Running Without Injury

Before Your First Run

Rule #1: Before you lace up for the first time, schedule an appointment with your sports medicine doctor or physical therapist.

You probably did this before you started your previous exercise routine. If you are beginning a running program—even if you have already been exercising—you should get the go-ahead from a pro. This is particularly important if you’re 40 or older. At this appointment, your doc will: 

• Do a biomechanical assessment. Running is a high-impact sport, which means your joints are going to take a lot more pounding than they would if you were doing a low-impact activity. For this reason, your sports medicine doctor or physical therapist will check to make sure there are no problems with your legs, feet, hips, ankles, or knees that may be aggravated by running. Some of the potential problems your doc will look for include:

-- The formation of arthritis or other joint problems

-- Breakdown or weakening of cartilage in the hips, knees, ankles, and feet

-- Bone spurs in your heels, bunions, or other problems with your feet and toes

-- Structural faults and biomechanical abnormalities

• Check your heart. If you have already been exercising, your ticker is likely in top shape. But remember, running can be more taxing to your cardiovascular system than other exercises, so your doc will want to make sure everything is working like it should be before you get going. “Older” patients most likely will be referred for a heart stress test.

• Assess your gait. The process of determining your type of gait is called a gait assessment or gait analysis (the terms are interchangeable). This assessment helps identify biomechanical abnormalities and the ways in which they can be corrected. During a gait analysis, your physical therapist will observe you as you walk or run on a treadmill. The PT will then evaluate the anatomical structure of your feet, hips, back, arms and knees, as well as your muscle flexibility and strength. The physical therapist will also assess your balance while you are standing and will analyze your hip alignment, posture, strength and stride. In addition, the physical therapist will record your gait cycle on film, which will later be reviewed using slow motion and freeze frame techniques. This will give the physical therapist a chance to more carefully assess your running or walking style.

A gait analysis generally lasts 30 minutes and includes a discussion of past injuries or pain, current training regimens and fitness goals.