Advice for Runners

April 20, 2016

Mercy Sports Medicine Athletic Trainers answer commonly asked questions regarding running including training, warm up and cool down, injuries and recovery.

Why should I strength train?

Many people have the misguided idea that strength training for runners isn't needed and only adds unnecessary muscle weight for you to carry while running. When done properly, strength training for runners or endurance athletes should help reduce injuries, improve flexibility and range of motion, and provide a strong foundation for efficient movement to occur throughout the entire body.

Let’s think about running for a minute. Running is one of the most dynamic and overlooked movements that almost every athlete needs to perform in some fashion. Here is something to consider: each time you land on your foot while running, the body has to absorb roughly three times its weight. That’s a lot to absorb and that’s with just one stride! Now think about how many strides you take in the course of only one mile. The body needs to be able to appropriately absorb that weight through efficient movement, which comes from good flexibility, range of motion and strength. In some instances, running injuries occur because the load put on the body while running is too high, causing it to stray from efficient movement to compensate poorly. This compensation tends to increase load on areas of the body not meant to handle these loads, which inevitably results in an injury.  

It's important to have a strength program  targeted specifically for the type of sport or activity you're participating in. This way the most appropriate exercises are utilized within the program. Always speak with a certified strength conditioning specialist before starting any program to be sure the safest and most appropriate methods are being used to meet your physical needs.


Should I heat my injury or use ice?

Ice and heat are one of the first things thought of when an injury occurs to help treat an injury and reduce pain. So what is better to use in the event of an injury, ice or heat?

When an injury occurs, the body increases blood flow to the injured area to provide vital nutrients to the injured body part. This increase in blood flow is one of the causes of inflammation and often the cause of some of the pain. When ice is placed on the skin over the injury, the blood vessels, to a certain depth, respond by constricting, helping reduce the blood flow to that particular area of the body. This can help reduce some of the pain. When heat is applied, the opposite of constriction occurs. Heat causes the blood vessels to dilate, to a certain depth, increasing blood flow at that particular area. With this being said, ice is going to be the best initial treatment after most injuries to help reduce pain.

As noted earlier, inflammation brings vital nutrients to an injured area, so it's an important response to every injury. We never want to try to completely stop this inflammatory response with constant use of ice or nonsteroidal anti-inflammatory drugs (NSAIDS). Be sure to always consult with a medical professional to properly diagnose and establish the best treatment plan for any injury.   

How soon should I return to running after injury?

Returning to running after rest due to an injury:
Assuming you're no longer injured, a gradual return to running is always the preferred method. It's typically okay to start a gradual running and strength program when pain is no longer being experienced and full range of motion has been restored. Returning too quickly is never a good idea because it drastically increases the risk of re-injury. If it's an injury you're seeing a medical doctor or receiving rehabilitation for, be sure all medical professionals have cleared you to begin such activity.

Running with an injury:
If you're running with any injury, it's never a good idea to continue running through this injury or merely take medication to alleviate pain. For example, when the check engine light goes on in a car, it's a good idea to have your car serviced by a mechanic to find the problem and correct it. The body is similar, only it uses pain as its check engine light. Pain is the signal to the brain that informs you when something is wrong. Just like the car example, if you were to continue driving with the check engine light on, the problem will not get fixed and there is a good chance more problems may occur. Furthermore, if you continue to run with an injury and ignore it with pain relieving medication, you're putting yourself at a high risk for a more severe injury. Always consult with your primary care or sports medicine physician when pain occurs before returning to your normal running program.

How should I warm up and cool down during a team relay race?

One of the more challenging aspects to running a multi-leg relay race is proper warm up and cool down between the legs. In most multi-leg relay races, there could be at least an hour and a half between legs, causing stiffness in a runner’s muscles and joints if not continually running.

Some races will find teams transporting from checkpoint to checkpoint, leaving the runners sitting for prolonged periods of time. Utilize a dynamic warm up to not only get blood flowing to your muscles, but also to properly loosen them up. Each runner has his or her own version of this warm up, so use the same prior to each leg you run during the race.

The same concept should be applied for a cool down after each leg of the race. Use the first three to five minutes after the run tp stretch your hip flexors, hamstrings, quadriceps, glutes and calves. Hold each stretch for three to five seconds, 10 times on each leg.  This is a quick and effective form of stretching.

Lastly, remember to replenish fluids as part of your cool down. This is essential to move lactic acid out of your muscles and allowing a quick recovery to begin.

What should my nutrition be during a day-long team relay race?

