By Doug Tvrdy, PT, DPT, OCS, CSCS
 Madonna TherapyPlus ProActive 
 RunWell Program 



As we start to really get into the grind of training for the race season there are a few things we need to consider to prevent overuse injuries later on.

Why do we get overuse injuries?  Overuse injuries are typically the result of too much force to a specific area of the body for too long a period of time without enough rest for the tissues to recover. You only have so much tensile strength of your tissues.  They can only take so much load, for so long before they start to swell and cause pain.

Whether you have just started training for a marathon or a seasoned runner there are some pitfalls to avoid when training. 

Poor or abnormal mechanics

Abnormal mechanics create increased strain on certain areas of the body. If you walk on the side of your foot for a few steps it probably hurts a little. Now, imagine doing that for thousands of steps during a run. If there is an abnormal running form, simple rest will not correct the problem and as soon as you get back to running, the injury will flare up again.

So getting a running and strength evaluation is vital to treating the root cause of the injury. The RunWell Program uses video analysis to find and correct abnormal mechanics. Going frame by frame on the video, we can see any abnormal mechanics that can easily be corrected over a few weeks. These corrections can help prevent and/or recover from an injury and improve performance.

In addition, the RunWell Program uses dynamometers to measure muscle strength, down to the 1/10 of a pound, to find out if there is a right-to-left difference of more than 10 percent.  More than a 10 percent difference can result in abnormal mechanics that can lead to pain and injury. You may not be able to feel a difference, but it can be enough, over the course of 10,000 steps a day, between running and walking, to create a problem.

Specific exercises may help to prevent or correct certain abnormal mechanics or weakness. One example of this is knee pain, clinically known as quadriceps tendonitis.

Glute strength and control is often a major culprit when it comes to quad tendonitis/knee pain in runners. Weak hips allow for a “knock knees” position where the knee caves into the middle. This alters the pull of the quadriceps muscle and creates abnormal forces on the knee that over time results in pain and swelling. 

Working on changing that knee angle starts with increasing glute strength. Hip abduction exercises such as side-lying leg lifts and standing hip abduction holds at the wall for 30 seconds for 3 sets.

Side-lying hip abduction - 3 sets of 15 reps

Standing hip abduction walk push - 3 sets of 30 seconds

Running form correction

When you are running, focus on keeping your glutes tight to pull your knees out and keep them pointed straight ahead.  Think about this every quarter mile and correct your form as needed.

Eccentric training

Eccentric training is having the muscle resist against a forceful lengthening of the muscle/tendon. A forceful lengthening of the muscle promotes remodeling of the collagen to rebuild stronger and more dense. Doing a single-leg sit-down is a great way to create an eccentric workload for quadriceps tendon.

Eccentric sit downs, keeping knee, hip, and ankle in straight line and knee behind the toes - 3 sets of 10


We all know we need it, but most of us don’t get enough. We can only run our bodies at 100 percent of their capabilities for so long before they give out. We need to work hard, but rest hard, too, so to speak.  Our bodies need at least 24-48 hours to recover from a hard or near-max-effort workout and allow our tissues to recover and build back stronger before we stress them too much again. If we have another strenuous workout before we have recovered, we further weaken the tissues. The more we damage those tissues, the longer rest period that is needed to recover.

Active rest and varied training

Rest that doesn’t always mean just laying in bed. We can have a hard workout, and then workout at a lesser intensity the next day, still allowing the body to recover. Another way we can allow our body to recover is by varying our training. This can give certain muscles and joints a rest. Running uses specific muscles in specific ways. Even just using a muscle in a different manner can give the muscle a rest.  So instead of running 6-7 days a week, run 3-4 days a week with 3 other days a week with another form of exercise. That could be weight lifting, swimming or elliptical, just something different to change the loads that we put on our body.

Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7
Long run

Short run



Weight lifting OFF Long run Weight lifting at 50 percent Sprints

Making some changes to your routine now and adding in some specific exercises, we can avoid some pain down the road. 

Madonna TherapyPlus and Madonna ProActive are proud to support the BRIN running series! We'll see you at the Leprechaun Chase on March 3.

If you're interested in more information about Madonna TherapyPlus' RunWell Program, click here.

The information shared here is for educational purposes. Check with your health care provider before starting a new exercise plan.