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I want to start running. However I am afraid of damaging my feet, knees or hips by running on a regular basis. So what are the most important things to have in mind to avoid any dangers for my joints from the beginning.

I should mention that I am not overweight on the contrary, I am in very good shape and 27 years old. However I don't have any running experiences. Perhaps I should add that I like it to work out hard.

The running distances I have in mind are 4km - 8km, so I don't want to run very long distances. However I would like to incorporate some interval runs and sprints into my running sessions.

It would be nice if you could add some (sports-scientific) references to your answers.

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8 Answers 8

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While the other answers mention several possible causes, they fail to address why. So I'm going to add my 2 cents here as well, which I'll base mainly on the results of the phd-thesis from Tine Willems from the university of Ghent (Belgium), which focused on the intrinsic risk factors for exercise related lower leg pain and Murphy et al. in a study about risk factors for lower extremity injury.

The first thing you must understand about injuries, is that there are many possible causes and they all interact with each other, so it can be difficult to prevent any form injury. You can get an injury from either a single overload, that exceeds a tissue's maximum tolerance (trauma) or from repeatedly overloading, which causes an overuse injury. As you're most likely to sustain an injury in your weakest link, you want to prevent overloading it.

The factors that might cause this are divided in extrinsic and intrinsic risk factors. Amongst the extrinsic risk factors we count things like:

  • poor quality shoes, because their material properties aren't constant, they can load your joints in unexpected or simply the wrong ways.
  • hard underground surfaces, if you're an inexperienced runner, you'll probably have a poor technique as well. Especially in heavier runners, this means that when they land, they insufficiently dampen the impact by flexing all the joint. Instead, they land with a hard impact, which overloads the muscles/soft tissue around the ankle that have to bear the load.
  • exercise load, doing running as a cardio exercise is done at lower speeds and thus require less forces. Whereas, when you want to do sprint intervals, you get short intervals of high intensity during which you have very high impact forces. You're more likely to sustain a trauma at higher intensities, because you're body is no longer able to withstand the forces. However, due to various intrinsic factors, exercise load is also a problem in beginning runners, because their body has not yet adapted to the loads of running.
  • exercise frequency, if you're already risking overloading your muscles, they need sufficient rest between workouts to fully recover. However, a lot of 'fit' beginners will jump in running head of heels and overdo themselves by not giving their body sufficient rest.

Among the intrinsic risk factors are:

  • a lack of running experience, which as notes above can cause overloading, because of wrong foot placement, insufficient dampening of the impact forces and your muscles/tendons aren't adapted to running loads.
  • poor aerobic fitness, might cause altered muscle recruitment patterns, which alters the distribution of forces through the muscle-tendon complex. It also has a negative influence on your running technique and causes your body to be less capable to withstand certain loads.
  • previous injuries, if you have sustained injuries in the past and possibly rehabilitates insufficiently, you are more likely to sustain new injuries due to lax tendons, muscle strength impairment and imbalance or scar tissue.

There are several others, such as body composition (high BMI), postural stability, anatomical misalignment or a lack of joint flexibility and range of motion. However, the strongest contribution is attributed to an adverse biomechanical running pattern. The most important factors for ankle sprains were: landing too much on the lateral side of the heel, pushing off too medially and too late resupination during the roll off. Most of these will improve when you increase the strength of the muscles around your ankle and improve your rolling off (which requires some experience).

For overuse injuries the most important factor was: increased inversion (of the foot/ankle) and increase loading under the medial side of the foot. This is normally called (over)pronation, which has several negative influences. Amongst them are rotational strain on the shank, increased strain on the soft tissue and stabilizing muscles. Another risk factor was a more forward position of the COP at first foot contact, which indicates a lack of the early pronation that's required to absorb the impact forces, so this takes place further ahead in the roll off in an exeggerated form. However, while too much or too late pronation is considered a problem, the exact opposite isn't good as well. All these movements can come from a lack of muscle strength, poor control of the muscles and technique or the wrong footwear.

