Nate Helming from The Run Experience breaks running injuries into two types: acute injuries from falls or collisions, and overuse injuries from exceeding your body's capacity. Most runners miss the underlying deficits in mobility or stability that cause overuse injuries. He recommends testing your own movement with a deep squat and overhead reach to catch problems before they become injuries.
Chapters
I would probably say there's two buckets of injuries that we can, that we could put in. One is the, the, oh, sudden, I just fell, twisted my ankle. I stepped out on a sidewalk and got hit by a bicycle or a car, like something. I don't mean to be morbid, but just, you know, like the sudden out of nowhere injury that occurs. More likely to happen. More like an accident-ish. Exactly. Like, like, and those exist, you know. Sometimes people are going down the trail and they eat it, you know, and they, and they all of a sudden they're like, I sprained my wrist or sprained my ankle, right? Like, that's a category of injuries where it's like, okay, this was a bad moment. You just need to literally rest, recover. There's maybe a few exercises you need to do, but there's nothing intrinsically wrong with your mechanics. So you can just kind of go back to normal and you'll be fine. The other more pervasive and insidious level of injury is the overuse injury. And I think the overuse part of the word is almost a misnomer. It's sort of like, well, I was fine until I just did too much and now all of a sudden I'm hurt. But what that sort of ignores is, is, is what the volume probably showed. And what the volume probably showed was, was the limits of your capacity both from a mechanics standpoint and maybe a stability or strength standpoint. Right? You just earlier on, maybe it was a small little wiggle, but you were fine, but then you started running more and more. Not only does that wiggle catch up with you, but maybe that wiggle gets even bigger. And all of a sudden, you start to see collapse. So if you're that person who deals with an IT band issue, a knee issue or something else, if you just rest and ice and hope to return to normal, you actually haven't gotten anywhere because you're not taking ownership over the mechanical part. And the ownership part only really works when you're educated on that there's a problem in the first place, because if you don't know there's a problem in the first place, well, you don't know what to fix. But it's questions we need to start asking. And every time a runner like, I was like, man, I was feeling great. And all of a sudden I got this weird calf strain. It came out of nowhere. And it's like, really, really came out of nowhere. Like, get out of here. Like, these injuries are like lingering below the surface of our awareness. I bet if we had a massage therapist dig into that calf of yours a week before, it was probably pretty darn tight. You would have hopped, yelped off the table. So, this is where a lot of more preemptive work where I'm doing regular mobility work, I'm exploring my edges of my strength and my stability. It's not when— it's not if people fall apart, it's when. No one can hold a plank for infinity. So, the goal is just to push my strength out commensurate with the distances I'm trying to run or the speed I'm trying to run. If there's a big mismatch is when we sort of have a problem. So that's kind of what I say with the injury prevention or the injury stuff is like we need to take ownership over the overuse stuff. And you're not always going to figure out alone, seek help, but you have to be your own advocate and you have to realize that if I have this injury, that's this little niggling thing. Like, I can't just rest and ice and go back to normal thinking everything's going to be fine because maybe every once in a while it will be. And if that's you, Kudos to you. But for a lot of us, myself included, it is— it is not the case at all. If I don't have a good understanding of how my body's supposed to move, how to create stability at the hip and the shoulder, how much extension I should have in the hip, how much flexion I should have in a hip, which is basically the difference between squatting all the way down to being in a full lunge where I can extend my leg out the back. If I'm— if I don't understand those basic things, my stretching is going to feel a little bit more arbitrary. Like, well, I guess I'm just sort of lengthening my hamstrings. And it's really not about lengthening any muscle. It's really about, hey, I know that to be a strong, healthy human, I need to be able to hit certain positions. I need to be able to bring my arms all the way up overhead. I need to bring that hip all the way back behind me. I need to be able to squat all the way down so that my butt can be right above my ankles and my feet are flat and straight ahead. And, okay, if I can't do one of those positions, okay, why can't I do it? Am I lacking range of motion or is it a stability motor control thing? Oh, it's a— it's a range of motion thing. Okay. My ankles are stiff. Well, why are my ankles stiff? Well, maybe there's something connected to my shins and my calves. Okay. So maybe I'll start to increase the range of motion there in the calf. But keep in mind when you're stretching your calf, it's not just lengthening the muscle for the sake of lengthening the muscle. You're affecting your ankle joint. So what we really care about is not stretching, but the mobility of the joint itself. We have to understand that every muscle is connected to a tendon, which is connected to a joint. So we wanna make sure that we're holding a high standard for what that joint movement should be. And this may sound more complicated, like, well, man, how— where do I even start with that? It's simple as starting with a few basic positions we should all have, which would be a squat. You keep coming back at the squat, huh? That is definitely one key one that I— yeah, yeah, you know, just it's a simple sound bite for things like this, especially when I'm not able to like visually represent with people. That certainly is the tip of the iceberg. There are more things, you know, you could talk about being able to bring your arms all the way back up overhead. There's other little shoulder internal external rotation tests that you can do that can affect your arm swing, that affect your posture up overhead. There are certain tests you can do to look at how stiff your thoracic spine is, and they're a little more subtle, but, you know, sort of important. But I find that is really helpful to then give someone understanding of like, okay, these are the areas you need to stretch, because there are certain people that stretch too much. They're actually overly flexible, and it's actually not flexibility that's holding them back. It's lack of stability. They actually are not able to stabilize their joints, and that's why they break down and they get hurt. So it's not just stretching more, but it's, it's, you know, stretching the right places and stabilizing the right places.
