A guide to long distance running

Elle Richardson
Ellie Richardson is an experienced MSK and Sports Physiotherapist with 10 years clinical experience under her belt. She holds postgraduate diplomas in Orthopaedic Medicine and MSK Physiotherapy, and is currently studying a part time MSc in Advanced Musculoskeletal practice. Ellie is also a former Scottish National Champion in athletics as well as current and 9 times Scottish National Champion and National Record Holder in track cycling. She represented Scotland on numerous occasions including at the Glasgow 2014 Commonwealth Games, ridden in a World Cup and represented Great Britain at the UCI 6 Days in Rotterdam in 2016.

Ideally before taking up any sport you should ensure that you lay a foundation from a training perspective that enables your body to cope with the imposed stresses and demands of the new activity. Here Ellie answers questions about training for a 10k or long distance running and avoiding injuries along the way.

From a physiotherapy perspective, what kind of preparation should someone do before taking up distance running?

This involves breaking down the activity and assessing whether the body is equipped to deal with each component of the movements involved. As running is a whole body activity it requires both flexibility and stability throughout the whole kinetic chain, and a stiff or a weak link in the chain can lead to injury. For this reason it is prudent to familiarise yourself with a whole body stretching regime, and also to seek professional advice if you are prone to pre-existing "niggles" before taking up distance running.


As well as of ensuring you are flexible enough for your new activity it is also wise to do some background conditioning and stability training before exposing your body to the very repetitive demands of distance running. This could involve taking up Pilates as an additional activity to your running. It is important to remember that everyone could always be stronger, more flexible and fitter and all you want to do is get your body fit enough to cope with the demands you personally want to put it under week in week out. 

How does running on different terrain affect the body? Tarmac as opposed to grass for example.

It is not necessarily black and white when it comes to which running surface is “safest” to train on because individual biomechanics, feasibility and personal preference must all be considered. Harder surfaces (like tarmac) can subject the body (specifically the joints) to increased strain due to higher impact forces whilst softer surfaces (like uneven grassy terrain) can increase the demands on the muscular systems that stabilise the ankle, knee and pelvis.

Anything done repetitively can lead to overuse injuries, even in elite athletes, and so “variety is the spice of life”. In other words, think about varying the terrain you train on not just to challenge your body in new ways but to “spread the love” in terms of which structures are being subject to repetitive loads. This includes varying the type of surface (grass, sand, tarmac, 3G pitches etc) and also the incline (hilly, flat etc) whilst also applying an element of common sense to your training. For example, if it’s a high mileage week and you have good ankle/knee/lower limb stability then look to do the majority of your training on a softer flatter surfaces.

Conversely, if you are looking to develop speed endurance in preparation for that end of race “kick” then think about using hills to increase the power required by the body whilst shortening the distance to minimise the risk of injury.

What are the most common injuries you come across with a sport like this?

Knee pain
  1. Anterior Knee Pain/PFPS (patella-femoral pain syndrome)
  2. ITBFS (iliotibial band friction syndrome) 
  3. Low grade muscle strains (most commonly in the calf muscle)
  4. Tendinopathies (including Achilles tendon, peroneal tendons, patella tendon, iliopsoas tendon etc)
  5. Sacroilliac dysfunction (excessive or reduced force closure) and generalised low back pain
  6. Referred neurogenic pain (e.g. from tight myofascial structures “tethering” peripheral nerves such as piriformis syndrome)
  7. Stress fractures (most commonly in the bones of the foot and the lower leg although can also occur in the thigh bone)
  8. Acute flare ups of pre-existing injuries otherwise dormant (e.g. hip labral tears, osteochondral defects in the ankle etc)
  9. Medial tibial periosteal reaction ("shin splints")

Running Injuries infographic

Click here to see the full infographic. At BMI Healthcare we have specialist sports injury clinics and physiotherapy services which aim to help you return to fitness as soon as possible following either an acute or chronic injury.


What can people do to minimalise the risk of injury?

Asides from following the preparation guidance above, it is important to factor in adequate recovery, as this is where training gains are actually made! Don’t fall into the trap of training yourself into the ground – listen to your body and chances are if you’re feeling the odd niggle it’s because your body is asking for a couple of rest days to allow it to recover from the new training load. In addition to ‘training smart’ it is also important to ensure you are getting adequate nutrition and hydration both during and after your training sessions. Remember, if you are training for performance your body needs access to reserves – in other words fuel appropriately and don’t’ let malnutrition lead to cramps and strains that cut your training runs short.

How important is having the right kit i.e. running shoes etc?

Footwear is undoubtedly important. However, I would suggest that if you haven’t had any problems before you are probably using something your body is comfortable with and that works for you. If you have experienced any of the injuries listed above in the past or are aware of pre-existing niggles it could be worth booking yourself in to see a podiatrist for an assessment and subsequent advice on the most suited footwear for you (plus a possible personalised orthotic insole device). Regardless as to which shoe you ultimately go for, making sure the fit is good and that you have invested in some good quality socks as a bad blister can mean the difference between finishing a 10k and not!

What are the right things to do once the race is complete to reduce the risk of injury?

Make sure you hydrate and fuel your body properly and go through a thorough cool-down regime. This may include a period of walking followed by some slow sustained stretching and possibly even a post-race massage. Even if you feel fantastic after race day it is ALWAYS worth taking a good few days off afterwards to let your body fully recover before resuming your training – sometimes we feel great because of post race adrenalin and it’s important to resist the temptation to hit the roads again immediately after a race as this can mask the body’s general post-race aches and pains. During this period a bit of light cross training is always a good way to keep the body active whilst also allowing it to recover.

What advice would you give to someone running a 10k for the first time?

Assuming all the right preparation has taken place my first piece of advice would be to enjoy it and don’t put a time pressure or target on yourself. Use the time you run as a benchmark from which to improve upon now that you have some race experience under your belt. Don’t change anything suddenly on race day that you haven’t already trialled in training (for example, don’t suddenly try a new electrolyte or caffeine based drink pre race as you don’t know how your body will respond to it on the day) and try to keep to the pace you have set yourself in training in the weeks leading up to an event (e.g. by using a wrist watch or similar device). Getting swept up in the crowd and being pulled along by faster runners might be okay in the early stages of the race but the early increased demands on your body might put you at injury risk later on in the race. So run your own race.

What are your three top-tips for avoiding injury whilst distance running?

  • Lay the right fitness foundation
  • Train smart and don’t skip recovery days
  • Cross train to vary repetitive loads and listen to your body

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