Sore from running — Injury prevention?

Hey Alice,

I've been running at least two miles every day and I find that nothing is wrong with me physically except that at night my Achilles heel is somewhat sore. What do you think the reason is? I stretch enough before exercising and it still hurts. Am I running too much or with too much frequency?

Also, I'm trying to lose some fat or gain some muscle for that matter, and I've lost quite a bit of weight but the last few pounds are a bit difficult to take off. What do you suggest? More aerobic training, low fat diet or strength training?

Achilles heel

Dear Achilles heel,

Running is a great cardiovascular workout and it can be one of the cheapest ways to stay fit. Perhaps the main draw back is the jolting, jarring impact it can put on ones body. The repeated pounding and the accompanying stress are transmitted through joints and ligaments — up to three or four times your body weight with each footfall! Some of the most common runner's injuries include runner's knee, heel spurs, tibial stress syndrome (shin splints), plantar fasciitis, and Achilles tendonitis. Fortunately, there are ways to decrease the risk of injury and strain.

One possible reason for the pain may be related to improper running equipment (i.e., shoes). Proper running shoes provide more support and cushioning than other types of sneakers and they are lighter and still allow feet to "breathe." Stores specializing in athletic shoes often have staff that will assist you in finding not only the right fit, but the right type of shoe based on your individual arch and your gait. Running shoes typically need to be replaced sooner than other types of shoes, even though the surface of the shoe may not look that worn. The padding inside the shoe usually gets pounded down after a certain number of miles so waiting too long to change shoes can increase injury risk or soreness. A general rule of thumb is to replace your kicks after 300 to 500 miles or six months of use. (Side note for those who have caught wind of the shoeless running trend: Running barefoot or with unstructured shoes may work for some, but if you're interested in trying it out for yourself, it's best to start with very short runs, adding barefoot distance slowly, to give your feet, legs, and muscles time to adapt to a very different form of running. Consulting with a trainer or health care provider wouldn't hurt, either. And please, watch out for sharp objects!)

Have you noticed any difference in your soreness depending on where you run? Two miles on a hard running surface can certainly be tough on the body. Sidewalk pavement is the hardest on your joints and tendons. Asphalt is slightly better for the knees, joints, and tendons. Dirt or gravel paths are even better. Also, well-maintained grass provides lots of padding and a slightly better work out for the leg and ankle muscles, just be sure to do a little extra ankle stretching before and after the run. Running on a sandy beach not only makes for good fodder for personal ads, it also provides a softer surface. The drier the sand, the better the workout. Even beach runs, however, need good, supportive, running shoes. Save the barefoot experience for the cool down walk that follows.

Proper warm up, stretching, and cool down are also key injury preventers. The mild pain you are experiencing could be indicative of Achilles tendonitis, micro-tears that result from stress. If so, seeing a health care provider and decreasing your level activity until the pain subsides may help you prevent a serious injury. In addition to warming up and stretching, giving your muscles enough rest is essential to building strength and running capacity. If you're running every day, could you consider cutting back the number of days per week you run? Some people choose another aerobic activity on non-running days, such as biking or swimming. Cross-training can help build muscles that running doesn't target and give your joints and tendons a chance to heal from the stress caused by pounding the pavement.

You also asked about running and weight loss. It is true that supplementing your running workouts with some weight training could provide some extra benefits. Increasing muscle mass can help boost your metabolism. Because of your soreness, however, it would be most beneficial to talk to a health care provider before intensifying your running or strength training workouts to prevent further injury or strain.

Here's to your health!

Last updated Apr 16, 2015
Originally published Mar 01, 1994

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