So what can you do?

Try to manage your extrinsic factors: so get the right shoes, try to workout on software undergrounds, use a training program or join an athletics club, that helps you rate limit your workout frequency and intensity and also ensures sufficient rest.

You'd need a checkup to see whether some of the intrinsic risk factors apply to you or not. However in all cases what you yourself can do is: make sure you get in a decent shape before you increase your pace; a decent aerobic capacity doesn't guarantee you're adapted to running. If you have a history of injuries, make sure you do additional exercises to strengthen this area. Doing yoga is a great exercise, because it mixes stabilizing joints with increasing the range of motion.

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The link to the Willems thesis is broken. Clicking on the link that you refer to as "Payne et al." takes me to an article by Murphy, Connolly, and Beynnon. The Murphy article has low relevance to running. It covers lots of different activities, including military training and ice hockey. –  Ben Crowell Nov 30 '13 at 22:26
    
@Ben I think I fixed the link to the Willems thesis, the university apparently changed its ID. I changed the name to Murphy et al, though I agree its probably not the best citation. Please do note that the answer is over 2.5 years old, there has been a lot of research in this area lately. Also, I think you might like Payne's blog about running research, this time I'm sure the name is correct :-) –  Ivo Flipse Dec 1 '13 at 14:15
    
OK, thanks for the fixed link. But the Willems thesis appears to be almost entirely about ankle injuries, which are not really a major hazard of running. Runners mostly have problems with overuse injuries such as plantar fasciitis and shinsplints. –  Ben Crowell Dec 2 '13 at 3:39
    
@BenCrowell after reading the summary of the thesis, the second part should cover 'exercise related lower leg pain', which covers mostly overuse injuries. Either way, while the main gists of my answer is probably still correct (albeit useless in practice), its probably in dire need of an update given the studies that have been published in the past few years. –  Ivo Flipse Dec 2 '13 at 8:32
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For 11 years (age 14 to 25) I ran with typical running shoes on pavement or track surface. Pain developed in my hip, foot, and lower shin (not shin-splints, a different pain).

8 months ago I began running barefoot on grass (just inside the inner loop of the track). It was the best decision I ever made. Zero joint pain. All kinds of foot & leg muscles are now exercised that I never felt before (I was quite sore for the first two weeks, but afterwards I some some serious muscle growth in my foot/ankle/lower shin region). My stride is no longer "heel-strike", but deeper and smoother.

I highly, highly recommend you try running barefoot on soft grass. It totally changed my idea of running for the better. I will never go back to shoes or hard surfaces.

(Watch out for broken glass or debris in the grass. I find the inner-loop of tracks to be safe & clean. Do not run barefoot on harder surfaces, you will damage your natural fat soles on the bottom of your feet)

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You should also be aware of your posture while running. A good posture doesn't load your weight on a certain muscle group.

Good posture involves having a reasonably straight spine with not too much straightness and not too much bend. The more you slump, the more your body's muscles need to work to hold you upright. Poor posture not only restricts the circulation of blood to your muscles and organs but also inhibits the oxygen supply to your brain. (Source)

  • Keep your head straight, chin up and look ahead naturally. Imagine there's a string attached to your head pulling it up just a bit.

  • Your shoulders should be low and loose - not high and tight. If your shoulders get tired, shake them to get off the tension.

  • Your arms should swing straight forward and back, not across your body. Your elbows should be bent at about a 90-degree angle. If you feel your forearms tensing, drop your arms to your sides and shake them out for a few seconds to release the tension.

  • The position of your torso while running is affected by the position of your head and shoulders. If you start to slouch during a run take a deep breath and feel yourself naturally straighten. As you exhale simply maintain that upright position. Remember the string pulling your head straight up.

