Certain trail running injuries are more common than road running injuries. As you would expect, there are more hazards in terms of the terrain. It’s not unusual to roll an ankle when running off-road or trip over uneven ground resulting in a fall. So, what are the common trail running injuries and more importantly, how can you try and avoid them? Also, what should you do if you have picked up an injury?

One of the frequent injuries encountered is the ankle roll, especially prevalent during off-road running on rocky or gravelly terrains with uneven surfaces. We’ve certainly experienced this more than once. Fortunately, it has never resulted in more than temporary discomfort, either around the ankle or on the outer calf.

Rolled ankles and other trail running injuries are possibly more common when you are new to trail running. You haven’t got the experience, the technique or the strength required to handle tough terrain effectively – this only comes with practice. This was certainly the case when I started trail running. It very much depends on the individual though and how much strength, balance and core stability you have.

You also have to consider the type of trail running that you do. If you have been used to running mid-distance on the road and now are running much longer distances, perhaps training for your first ultra,  you may be putting much more stress on your body. Ten miles off-road usually takes longer than on the road and presents more hazards that you are not used to. Therefore, it’s not uncommon to have more niggles, more severe DOMs and aches and pains in the places you aren’t used to. Trail running does use different muscles than road running.

Common Trail Running Injuries

Common trail running injuries, apart from the aforementioned rolled ankle, include:

  • Cuts and bruises from falls
  • Bone stress injuries
  • IT band – a favourite on and off-road
  • Achilles tendon issues
  • Bad back (often from so much hill climbing and/or heavy backpacks

What Causes Trail Running Injuries?

There are many things to consider with any type of running but perhaps a few more potential considerations when running off-road.

Your Trail Running Shoes

As well as the obvious uneven terrain, climbing, steep descents etc, there is also evidence to suggest that wearing certain trail running shoes with stiff midsoles and rockplates may also cause issues. When choosing the right trail shoes for the type of off-road running you are participating in you need to think about:

  • The weather and how it affects the ground – is it wet, muddy, slippery, rock hard? This will influence the type of shoe you choose including the size of the lugs.
  • The distance – how far are you running and is the distance increasing?
  • The type of terrain – grass, muddy trails, woodland trails, rocky terrain
  • Will there be any road in your run and if so, how much?

The Elevation

Lots of climbing can also cause issues with your back – I certainly start to notice this later on in my training – especially if I have been neglecting my core. However, one of the biggest causes of injuries is descending, especially at pace. This is usually the time that you are most likely to fall. I have certainly had my worst fall on a descent, although, in my defence, it was at night.

Despite all my comments on elevation, some of the most spectacular falls occur on the flat when you’re not paying attention. A large scar on my knee is testament to that!

Low Visibility

Running with a head torch on the hills is an exhilarating experience; there’s nothing quite like being enveloped in darkness, away from the glow of streetlamps and car lights. Pause mid-run, switch off your head torch, and gaze up at the stars—it’s a breathtaking sight! However, it’s crucial to stay focused as it’s all too easy to stumble over rocks or collide with overhanging branches that are normally visible during the day. Invest in a reliable head torch and exercise extreme caution when running at night. Safety first!

Lack of Experience/Technique

Looking a few steps ahead, taking smaller steps, keeping yourself upright, balancing your arms… all of these techniques come with practice and help to prevent you from tumbling while out on the trails. Focus and concentration are also required.

A Weak Core

A weak core will certainly be at the root of many trail running injuries – the ones where you fall over anyway. Having a strong core gives you the ability to keep upright and balance. Core strength training should be a key part of everyone’s trail running programme.

Lack of Preparation

Not warming up properly is one of the biggest causes of running injury. We examine this in greater detail shortly but don’t underestimate the importance of a proper warm up and cool down.

Avoiding Trail Running Injuries

As well as taking heed of all of the aforementioned causes of trail running injuries, there are many other things to consider

Warm Up Properly

A lack of warm-up can have severe consequences, especially if you are heading out on a tough run. Often, we got out of the car and ran straight up a hill. This has often led to niggles and soreness afterwards. What you should do is start slow, warm up gradually and try and run a flat section before you hit the hills, or walk the first hill. Likewise, if you are going out to do hill reps, make sure you are sufficiently warmed up before any efforts. It’s the same as how you would treat a road running effort or tempo session. You wouldn’t go straight for 400-metre sprints or a tempo run without a warm-up. Flat speed sessions involve 10 minutes of dynamic stretches e.g. side straddles, heel flicks, high knees, walking lunges etc. When it comes to trail running, we start slow and even walk the first hill until we have warmed up – a history of injuries has taught us this.

