pilates will help you with your core and glute strength, which supports your gait and everything about your lower extremity mobility and coordination. Weight training would focus on the large muscles, but Pilates addresses the whole muscle system, both active and resting, and includes the small supporting/stabilizing muscles along the large muscles. You will find that participants in many Pilates classes are primarily female-presenting, but if you are concerned about this, the workout does not exclude men and you might be able to ask around to find trainers who are experienced with working with men or who have classes that some men go to. You can certainly do both weight training with a personal trainer and Pilates with a trainer or in a class, the workouts would complement each other well. (I am not a Pilates trainer but working with one has helped me greatly.)
posted by matildaben at 4:43 PM on September 18, 2019 [2 favorites]

On 1, I go to a kettlebells class I really like - having a set time and a bunch of nice people to do strength work with makes me more likely to stick with it. Also solves the “How do I do it?” problem.

I’ve never had a PT, but if I were to get one now (in my mid-40s) I’d probably look specifically for one my age or older. I think until it happens to you, the stuff that happens with age - more frequent injuries, slower recovery - is hard to wrap your head around and younger coaches are more inclined to adopt a “just push through it” approach which isn’t appropriate or useful as you start to get a little older.
posted by penguin pie at 5:02 PM on September 18, 2019 [1 favorite]

This isn't the same situation, but I needed to strengthen my back and glutes due to back pain from lifting a kid. I worked with a physiotherapist and she designed a strength training routine for me using mainly body weight exercises, some stretchy bands and a few dumbbells. I can easily do it at home in my living room. It fixed my back problems, and I was surprised at how well I was able to bicycle at the beginning of the season, even though I hadn't been cycling over the winter. Based on my experiences, I would highly recommend working with a physiotherapist for strength training, especially for injury avoidance or recovery.
posted by ice-cream forever at 5:19 PM on September 18, 2019

Best answer: My data point of one: lifetime runner/cyclist, doing tris up to IM distance, ultras up to 50mi. When I was 42, I started doing a popular training program that starts with a C (specifics don't matter here). I ultimately dropped my mileage quite a bit to make room for the crosstraining. Now I'm 53, still do crosstraining in the gym maybe four days a week, a long run on weekends, and I'm literally faster now than I was at any time in my life except my mid 20s. Since making this pivot 11 years ago, I've had two running injuries. So yes, I would agree with your hypothesis that some kind of strength training is going to help you with longevity and staying injury free. On to your questions:

#1 I would start by looking at some kind of group classes, as that is what motivates me to get into the gym most days. It doesn't have to be pure barbell/strength stuff, even something like a fitness bootcamp is going to help you quite a bit with getting more resilient.

#2 Regarding a trainer: if you are going to go it alone, yes, by all means get a trainer to help you, someone who understands endurance sports. Ask around in your local tri community for references. You won't always need a trainer, but if you are just getting started on a new program, it will be well worth it. If you are going to go the route of some kind of structured class or bootcamp, you are going to be stuck with the class format and won't need a trainer.

#3 Regarding self guided resources. The other thing that I believe helps quite a bit with injury proofing yourself is some kind of yoga or mobility routine. I've been doing some form of yoga regularly (like five or six days a week) for about seven years. It also makes a big difference in everything, because the flexibility just lets you get into more efficient shapes. Alternatively, you can do mobility work with rollers, bands, and balls. Some specific recommendations: ROMWOD, which is a yin yoga focused home program (subscription model). It has a CrossFit bias, just FYI. Kelly Starrett's rebooted MobilityWOD, which is now The Ready State. Another subscription based, do it a home on your computer thing. Jill Miller's book, The Roll Model. She also has videos. This is using various balls to roll out. Main thing is that if you aren't already on some kind of mobility program and you are putting in enough mileage to do a couple of 50Ks and longer a year, you are probably pretty jacked up and anything you like and can stick with is going to help.

Last piece of advice: if you just do even a little bit - one day of yoga a week or one day in the gym doing strength stuff, it will absolutely move the needle if you just stick with it.
posted by kovacs at 5:21 PM on September 18, 2019 [2 favorites]

I'm more of a cyclist and sometimes-runner myself, and I just started strength training with a personal trainer. I meet her twice a week. In the longer term, once I get more comfortable with the gym and the equipment and the routines, I'll drop down to once a week or less often. But right now I need the accountability and guidance, especially because I find gyms intimidating. It's so easy to do what she tells me to do -- I show up and don't have to worry about what I'll be doing in the gym that day.

For what it's worth, I've pretty much given up on running. I never got into the distances you are doing, but it's so high impact. It's been motivating to read about how important strength training is, not just to complement what I'm doing, but also just to keep me healthy as I age (I'm mid 40s). We lose bone density and muscle mass if we don't use it.

Do you hate strength training or just find it confusing and intimidating? A good trainer can help with that. As for how I found her: I have a local gym, and they matched me with someone. I met her and like her, so that was all pretty easy.
posted by bluedaisy at 5:37 PM on September 18, 2019

I really like Courtney Wycoff’s workouts - mostly 15-20 minutes a day with a serious focus on functional strength of core, pelvis, and glutes. I subscribe to “MommaStrong” but she also does a series with a focus on male anatomy, “PappaStrong.” The workouts would be good for people who aren’t parents; I think there’s just a bigger market for short workouts for people who have kids.
posted by Kriesa at 5:42 PM on September 18, 2019 [1 favorite]

I found a gym that does semi-private personal training. It's roughly a 4:1 ratio per trainer. They designed a program for me, and that gets changed as needed about every 16 sessions. The guys who run it have Sports Science Bachelors and generally seem to know what they're talking about. It's been helping me quite a bit.

