Common Trail Running Injuries (and How to Avoid Them)

Trail runners know the path to success may not be paved at all, but instead tracked with soft, bouncy soil and fun obstacles like tree roots, creeks, rocks, and of course, spider webs. When it comes to enjoying trail running safely, it’s important to recognize common trail running injuries and how to avoid them.

Sprained Ankles

This injury is known well by trail runners alike and typically results from the mild to severe rolling of the ankle when landing on an uneven bit of trail or part of the environment, like a rock, at an angle. A sprained ankle literally is the strained (and possible tearing) of the ligaments which hold the ankle in place, and can result in swelling, tenderness, limited range of motion, and pain. Most trail runners can heal a mild to moderately sprained ankle with rest, ice therapy, wrapping, and pain relievers. More severe sprains should be evaluated by a doctor.

Avoiding sprained ankles isn’t a guarantee, but you can take some measures to help reduce your chance of injury including strengthening the ankle with exercises and stretches, making sure your vision is checked and you can see at your best, and finding trail running shoes which provide ankle support and better stabilize your movements.

Metatarsal Stress Fractures

The repeated pounding of the forefoot to the trail and any obstacles on the environment, combined with the stiffer midfoot or rock plating of a trail running shoe can lead to teeny tiny cracks in the metatarsal bones in your foot. This is consider a high risk injury which can quickly be exacerbated, so it is important to know the signs.

Metatarsal stress fractures may not have any visible symptoms on the top or bottom of your foot, however, you will feel them – slight pain and weakness in your foot which gradually progresses the more you use it. The ending hyper-localized deep pain will be so severe to keep you from running, but remember, you still may be able to wiggle toes and move your foot, even with the stress fracture. Left untreated, the small crack can become a full break. It’s important to see a doctor for evaluation if you suspect metatarsal stress fractures. Some foot strengthening exercises can help build up the foot and ankle muscles engaged with running to prevent the added impact to your forefoot with trail running, and metatarsal pads that slip onto your foot like a short sleeve can provide extra cushioning.

IT Band Syndrome

The fascia tissue running from your hip down your outer thigh all the way to your shin is known as your iliotibial band, and the frequent hill work demanded of trail running can cause it to become tight, inflamed, and rub against the thigh bone. An improper functioning of the IT band can also destabilize the knee when running, resulting in pain between the hip and knees which worsens over time.

Working out the IT band with a foam roller and conducive stretching can help prevent this injury, as well as updating your trail running shoes and avoiding drastic changes in mileage and hill work, i.e. don’t jump from a 3 mile run on moderate terrain to a 10 mile uphill run the next week. That places too much stress, wear, and tear on the body’s muscles and connective tissues.

Achilles Tendinitis

The continuous engagement of calf muscles with running up and down hills as you do with trail running can stress and inflame the achilles tendon running down the back of the calf to the heel. Old, worn out running shoes, improper body mechanics (weak hips, bad pronation, tight calf muscles), and extreme changes in mileage and terrain can result in moderate to severe pain either in the heel or severely in the calf (it can even lead to a full-on tendon rupture which may require surgical intervention).

Updating your trail running shoes (at least every 500 miles), warming up to a trail run with a brisk walk, stretching warm, pliable calf muscles after your run, and avoiding excessive hill work can help prevent achilles tendinitis.

Plantar Fasciitis

That pesky but critical plantar fascia tissue that runs along the bottom of your foot from your heel to your toes is crucial to successful running and pronation. When it becomes strained, tiny little tears on the tissue combined with stiffness and inflammation can result in painful walking and running. Old running shoes, improper running technique, tight foot muscles, and weak arch support (especially for people with high arches or flat feet) can cause plantar fasciitis.

Stretching the plantar fascia and calf muscles as well as updating your trail running shoes, and possibly even wearing a foot arch support brace can help prevent (and aid) the pain associated with plantar fasciitis. How do you know what type of arch you have? Do the wet test – simply step in a pool of water and step out flat onto a white towel or brown bag to leave solid footprints. Examine the footprints – a very thin crescent moon shape indicates excessive outward rolling of the foot and a high arch, a regular crescent moon shape indicates a normal arch (neutral pronation), and almost little to know crescent moon indicates a flat foot, or excessive inward rolling of the ankle resulting in almost no arch.

If you’re thinking about taking up trail running, don’t let this scare you! Any running, from trail to road to treadmill, comes with its own set of risks, especially if you are not prepared. Muscle stretching and strengthening exercises, updated running shoes, and gradual increases in mileage and terrain shifts can go a long way in preventing running injuries.

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