January 11, 2023

From BS&W: Injury Prevention, Stretching, and Hydration

By Rachael Cook, PT, DPT and Jennifer Miller, PT, OCS from Baylor Scott & White Institute for Rehabilitation

As runners, we never want to talk about one thing that we all have in common: injuries! Whether they happen before, during, or after your training cycle, injuries challenge most runners and can affect multiple areas of your life. In our experience, most running-related injuries can come from these six factors:

  1. Too much load/overtraining
  2. Not incorporating recovery, rest days, and sleep 
  3. No strength training
  4. Poor terrain choices and footwear
  5. No flexibility training
  6. Poor hydration during training

A lot of these things tie into each other, but let’s break them down. 


Overtraining syndrome occurs when the body isn’t able to recover properly from the stress it takes in. The majority of running-related injuries come from doing too much too soon, especially if you’re a newer runner. The old rule of not increasing your mileage by 10% each week is conservative for most people, but it helps avoid overtraining leading up to a big race.


If there’s a new buzz word in the running community, this is it! There’s a reason professional athletes are also professional nappers. The body needs rest to recharge and heal from the effects of running. The CDC recommends at least seven hours of sleep per night for adults, but we know that’s not always possible. Aiming for as much sleep as you can will help every area of your life.  

Strength Training

Runners who love to run also need to develop skills in other exercises if they want to keep tendons and muscles healthy. Lifting weights can help develop resilience in the muscles that help you run and in the ones that you might forget about. This includes your feet and what we like to call the “foot core”, which stabilizes your feet with every foot strike. Plyometric training also improves your whole body’s tolerance to impact by jumping and landing forcefully. 

Terrain and Footwear

The best running shoe for you is the one that you feel most comfortable in! Shoe technology is always changing and you want to make sure you’re changing your shoes often enough to prevent injury. Running in old, worn-out shoes can increase your risk for injury. The surface you run on matters too! Mixing it up between roads, trails, and tracks can extend the life of your shoes and prevent repetitive stress on your body. 


As we get older, our flexibility tends to worsen as tendons and muscles get stiff. Strength training without proper stretching can make you stiff too. There are lots of different muscle group stretches that can benefit runners, including calf and hamstring stretches, but it really just depends on how you feel. There are benefits to active stretching before a workout and static stretching after a workout. 


Depending on what the weather is like, the distance you’re running, and whether you sweat a lot or a little, you need to practice a game plan for hydration on the run. There are a ton of products on the market to help replace electrolytes that you sweat out and to give the muscles the energy they need. Your main rehydration window after a race is 4–24 hours after you finish, and the best drink for you is one that you like the most! 

Overall, even if you do everything right, you may end up with a running-related injury. Physical therapists can help with more in-depth screening and treatment if you have pain that prevents you from running. Good luck with your race and happy running!