I’m headed into my 19th year as a practicing physical therapist. After you’ve been around for a while, you start to notice patterns in the problems patients come to see you about, especially those that seem to change with the seasons.

Now that the weather is finally trending positive, I’ve noticed a significant uptick in the number of runners I’ve seen out on the roads and trails. Unfortunately, this also means I’ve seen an increase in the number of runners coming to me for advice on getting over various aches and pains that have caused them to take time off their preferred training schedule.

The cycle is a predictable one. Many runners find other fitness activities to keep them moving during the winter months. Once the weather breaks and the roads and trails are clear, they usually try to resume whatever frequency and mileage they left off at back in November. “After all, that was just a few months ago, and I’ve been staying active, so I should be fine, right?”

There are some seasoned runners who can get away with that approach, but they are most definitely in the minority.  We forget sometimes that, in addition to our heart and lungs, running can be stressful to the rest of the body. When our body tissues (ligaments, tendon, muscles, and bone) are subjected to stress, the tissues toughen up in response. However, if too much stress is placed on them too quickly, they will break down.

An analogy I like to use is to think of a younger child’s heel. When kids first start walking, their heel pad is just as smooth as the rest of their body. Over time, the skin on the heel that is constantly stressed gets tougher, forming the largest callous on the body. It is the gradual application of stress over time that toughens the tissue. The same thing happens to our other tissues under continued stress.

To learn more about injury prevention techniques for people getting back into a running program, I spoke to Mary Sullivan, PT, and Jennifer Wolf, PTA. Mary and Jen are the lead clinicians for the Run360 program which aims to help runners of all ages and ability levels stay on track.

What are some common errors runners make when they resume a seasonal running program? The most obvious error is starting too fast, too soon. If someone was running 5 miles/day, 4 days/week in October, then takes time off until Spring, they often go right back to running 5 miles. This almost always leads to injury. It’s a much better idea to start with a couple of miles, a couple days per week and build from there.

What steps can a runner take to minimize the chance of injury during the first few weeks of starting their program? Check your shoes! Most runners forget that running shoes have mileage limits. Since all shoes are different, it’s usually a good idea to replace them every 300-500 miles. When in doubt, ask the experts at your favorite specialty running store.


If a runner does start to experience aches and pains beyond their normal level, how long should they wait before getting it checked out? Any pain that makes you change your stride should be evaluated. Any pain that lasts longer than 10-14 days should be checked to prevent it from becoming a larger problem. Finally, if the same body part seems to be an issue every time you up your mileage, that is a sign that there may be a biomechanic that should be addressed.  If anyone is in doubt, we always offer free consultations to help point you in the right direction.