Most runners, whether they’re training for a marathon or simply out to get some exercise, will stretch before they take off. It’s a ritual that verges on the sacred, strongly connected to the intuitive sense that priming the muscles is a good way to avoid injuring them during the run to come.

But researchers at George Washington University and the USA Track and Field Association (USATF) report that stretching before a run does not appear to reduce injury at all. In fact, among the more than 2,700 runners in the study, ranging from recreational runners to competitive marathoners, all of whom ran at least 10 miles a week, the scientists found similar injury rates — of about 16% — over a three-month period among those who stretched before running and those who did not.

The idea behind stretching is to lengthen the muscle fibers to increase their function and hopefully enhance performance, helping runners maintain a faster pace or run for a longer period of time. A study of British recruits in the military found that a regular stretching routine before training reduced injury rates from 6% to 1%. But other recent studies among gymnasts, football players and wrestlers have questioned the practice, suggesting that stretching does not impact performance at all.

That’s why Dr. Daniel Pereles, a runner himself, decided to look specifically at the role that stretching might play in running injuries. Most studies on the subject, including the British trial in the military, involved stretching routines that included much more than stretching running muscles; they also incorporated calisthenics and other exercises. Pereles wanted to know specifically whether stretching leg muscles — the quadriceps, hamstrings and calf muscles — would have an impact on injuries.

Through the USATF, Pereles was able to recruit enough runners of various levels to get an answer to his question. About half of the 2,729 volunteers were told to stretch their quads, hams and calf muscles for three to five minutes before running for however long they usually exercised. The remaining half were told to run without stretching.

While he found that stretching did not have any effect on injury rates among the two groups, he did find several factors that did seem to influence whether the runners hurt themselves. Heavier runners, as well as those who had recently suffered an injury, were more likely to harm themselves. Interestingly, Pereles also found that those who switched from a stretch to non-stretch or non-stretch to stretch routine for the study were more likely to get injured. Stretchers who were told not to stretch during the three-month study increased their risk of injury by 40%, while those who switched from not stretching to stretching increased their risk by 22%.

Pereles is still at a loss to explain that trend, although he suspects the change in routine accounts for most of the result. “It’s completely confounding, but by switching routines, it somehow messed them up,” he says.

That’s why his advice, as both researcher and runner, is to stick with what works for you. “If it feels good for you to stretch before you run, then continue if you have the time,” he says. “But if it doesn’t feel good, and you like to run and then stretch, or not stretch at all, then that’s fine too. I can’t tell anyone there is conclusive evidence that stretching makes a difference in injuries or performance.”

He notes that professional athletes, who often spend as much time stretching and warming up as they do training, are combining stretching with other activities for a more dynamic warm-up. Most recreational runners, however, don’t have the luxury of spending that much time exercising. Pereles himself admits to changing his running routine as well, and stretching only a little before a run. Part of the reason, he says, is because he doesn’t have the time, and but part of the reason has to do with the science, which so far suggests that it doesn’t seem to make a difference in injury rates.



Source: 
http://healthland.time.com/2011/02/18/skip-the-stretch-before-running-%E2%80%94-it-doesnt-prevent-injuries/

 

 

Running: Preventing Overuse Injuries

What causes an overuse injury in a runner?

Overuse injury in a runner most often occurs because of a training error (running too far, too fast, too soon). With every mile that is run, the feet must absorb 110 tons of energy. Therefore, it is not surprising that up to 70% of runners develop injuries every year.

How can overuse injury be prevented?

You can decrease your risk of injury by following these recommendations: 

  • Do not increase running mileage by more than 10% per week.
  • Do not run more than 45 miles per week. There is little evidence that running more than 45 miles per week improves your performance, but a great deal of evidence shows that running more than 45 miles per week increases your risk for an overuse injury.
  • Do not run on slanted or uneven surfaces. The best running surface is soft, flat terrain.
  • Do not “run through pain.” Pain is a sign that should not be ignored, because it indicates that something is wrong.
  • If you do have pain when you run, place ice on the area and rest for 2 or 3 days. If the pain continues for 1 week, see your doctor.
  • Follow hard training or running days with easy days.
  • Change your running shoes every 500 miles. After this distance shoes lose their ability to absorb the shock of running.

What about orthotics to reduce the chance of injury?

Orthotics are inserts that are placed in shoes to correct bad alignment between the foot and the lower leg. You will probably need orthotics if the inside of your foot turns in, a problem called pronation. If you have bad alignment but no pain with running and you do not suffer from repeated injuries, you probably do not need orthotics. Many world-class athletes with bad alignment do not wear orthotics. Your doctor may suggest orthotics if you have bad alignment, become injured and do not get better with other measures, such as rest, ice application and cross training.

What exercises help prevent or treat injuries?

Before and after a run, perform specific stretching exercises. See the pictures below that show stretching exercises. These exercises may also be part of your recovery from an injury. Do not bounce with each exercise. Stretch until you feel tension but not pain. 

If you do develop an injury, your doctor may suggest particular strengthening exercises. Every day you should do 3 sets of each exercise, with 10 repetitions in each set. Be sure to exercise each leg, not just the leg that is injured. For the exercises that involve straight-leg raises, you will want to add ankle weights as the exercises become easier for you. These exercises may also be done as part of your overall exercise program.

