injury-management

name: injury-management description: Common running injuries, red flags, load modification, cross-training, and return-to-running protocols

Injury Management

Important Disclaimer

You are a coaching AI, not a medical professional. Always recommend seeing a doctor or physiotherapist for:

• Pain that persists more than 2 weeks
• Sharp or sudden-onset pain
• Swelling or visible deformity
• Pain that worsens with activity
• Any of the red flags below

Common Running Injuries

IT Band Syndrome (ITBS)

• Location: Outside of knee
• Feels like: Sharp pain on outside of knee, often at specific point in run
• Common causes: Rapid mileage increase, weak glutes, excessive downhill running
• Modification: Reduce mileage 30-50%, avoid hills, strengthen glutes/hips
• Cross-train: Cycling (low resistance), swimming, elliptical

Plantar Fasciitis

• Location: Bottom of foot, heel
• Feels like: Stabbing pain in heel, worst in morning or after sitting
• Common causes: Tight calves, unsupportive shoes, sudden mileage increase
• Modification: Reduce mileage, avoid speed work, calf stretching and rolling
• Cross-train: Pool running, cycling

Shin Splints (Medial Tibial Stress Syndrome)

• Location: Inside of shin bone
• Feels like: Diffuse ache along shin, worse during/after running
• Common causes: New to running, hard surfaces, worn shoes, rapid increase
• Modification: Reduce mileage 50%, soft surfaces, new shoes if >500km
• Red flag: If pain is localized to one spot -> possible stress fracture

Achilles Tendinopathy

• Location: Back of ankle/lower calf
• Feels like: Stiffness in morning, pain at start of run that may ease
• Common causes: Excessive speedwork, hill repeats, low drop shoes too soon
• Modification: Reduce intensity (no hills/speed), eccentric heel drops 3x/day
• Cross-train: Cycling, swimming (avoid push-off)

Runner's Knee (Patellofemoral Pain)

• Location: Front of knee, around/behind kneecap
• Feels like: Ache during/after running, worse on stairs and sitting
• Common causes: Weak quads/glutes, overpronation, too much too soon
• Modification: Reduce mileage, avoid downhill, strengthen VMO and glutes
• Cross-train: Swimming, cycling (adjust seat height)

Stress Fracture

• Location: Common in metatarsals, tibia, femoral neck
• Feels like: Localized pain that worsens with impact, may hurt at rest
• RED FLAG: Stop running immediately. See doctor. Needs imaging.
• Recovery: 6-8 weeks non-weight-bearing typically
• Cross-train: Pool running, cycling (if pain-free)

Red Flags (Medical Referral Required)

• Pain that doesn't improve with 2 weeks of modified activity
• Night pain or pain at rest
• Localized bone tenderness (stress fracture risk)
• Swelling that doesn't resolve within 48 hours
• Loss of range of motion
• Numbness or tingling
• Pain that gets worse (not better) as you run
• History of recurrent stress fractures

Load Modification Protocols

Level 1: Minor Discomfort (pain <3/10)

• Continue running but reduce volume 20-30%
• Drop intensity (easy runs only)
• Monitor: if not improving in 1 week, escalate

Level 2: Moderate Pain (pain 3-5/10)

• Reduce volume 50%
• Easy runs only, shorter duration
• Add cross-training to maintain fitness
• If not improving in 2 weeks, see professional

Level 3: Significant Pain (pain >5/10)

• Stop running
• Cross-train only if pain-free
• See a healthcare professional
• Don't resume until pain-free walking for 3+ days

Cross-Training Substitutions

Return-to-Running Protocol

Walk/Run Method

After time off due to injury:

Week 1: Walk 25min / Run 5min, 3x per week Week 2: Walk 20min / Run 10min, 3x per week Week 3: Walk 15min / Run 15min, 3-4x per week Week 4: Walk 10min / Run 20min, 3-4x per week Week 5: Walk 5min / Run 25min, 4x per week Week 6: Run 30min, 4x per week

Rules During Return

• No speed work for at least 2 weeks after full running resume
• Pain above 2/10 = stop and walk
• If pain returns, go back one week in the protocol
• Don't increase frequency AND duration in the same week
• Strength training is critical during this phase

Preventive Measures

Strength Work (2x/week minimum)

• Single-leg squats
• Hip bridges / glute bridges
• Calf raises (both straight and bent knee)
• Side-lying leg raises
• Planks and core work

Mobility (daily, 10 minutes)

• Calf stretches
• Hip flexor stretches
• Foam rolling (IT band, quads, calves)
• Ankle mobility

Shoe Rotation

• Rotate 2-3 pairs to vary ground forces
• Replace shoes every 500-800km
• Track shoe mileage in observations

Load Management

• Follow 10% weekly increase rule
• Recovery week every 3-4 weeks
• Never increase volume AND intensity simultaneously
• Rest day after quality sessions