Start your morning off as you would before any long run or race. Every runner has his or her pre-run nutrition routine and it's important not to change anything on the morning of the race. Simple options would include oatmeal, a banana or  a protein bar. Be sure to maintain proper hydration prior to your race day.

As the day progresses, hunger will set in. Most runners don't want to run on a full stomach, so it's best to eat small amounts throughout the day. This can be fulfilled through various nutrition bars, energy gels, granola, bananas or protein/recovery shakes. The key is to find a balance that will not upset your stomach, yet ensure you are providing your body with simple carbohydrates and protein to quickly refuel and easily digest the food. Your body needs the nutrients to properly maintain function throughout a day-long event. Think of your body as a car and the car needs fuel to continue to run properly. The better the quality of fuel, the better your body will operate throughout the day. Lastly, continue to maintain water and electrolyte consumption to ensure optimal performance.

Should I stretch before or after running, and what stretches should I be doing?

Yes, you should stretch before and after running. In addition to stretching, it's most important to perform a dynamic warm up before a race. A dynamic warm up should consist of exercises similar to the activity you are going to perform. This warm up can assist in decreasing the risk of injury as well as improve performance. It will increase blood flow, activate the nervous system's protective responses, make tendons and muscles more pliable, and improve muscles' reaction times.

For runners, a dynamic warm up should include light jogging and consist of dynamic movements such as high knee walk, straight leg march, lunge walk, deep lunge with rotation, high knee run and high knee skips. Static stretching prior to a run can cause a decrease in the neuromuscular responses and therefore slow down the response time of muscle firing. This isn't what we want our muscles to do prior to activity.

Stretches for the hamstrings, quadriceps, calves, gluteus maximus, shoulders and trunk should be included. After running, these same stretches should also be performed as static, holding each for 10 seconds or longer.  This provides the muscles a chance to calm down and relax after activity. 

Should I be wearing compression running socks?

Compression socks tout compression technology. Many runners also tout their effectiveness and say their legs feel fresher during and after a long run. Though, some researchers studying compression sock effectiveness say results are still equivocal. Nonetheless, compression has shown to improve venous return, particularly in individuals who are on their feet most of the day. And marathon runners and ultra marathon runners are on their feet for long periods of time.

Compression also increases blood flow, which theoretically may help improve a runner's performance and recovery time after a race. For trail runners, compression socks can also help protectlegs from from scratches, abrasions and dirt. They may also provide some warmth on colder runs. With these benefits, runners should give compression running socks a try at the very least.

What should I wear when running?

Besides wearing good fitting running shoes that match your foot type and running style, you need to make sure you are wearing the proper clothing for the weather. When dressing for cold weather running it's important to keep your head, neck, and hands covered since you lose a lot of body heat from those areas. A pair of thermal mittens, a thermal hat, neck gaiter and/or balaclava should work well.

For your upper body it's important to dress in layers. The first one or two layers should work to wick away moisture while the outermost layer should allow that moisture to escape. The base layer should be a wicking material while the second layer (for well below freezing temperatures) should be an insulating layer. The outer layer should be wind and/or waterproof to help protect you against the elements but still allow moisture to escape. Since not as much heat is lost through your lower body, you generally just need to wear a good pair of running tights or pants, but consider also a second layer if temps are well below freezing.

Now for warm weather. Dress lightly and wear synthetic blend clothing to avoid chafing and have moisture be wicked away. This allows evaporation to occur and helps regulate your body temperature appropriately. Wear sunglasses, a visor or hat, and sunscreen to help protect against the sun's UV rays. For longer runs, or runs in higher heat and humidity, make sure to have a handheld or belt water bottle with you.

When temperatures are above freezing but still cold, it's important to remember as you get into your run, your body temperature will increase. So it's a good rule of thumb to dress as if it were 10-15 degrees warmer than the actual starting temperature. This is where layers are a good idea if the start of race morning is cold.

Finally, no matter what the weather is, be sure to wear a good pair of running socks made of wicking material in order to avoid blisters from wet feet.


Mercy, named one of the top five large U.S. health systems in 2017 by Truven, an IBM Watson Health company, serves millions annually. Mercy includes 44 acute care and specialty (heart, children’s, orthopedic and rehab) hospitals, more than 700 physician practices and outpatient facilities, 40,000 co-workers and more than 2,000 Mercy Clinic physicians in Arkansas, Kansas, Missouri and Oklahoma. Mercy also has outreach ministries in Arkansas, Louisiana, Mississippi and Texas.