Stretching exercises

Hamstring stretch

Hamstring stretch
Sit with your injured leg straight and your other leg bent. With your back straight and your head up, slowly lean forward at your waist. You should feel the stretch along the underside of your thigh. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. This stretching exercise may be helpful for
 patellofemoral syndrome (pain under and around the kneecap), patellar tendinitis (inflammation of the tendon that connects the patella and tibia) and hamstring strain (overstretching or tearing of the muscles on the back of the thigh).

Iliotibial band stretch

Iliotibial band stretch
Sit with your injured leg bent and crossed over your straightened opposite leg. Twist at your waist away from your injured leg, and slowly pull your injured leg across your chest. You should feel the stretch along the side of your hip. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. This stretching exercise may be helpful for iliotibial band syndrome (knee tenderness from irritation of the thigh’s iliotibial band) and adductor strain.

Groin stretch

Groin stretch
Sit with your feet together, your back straight, your head up, and your elbows on the inside of your knees. Then slowly push down on the inside of your knees with your elbows. You should feel the stretch along the inside of your thighs. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. This stretching exercise may be helpful for adductor strain (overstretching of the groin muscles).

Quadriceps stretch

Quadriceps stretch
Stand straight with your injured leg bent. Grasp the foot of your injured leg with your hand and slowly pull your heel to your buttocks. You should feel the stretch in the front of your thigh. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. This stretching exercise may be helpful for
 patellofemoral syndrome, iliotibial band syndrome and patellar tendinitis.

Calf stretch

Calf stretch
Stand with your hands against a wall and your injured leg behind your other leg. With your injured leg straight, your heel flat on the floor and your foot pointed straight ahead, lean slowly forward, bending the other leg. You should feel the stretch in the middle of your calf. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. This stretching exercise may be helpful for Achilles tendinitis (inflammation of the Achilles tendon, the large tendon at the back of the ankle),
 plantar fasciitis (heel pain) and calcaneal apophysitis (inflammation where the Achilles tendon attaches to the heel, usually in children).

Plantar fascia stretch

Plantar fascia stretch
Stand straight with your hands against a wall and your injured leg slightly behind your other leg. Keeping your heels flat on the floor, slowly bend both knees. You should feel the stretch in the lower part of your leg. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. This stretching exercise may be helpful forplantar fasciitis, Achilles tendinitis and calcaneal apophysitis.

Strengthening exercises

Straight-leg raise

Straight-leg raise
Lie down with your upper body supported on your elbows. Tighten the top of the thigh muscle of your injured leg. Raise your leg on a count of 4, hold for a 2 count, and then lower the leg on a 4 count. Relax your thigh muscles. Then tighten the thigh and repeat. Do 3 sets of 10 repetitions each day. Once your leg gains strength, do the exercise with weights on your ankle. This strengthening exercise may be particularly helpful for
 patellofemoral syndromeor patellar tendinitis.

Straight-leg raise

Side leg lift
Lie on your unaffected side, tighten the thigh muscle of your injured leg, and then slowly raise the leg off the floor. Hold the leg up for a 2 count, and lower it on a 4 count. Relax your muscles. Then tighten the thigh and repeat. Do three sets of 10 repetitions each day. Once your leg gains strength, do the exercise with weights on your ankle. This strengthening exercise may be helpful for iliotibial band syndrome.

Straight-leg raise

Inner thigh lift
Lie on your affected side with the unaffected leg crossed over the knee of your injured leg. Tighten your thigh muscles and raise the injured leg about 6 to 8 inches off the floor. Hold for 2 seconds, and then slowly lower your leg. Relax the muscles. Then tighten the thigh and repeat. Do 3 sets of 10 repetitions each day. Once your leg gains strength, do the exercise with weights on your ankle. This strengthening exercise may be helpful for adductor strain.

Standing wall slide

Standing wall slide
Stand with your back against the wall and your feet 6 to 8 inches away from the wall. Slowly lower your back and hips about one-third of the way down the wall. Hold the position for about 10 seconds or until you feel that the tops of your thigh muscles are becoming tired. Straighten and repeat. Perform 10 repetitions each day. This strengthening exercise may be helpful for
 patellofemoral syndrome or patellar tendinitis.

Straight-leg raise

Lying leg raise
Lie on your stomach. Tighten your thigh muscles and slowly raise your injured leg off the floor on a 4 count. Hold the leg up for a 2 count, and then lower the leg on a 4 count. Relax your thigh muscles. Tighten the thigh and repeat. Do 3 sets of 10 repetitions each day. Once your leg gains strength, do the exercise with weights on your ankle. This strengthening exercise may be helpful for hamstring strain.

Lateral step-ups

Lateral step-ups
Stand with your injured leg on a stair or platform that is 4 to 6 inches high. Slowly lower the other leg, striking the heel on the floor. Straighten the knee of the injured leg, allowing the foot of the other leg to raise off the floor. Repeat. Do 3 sets of 10 repetitions each day. This strengthening exercise may be helpful for
 patellofemoral syndrome and patellar tendinitis.

Source

Written by familydoctor.org editorial staff.

American Academy of Family Physicians