Common trail injuries

The very aspects that make trail running an alluring alternative are the very reasons it can be hazardous. Uneven terrain and unexpected elements keep runners engaged but can also lead to difficult trail injuries.

By Tania Haas

Ankle Sprains

“I see ankle sprains a lot,” says Melanie Boultbee, ultrarunner and winner of the Haliburton 100-miler, Seaton 50k and Creemore 50k. “It can happen at any time on any trail whether it’s technical or not.”

How to get over it: For an acute ankle sprain, stay off it for a week or two. In most cases, over-the-counter pain relievers and ice are enough to manage the pain and swelling. When the swelling goes down, focus on exercises to restore the ankle’s range of motion, strength, flexibility and balance.
Strengthen ankle muscles and work on leg balance, says Dr. Clara Leung, chiropractor and running coach. Stand on one foot and aim to balance for 30 to 60 seconds. When this gets easy, repeat while standing on a cushion. The unstable surface will add a degree of difficulty and will train the quick-firing ankle muscles to keep the ankle from rolling over.

Iliotibial Band (ITB) Syndrome

“I see this occur quite often,” says Boultbee. “I dnfed a 100-miler this past summer because of it.”
ITB pain is due to repetition and compression of the distal component of the band, says Dr. Greg Lehman, a physiotherapist, chiropractor and founder of TheBodyMechanic.ca. He urges athletes not to run through ITB pain but to run to the edge of pain and then look for ways to modify it.

How to get over it: Become regular friends with a foam roller and a good therapist. Active release therapy in the hip can help a lot to release some tight spots.

Since the pain stems from strength imbalance, Dr. Leung recommends strengthening hip abduc- tors by focusing on your gluteus medius. Clam-shell exercises are a simple way to target them, as are exercises that address the entire leg and trunk.

Dr. Lehman says interval training that increases running speed and running every other day can also help.

Metatarsal Pain

“I’m dealing with this sucker right now,” says Phil Villeneuve, a trail runner in Canmore, Alta. “It feels like I have pressure from a rock under my second toe.”

Metatarsal pain is due to overload of the small bones of the foot, says Dr.Lehman.

How to get over it: “It’s simply due to too much stress. Runners should unload these areas temporarily with cross-training, temporary metatarsal pads, different shoes, avoiding hills and again not running through pain,” says Dr. Lehman.

Cuts and Bruises

“It’s inevitable that you will experience a fall at some point,” says Boultbee. “I once bruised my quad muscle so badly when I landed on a big protruding root that I had to take two weeks off to let it heal.”

How to get over it: Fractures, dislocation, shoulder separations, cuts and scrapes are all treated differently, says Dr. Leung. Go to the hospital and get an X-ray when in doubt.

Blisters

These injuries should not be underestimated. They may be small but can be very painful and can remove you from a race.

“I’ve done well with single shoe-sock combinations in most of my races,” says Boultbee, who says some racers change shoes or socks during a longer race when foot swelling or wet feet may occur.

How to get over it: Other racers swear by socks with toes. Other options include Smartwool and Drymax when running with wet feet, adding a lubricant to blister-prone spots and pre-taping. Boultbee recommends reading John Vonhof’s Fixing your Feet.

Achilles Tendonitis

“This is what I am currently dealing with,” says Boultbee. “I’m following a routine that includes foam rolling, cross-friction massage, ankle mobility exercises with a resistance band, and then using a tennis ball on the really sore spots.

How to get over it: “Start with lots of ice if it’s still red and swollen,” says Dr. Leung. Then, stretching the calf muscles, therapy to release tension, scar tissue and help with proper healing. When they’re ready, strengthen the calf muscles.

Returning to the Trail Post-injury

Same principles of all injuries should be followed, says Dr. Lehman. Re-evaluate your training program. Consider your recovery. Be reflective of all of the different life stressors–sleep, work-life balance, emotional health. All these factors can influence pain. Consider if your training paces and routes lack variety. If you have existing injuries be sure to rehabilitate these properly as previous injuries are good predictors of future injuries.