Department of Family Medicine and Community Health (Drs. Sidhar and Hammer) and Department of Orthopedics and Rehabilitation (Dr. Hammer), University of Wisconsin School of Medicine and Public Health, Madison kartiksidhar@gmail.com
The authors reported no potential conflict of interest relevant to this article.
Cross-training exercises for runners include cycling, an elliptical workout, swimming, and weightlifting. Incorporating cross-training can be protective against running injury because cross-training requires different movement patterns, prevents overuse, and equalizes muscle imbalances that occur with running.7 In addition, replacing running with a cross-training activity can decrease weekly running time and mileage, which can further reduce risk of running-related injury.7 Runners—especially higher-mileage runners—should be encouraged to incorporate cross-training into their workout regimen to decrease their risk of injury.
There is no reason to counsel runners to run on a softer running surface, unless they find that doing so is more comfortable.
Stretching. The authors of a Cochrane review concluded that there is no significant reduction in injury associated with hamstring or gastrocnemius stretching.32 A small randomized, controlled, crossover study concluded that participants subjectively felt their performance was better when warm-ups included stretching.38 This perceived improvement in performance was similar between groups who completed dynamic or static stretching. However, no difference was noted in flexibility or objective performance between groups who stretched or did not stretch before activity.
Although there is no supporting evidence that stretching reduces the risk of injury, stretching is a low-risk intervention. Because stretching might provide subjective benefit to runners, you need not discourage patients from including this activity in their running program.