  • Your hips are your center of gravity, so they're key to good running posture. If you allow your torso to hunch over or lean too far forward during a run, your pelvis will tilt forward as well, which can put pressure on your lower back and throw the rest of your lower body out of alignment. You can fix the position of your hips by running really fast for a short while, say 30 meters. That will naturally correct the position, try to maintain it after the dash.

  • Your feet should land directly underneath your body. Don't lift your knees too high unless you're a sprinter. As your foot strikes the ground, your knee should be slightly flexed so that it can bend naturally on impact. If your lower leg (below the knee) extends out in front of your body, your stride is too long.

  • Use your ankles like springs. Keep your feet straight, pointed forward. With each step, your foot should hit the ground lightly - landing between your heel and midfoot - then quickly roll forward. Keep your ankle flexed as your foot rolls forward to create more force for push-off.

During the exercise constantly keep thinking about these things about your posture. Have an experienced friend run with you and say if there's something wrong. You will not always see it yourself.

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The basic answer is that although there has been quite a bit of medical research on this kind of thing, research does not strongly support any specific advice for avoiding injury as a runner.

People used to say that it was important to use good running shoes that provided a lot of cushioning against impacts, and to replace the shoes frequently because they could lose their cushioning ability. This conflicts with the fact that humans evolved to run barefoot, and the recent popularity of barefoot running and minimal running shoes has also raised questions about this belief. Kong et al. found that cushioning affected comfort, but not injury. Studies with accelerometers have found that people subconsciously adjust their style to avoid the discomfort associated with large impact forces, and this is probably the reason that cushioning is not beneficial. It then seems reasonable to expect the same to hold for running on hard versus soft surfaces, and although I don't have access to the paper, apparently there is a 1992 paper by van Mechelen (cited here) confirming that softer surfaces don't help.

People have claimed that feet were normal, pronated, or supinated, and that you should buy shoes that were matched to your style. The classification is not supported by evidence. A study falsifies the theory that you need shoes to correct your pronation.

People have claimed that to avoid injury, you shouldn't increase your mileage by more than 10% a week. Only one study has been done of the 10% rule, and it found no difference in injuries between those who followed it and those who didn't. In general, the evidence does not support claims that mileage is correlated with injury. In fact, there is some evidence that running very long distances is safer, possibly because the runners tend to go slower at those distances.

People will tell you to stretch, but static stretching before going running doesn't seem to change the injury rate, and static stretching has a neurological effect that inhibits muscle from stretching more later. Keep in mind that for most sports, running is considered a warm-up.

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There are many things that you can do right or very wrong when you start a running-career. Since your question focuses on feet, knees, and hips, the field of possible answers is narrowed down drastically.

I have 21 years of running experience, the last 6 years as a member of a local athletics club. You can Google the science behind running, and also find some links to the science behind specific areas here on fittness.stackexchange.com. For example, you can look at this question I asked about running shoes, which has a good answer with links to a scientific article behind it.

Now to some more specific advice:

  1. Get some good running shoes!!! All your weight will be put on your feet - actually just one foot at a time - over and over during a run. This is the alpha and omega when it comes to running. This point can't be stressed too much, so I'll say it again: Get some good running shoes!!!
  2. Start up slowly, and join a running club with experienced coaches, or find an experienced runner to start with. People often tend to start out on their own, since they are ashamed of the (bad) physical state they're in. Don't be. Run with others who know how to run, and ask for their advice. If you tell them you are a beginner who needs guidance, they will gladly give it to you.
  3. Giving your body time to recover is at least as important an activity, as the running itself. When running, you strain your body and induce numerous small "damages" to your body. This is actually a good thing - when your body repairs and recovers, it rebuilds the damaged parts to be slightly stronger than before. That's how your physical condition improves. But don't overdo it!!! "No pain, no gain" is not the right mantra when you start up on running, and it certainly doesn't mean "More pain, more gain". This leads us to the next point...
  4. Listen to your body. Running can be - and should be - a lot of fun. Don't push yourself more than what your body can deliver. If you have aches other than ordinary muscle pain after exercise, something is not right, and you should ask a doctor, physio therapist or the like. You'll just damage yourself. Take it easy, have fun, make sure you don't run faster than a speed where you still are able to talk. That's also why it's a good idea to run together with others - as long as you can talk, you're not pushing yourself too hard.

