Preventing Cross Country Injuries

Cross country is an outdoor endurance sport that involves running along a trail of natural terrain. The repetitive impact of running on irregular natural terrain can heighten the risk of injury in cross-country runners. Following a training regimen that incorporates cross-training and targeted strengthening plays a crucial role in preventing cross country injuries during the season. A physical therapist can not only effectively treat any injuries that occur, but also help cross country runners prepare for a successful season through a customized exercise program. Check out our 8 tips to prevent cross-country injuries!

Common Cross-Country Injuries

Cross country involves long-distance running on natural terrain that can include pavement, loose dirt, sand, or gravel, tree roots, grass, and moss as runners compete along an outdoor trail. Cross country courses often include rapid course changes like sudden twists and turns and steep up and down hills, subjecting a runner’s feet, hips, and legs to unexpected forces and stresses that heighten the risk of injury. Female cross-country athletes are at greater risk for certain injuries and conditions, particularly lower extremity injuries, than their male counterparts due to anatomic and physiological factors.

Common cross-country injuries include:

•  Shin splints: Shin splints are caused by overtraining and involve throbbing pain in the front of the lower legs along the tibia. Shin splints are soreness and inflammation of the connective tissue that joins the tibia to the calf muscles, with small tears occurring in the tissues that attach to the tibia.

• Stress fractures: Stress fractures can occur in the weight-bearing bones of the lower body and result from overuse. Over the course of a long-distance run, the muscles become fatigued and the impact force of the pounding feet against the ground is transferred from the muscle to the bone. Stress fractures often develop in the shin bones and feet, causing a small crack in the bone.

• Achille tendinitis: Achilles tendinitis involves inflammation of the Achilles tendon due to overuse but can also lead to a strain or tear of the tendon. This can occur in runners when pushing off or due to tight calf muscles and poor footwear.

• Plantar Fasciitis: Plantar fasciitis is an overuse injury that causes inflammation and pain in the arch of the foot due to tiny tears in the fascia of the foot. The plantar fascia of the foot help with shock absorption and support when walking and running.

• Runner’s Knee: Runner’s knee, or patellofemoral pain syndrome, is an overuse injury of the knee in which the cartilage of the knee is worn down, causing pain in and around the kneecap. The knee becomes irritated and inflamed from the repetitive high-impact stress of running, especially on uneven surfaces.

•  Ankle Sprain: An ankle sprain occurs when the foot twists or turns beyond its normal range of movement, causing the ankle’s ligaments to overstretch or tear, leading to pain, stiffness, and instability in the ankle joint.

• Muscle strain: A muscle strain of the calf, hamstring, quadriceps, or gluteal muscles is common due to overstretching, pivoting, jumping, speeding up, or slowing down quickly. Cross country runners are particularly susceptible to ankle and knee tendon strains.

Physical therapy can treat each of these injuries to manage pain and restore function, strength, and mobility using manual therapy, therapeutic exercise, stretching and strengthening exercises, and functional training.

Preventing Cross Country Injuries

A training program that incorporates cross-training and targeted strengthening is essential to prevent cross-country injuries during the season. A physical therapist works with cross country runners to prepare for a successful season through a customized exercise and strengthening program. 

Here are 8 tips to prevent cross country injuries:

1.  Always warm-up and cool down. A muscle or tendon is less likely to overstretch or tear if it has been warmed up properly prior to running or racing.

2. Engage in static and dynamic stretching, particularly of the leg muscles. Static stretching after a run helps muscles relax after the high-endurance challenge of long-distance running, while dynamic stretches prior to running helps prepare the muscles to prepare for the endurance work of cross country running.

3. Vary training mileage, gradually increasing mileage and intensity of your training (10% increase). Nearly 80% of running injuries are caused by increasing mileage too quickly.

4. Maintain proper footwear, replacing your running shoes every 300-500 miles.

5. Cross-train throughout the season to prevent overuse injuries, which often occur due to working the same muscles continually when running. On rest days, cycle or swim to strengthen other muscle groups.

6. Perform targeted strengthening exercises of the legs, ankles, feet, hip, gluteal muscles, and core. A strong core is critical to maintain optimal running posture and maintain efficient mechanics when you fatigue. Strong gluteal muscles are key for an efficient running stride, keeping the hips level, absorbing shock, and decreasing the load on the knee. A strong hip musculature helps to maintain optimal lower extremity biomechanics and reducing the risk of a running injury.

7. Speed train on a variety of elevations and surfaces. This allows cross country runners to practice making quick stops and sharp turns without straining a muscle or tendon.

8. Maintain proper hydration and nutrition throughout training and competition for key performance.