I did not love going to the gym by myself and have lots of trouble motivating myself to work out at home, but having this sort of structure and coaching is great. I try to go as often as I can.

Mine is in Central/South NJ, on the off chance you're here. Otherwise I'd look for something similar in your area.
posted by pyro979 at 6:47 PM on September 18, 2019

If you understand the exercises that the PTs prescribe, and the problem is mostly making yourself do them, a common trick is to tie them to some other activity. E.g., stand on one leg while you brush your teeth, plies and elevees while you wait for the subway, planks during the commercials if you watch television or listen to radio.

Also, you probably want something more like yoga, pilates, or gymnastics than a barbell strength program. I am an intermediate lifter (1.6x bodyweight squat) and I spend most of Pilates lying on the mat resting. Totally different workout.
posted by meaty shoe puppet at 8:52 PM on September 18, 2019 [1 favorite]

As a fellow runner (hello!), what helped me get over my recurring injuries was a weekly prehab 1-1 with a kinesiology trainer under the guidance of my PT. Time had proven I would not do this stuff on my own, but I will show up if someone else will tell me what to do. So, I think your idea of a trainer is worth pursuing, though more beneficial if it's someone who deals specifically in physiology and athletes/athletic injuries-- not just a hard work out. (I've been very lucky to have health coverage for majority of the costs).

Happily, I did this weekly for about 8 months and things are going so well that I've started actually doing some basic workout stuff on my own! (On non-run days). It's been hard to build a habit, but now that I'm doing more prehab I can feel the benefits in my runs. Good luck to you!
posted by tamarack at 10:26 PM on September 18, 2019

I’m a regular runner (though not as accomplished as you) who modified Stronglifts 5x5 for home and using adjustable dumbbells instead of the barbell. In place of the squats I do single leg lunge-squats. In place of the bench press, I do a floor press in a kind of a bridge. For the deadlift, I add more reps to make up for the lack of weight. The military press is still a military press, just with the dumbbells.

I’ve gained a lot of strength, everywhere, but especially core, glutes, hamstrings and it’s only 30 minutes or so per workout, three days per week.
posted by notyou at 10:32 PM on September 18, 2019 [1 favorite]

I love running (and hiking), and enjoy biking and swimming. So I spend all my time doing those things. I really hate strength work

Have you tried bouldering? It is good for core strength, and it is possible that you will find it more enjoyable and more interesting than weight training.
posted by cyanistes at 6:48 AM on September 19, 2019

Best answer: I've (male) only been running half as long as you, but went through peroneal tendonitis, ITBS and a stress fracture. I've been doing ultras since 2017, and this year had 3 races in the 100mile+ range.

1) I limit strength work "obligations" to what I will do. So I don't tell myself that I'm going to start going to the gym and doing an hour of strength work. Instead, I will do the Mountain Leg routine in either 5 minute or 3 minute version right after my harder runs. Sure, getting to the gym and raising my squat ability would probably be great, but actually doing *anything* will be better than nothing.

Additionally, I've setup my daily routine, so my last hour-ish of the day, I'll watch something on my tablet, and while doing so, will do various body weight stuff, re-hashing some of the work I was given by PT's, balance work, SAM along with foam rolling or various self massage. I find it less mentally onerous to do "stuff" while watching something versus 30-60 minutes of exercises given by a PT where I'm doing a rigid order, concentrating on counting/timing every rep to perfection...

2) I started running at 37 and will be 42 for a few months longer. I've never had a personal coach, but one of my running groups is run by a coach, and he'll give workouts based upon timing for some local/non local races that we tend to have a lot of people run at. I've found that I tend to do the workouts harder, and am much more likely to do the workout. I've also found that hard/fast running is more likely to lead to injuries for this master runner. So I mostly go to the group runs for socialization and might grab some of the workout to do the next time I'm doing a workout.

Depending on insurance, it might make sense to see if your PT will give further exercise / work with you to further develop strength while avoiding injury. Personal trainer is almost more of a sales position than anything else, and they might not necessarily have any knowledge about preventing injury.

Alternately, consider a race coach who's also a PT. At least there are 2 in my area, and another few who are chiropractors who skew closer to PT than woo.

3) In a recent comment I mentioned Running Rewired by Jay Dicharry. This would be the best self-guided resource for avoiding running injury that I can think of.

General advice - don't do a hard workout if you aren't feeling great. It's OK to run a recovery run, or just easy aerobic running any day of the week. I did a race each month from May - August. I did 0 speed work since April. The closest to a workout I did was my hill walks described in the next paragraph. I was concentrating on recovery and continuing to just be able to run.

Unless you're an amazing runner, you're likely at least walking up the hills even in a 50k. How often do you pracice your walking? Similarly practicing your transition from walk to run and run to walk? I've got a good 22m tobaggon hill near my home, and at least 2x a month (when it's not covered in snow) I'll be there for 1-2 hours power walking up the hill, resting a bit, and then running down hill at either a sprint to toughen the legs towards eccentric wear, or concentrating on technique of being as gentle while not fighting gravity as I can.

I touched on it briefly, but especially if you're having ankle issues, one legged balance, and working on one's proprioception would likely be useful.
posted by nobeagle at 8:31 AM on September 19, 2019 [2 favorites]

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