Five warm-up or exercises to prevent injuries from running

This series on common health concerns among youth was created in collaboration with Tan Tock Seng Hospital.

Running is the most common physical activity in the world. However, the rate of running-related injuries is also high, especially in less experienced recreational runners. Most running-related injuries (i.e., anterior knee pain, iliotibial band syndrome, plantar fasciitis) are mainly due to training errors such as running too fast for too long. Other common risk factors include insufficient strength, flexibility and aberrant biomechanics.

All these factors are interrelated and can affect a person’s ability to attenuate impact forces, increasing musculoskeletal stress during running. When distance or duration and running speed increases beyond the threshold, injury can occur. Hence, improving flexibility and muscle force production before running could enhance performance and prevent injury.

Proper stretching exercises can improve joint range of motion (mobility) and psychological preparedness (perceived exertion), improving exercise performance and reducing the risk of muscle injuries.

The following are the five most important exercises for warm-up before running to help prevent injuries.

Running involves bodily coordination of the arms, trunk, hips, knees, and ankles. Allowing slight trunk rotation while keeping an upright posture can reduce stress and impact loading to the landing limb.

Hence, improving pelvic rotation and trunk stability during warm-up may be useful.

For this warm up, stand with legs shoulder-width apart and keep both knees straight. Twist your torso to the left and then to the right.

The calf and Achilles tendon is an important impact absorber. Insufficient flexibility may affect running posture when a person wants to increase stride length to run faster. The compensated movement may increase the magnitude of impact forces during running.

Adequate flexibility can reduce the risk of the calf, Achilles tendon, and plantar fascia injury.

For the calf stretch, place one leg in front of another with both feet pointing forward. Keep the knee of the back leg straight and the heel on the floor. Lean towards a wall/post and bend the front knee until you feel a stretch. Hold the stretch for 30 seconds. Relax and repeat two to three times.

The Achilles Stretch starts from the calf stretch position. Bend the back knee while keeping the heel down until you feel a stretch on the Achilles tendon. Hold the stretch for 20-30 seconds. Relax and repeat two to three times.

The hamstring consists of three posterior thigh muscles located between the hip and the knee. Poor muscular strength may limit a person’s ability to absorb impact forces. It may increase the risk of injuries when the running distance increases. A tight hamstring may affect the hip flexor, knee, and calf range of motion leading to an increased risk of lower back pain, hamstring injury, and plantar fasciitis.

Thus, improving hamstring flexibility and muscle force production before running may enhance running form and reduce the risk of injuries.

Place one leg in front with the heel on the floor. Keep the front leg’s knee straight, reach towards the toe scooping downwards, and return to standing.

Walking lunges help raise the heart rate, enhance hip flexor flexibility, and activate the core and quadriceps muscles. Adequate core and quadriceps strength reduces trunk lean to the side and improves knee flexion during running. Trunk lean and a straight knee landing during running is associated with anterior and lateral knee pain.

Raise your heel and take a wide step forward. Bend the knee till the thigh is parallel to the floor. Return to the standing position by bringing the back to the front.

This exercise is usually the last warm-up exercise. It increases the tempo, raises the heart rate, activates the core and calf muscles to enhance push-off quickly after landing.

A low step rate and prolonged footstep on the floor during running are associated with a higher magnitude of impact loading, reduced shock-absorbing capabilities, and medial calf pain (medial tibial stress syndrome).

Hop in place by lifting the opposite leg towards the chest. Focus on pushing off from the ankle.

Ray Loh is a Senior Physiologist at the Department of Orthopaedic Surgery, Tan Tock Seng Hospital.