Take care and have fun :-)

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Definitely do some shoe research. It looks like my IT Band Syndrome, was caused by my newer running shoes, which corrected one problem. But now after a few months caused an over use injury, they were causing under-pronation(subpination). –  user295734 Mar 8 '13 at 14:43
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If you're worried about joint issues, running on grass or dirt is better than pavement since it's softer and has more give under your feet. See if there's a cross country course or other flat, grassy area such as a soccer or football field near where you live. If you run somewhere that isn't maintained for exercise purposes watch out for anything that can trip you up, like acorns or sticks, holes from ground-dwelling creatures, or sprinklers.

All-weather tracks rank in between grass and pavement for give, and some are better than others. It depends on what they're laid on. Some have rubber underneath for extra spring, and some have just concrete, which won't be much better for your joints than sidewalks.

I know some people run on beaches for this same reason, but I don't have any experience with them since I live in the Midwest.

Another benefit, or downfall depending on your outlook, the softer the surface you run on, the more work it takes to maintain the same speed as on harder surfaces.

And don't forget tips like @yellowblood's and to stretch regularly and get enough water and nutrients to sustain your running.

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You don't give any evidence to support these claims about the benefits of running on softer surfaces. The empirical evidence seems to be that softer surfaces don't help: runresearchjunkie.com/… –  Ben Crowell Dec 2 '13 at 4:03
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Two things from my running experience:

  1. Its going to take a lot of running before you have to worry about long term injury. To prevent injury, listen to your body. Know where running impacts your body. This can be a lot of things. I sometimes get plantar fasciitis (soreness under my feet) when doing long distance training. Sometimes it can even impact my carpal tunnel. -- The good news is if you run regularly, you'll learn your weak spots. You'll figure these things out and target those areas for preventative intervention (different shoes/knee brace/change in gait/etc). Unless you have a serious fall, your joint pains start very slowly, may change, or go away entirely. You'll know where your body is the weakest starting with innocuous pain and if something bad is happening its a very gradual and almost always a preventable decline. In my experience, its much easier to twist/hurt/injure something suddenly and badly in most sports compared to running.

  2. Do meditative/stretching yoga along with your running. You'll find a lot of the complaints surrounding joint issues are really the result of excess muscle tension pulling on your tendons/ligaments. Doing meditative, relaxed yoga will make running more comfortable and reduce your risk for injury.

Its also worth pointing out that I've done mild running 5km+ everyday for 5+ years and am no worse for the ware. My body appears to have become acclimated to running. Its part of my homeostasis now. I only start to experience issues when I begin training for long distance events -- something outside my body's expected norm.

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Is there any evidence for the claim that yoga prevents running injuries? –  Ben Crowell Dec 2 '13 at 4:04
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I'm not running at all but I know the following tips:

  1. Small steps are better than bigger steps, less impact on your joints.
  2. It is best not to "jump" too high - always imagine as if you have a very low ceiling above you.
  3. Don't run on empty stomach (i.e. hungry) - you will get dizzy and you you will become tired too quickly.
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#3 depends on the distance being run. Short runs I wouldn't worry about it. You can sometimes do more damage eating right before a run. –  Doug T. Mar 17 '11 at 20:55
    
+1 small steps and high cadence –  rmx Mar 18 '11 at 13:51
    
Is there any evidence to support this advice? –  Ben Crowell Dec 1 '13 at 0:10
    
@BenCrowell about high cadence and short steps? It forces you to step underneath your body, resulting in less impact that if you would step in front of your body. –  Ahlqvist Apr 30 at 20:36
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