If you start to feel a strain or muscle pain during the run itself you should always be prepared to abandon it and head back to the start point by the quickest route. This is particularly important if you’re on your own, or if the weather is bad.

Post Run Recovery

After the run, grab your post-run recovery fuel, which for us is a bottle of water and a banana, then start your static stretches whilst refuelling. We focus on stretching the following areas; calves and Achilles, hamstrings, quadriceps, and adductors, as well as upper body stretches on torso and shoulders. Hold the stretch for approx. 15 seconds.

There are lots of scientific papers on the benefits of post-exercise static stretching, the main one being the reduction of muscle soreness after the run. You may have heard of this referred to as Delayed Onset Muscle Soreness, or DOMS. This can occur between 24 and 72 hours after the exercise, so any steps you can take to help reduce this feeling are well worth it.

We will often head out for a recovery run on the day after a long trail run. This is usually on the road so we can guarantee it will be flat, it should be at a very easy pace and we never go over 5 miles.

Also, consider the points we mentioned earlier in what causes trail running injuries:

  • Choose the right shoes for the conditions/length/type of run
  • Invest in poles – poles not only help you tackle the climbs but they may help if you are prone to suffering with your back. Our next project is to acquire some poles and put them to the test ourselves on a nasty Cheddar Gorge climb
  • Core Strength Training – even if it is once a week or a few minutes here and there – squats, press-ups, sit-ups, planks etc will all help you to build a stronger core. See more here.
  • Practise your technique – we mentioned above how the techniques used in trail running come with experience.

Foam Rollers and Massage Devices

If you have muscle soreness and are masochistic, you should consider investing in a torture device known as a foam roller. Rolling for 30 seconds on the affected area can be beneficial. Of course, there are also many other devices designed to massage and treat different different trigger points ranging from under £10 to £100+. Physiotherapists tend to use massaging ‘peanuts’ and other such tools including the massage gun displayed below.

A Popular Choice is the Massage Gun

Personally, I swear by a combo of my foam roller and my massage gun. A massage gun is a popular choice. You only have to look at how many reviews this professional massage gun has on Amazon to see just how many people have used it.

Many members of our running club rate devices such as the one pictured below for targeted muscle treatment. With 10 adjustable speed levels, the 24W high-torque motor strokes 1400 to 3200 times per minute and reaches the tissue as deep as 12mm to increase blood flow and thus relieve muscle soreness and stiffness better. The replaceable massage heads mean you can work on different muscle groups, and target specific areas for fast recovery.

Don’t Run While Injured

If you are already injured and about to run again, you are simply going to aggravate the injury more. First-hand experience tells us it’s better to miss one run rather than risk being laid up for longer!

Treating Trail Running Injuries

We are not medically trained, we don’t have qualifications and our advice would be to always seek professional advice if you’re injured. However, in the first instance, if your injury is recent, we recommend rest, icing the injury at regular intervals with anything from an ice pack to a boat of frozen peas and staying off your feet!

If the injury is a simple one and clears up quickly, a combination of ice and rest should be enough to get you back on your feet quite quickly however, if it doesn’t clear up quickly, or you suspect you may have done some greater damage, you may want to seek professional help from a qualified physio who can give you a proper diagnosis and subsequent rehab programme.

Ignoring the problem and hoping it will go away while continuing to run could cause greater long-term damage.

It’s tough as injuries are always so different. What could be a couple of days of rest for one person may be six weeks out for another. It may be worse than you think, it could be not as bad as it feels. Our pain thresholds are also very different. I cry off at the first sign of something hurting while others that I know will push on and ignore it. This is definitely the more dangerous of the two. It’s never worth pushing on and damaging yourself even more. A few day’s rest is much better than 6-8 weeks of forced rest.

As part of your trail training you should spend time on the warm-ups, cool-downs and stretches and take rest days to risk overtraining.

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