Running uphill won't get you injured if you train with caution

I'm a runner, and a running podiatrist, so I think a lot about safer running. Of course, this is a major concern for runners. In fact, a recent study from the journal Sports Medicine revealed that 25% of runners are injured at any given time. Now, not all runners are at equal risk for joining that 25%. In fact, 85% of new runners get hurt. Still, at least once a year, about half of all runners get hurt badly enough to have to stop running. 

So, those are the stats. But are there other factors that influence who will and won't join the legions of injured runners? Of course there are! I've talked about indoor vs outdoor training. I worry about people who run on concrete, trails or the sandy beaches. Heck, I even worry about you guys running when the weather gets hot and humid. (Which, let's face it, happens about 10 months of the year here in Houston.)

With all those running talks, I realized that I haven't talked a lot about elevation. (Don't worry, I'm as surprised as you are!) But don't worry, I'm going to fix that gap right here and now. So let's dive into the safety of running on hills, ok?

Is Hill Running Dangerous?

When you run on a flat surface, it's pretty easy to stick to your pace and stride. For that reason, you may think it's easier to avoid injury. But do you worry that going up or downhill will make you more likely to get hurt when you run?

Well, you're not alone! Former BYU track star Katy Andrews Neves was too. (She was most concerned about the effect of hill running on the Achilles tendon. ) So, together with three exercise science professors at BYU, she launched a special study. Her purpose? To explore the connection between hill transitions and heel injuries. (Remember, a tight Achilles tendon can pull on your plantar fascia. For that reason, we often need to address tendinitis to stop your heel pain.) Here's what the researchers discovered.

Hills and the Achilles Tendon

The 20 women in this study spent three days running on treadmills. (They ran at different incline grades on each of the three days. And they rested for at least 48 hours between each run. Which is critical, because rest days play a big role in preventing running injuries.) After each session, researchers took ultrasound images to see the impact of each run on the women's Achilles tendons. And what they found may be a surprise!

Here's the deal. Running on a hill (especially a down-grade) puts the most force on the runners’ limbs. But the grade changes didn't make a significant difference when it came to the thickness and health of the Achilles tendon.

With that observation, the study concludes that running up or downhill doesn’t put you at any greater risk for an Achilles injury. The study does have one caveat, though. "Even when the forces are higher, if the adaptation process is gradual, the injury risk drops,” according to Neves.

Translation? Don’t bomb up or down a hill at full speed on your first day of training. Instead, gradually build up to hill running. That gives your body enough time to strengthen and adapt to your new terrain. So you should not be at any greater-than-normal risk of getting a running injury. In fact, it may help prevent injury, if we can believe a new study on hill running and your Achilles tendon.

Can Downhill Running Heal Your Achilles Tendon? Downhill running to reduce Achilles tendon pain

If you already have Achilles tendon pain, we've got many ways to offer pain relief. Traditionally, rest, ice and lots of stretching loosens up the tendon. And that gets you feeling better.

Now, thanks to a new pilot study, we may have a new option: running downhill. Backward. I know it sounds crazy. (But if you know me at all, that's sort of my jam.) So stick with me here and listen to why it's so crazy, it just might work.

Over the course of a five-week rehab program, 14 runners trained nine times on a treadmill with a negative incline. They all ran backward. By the end of the study, 85% of participants had less Achilles tendon pain.

So, it really seems to work. But why does it work? Basically, downhill backward running mimics traditional Achilles stretches. (Especially that old favorite, dropping your heels off the back of a step.) After all, when you run backwards on a decline, you put a lot of load on your Achilles tendon. That makes it more resilient. So it's better able to stand up to the pressures of running. Which means you're less likley to get a running injury.

Even better? This hill-running option lets you train to reduce pain. That's a big contrast to traditional stretch-and rest methods, where you may lose stamina while you recover. Because, if you run backward to reduce tendon pain, you're still running. And that's a big deal for people who never want to miss a day of training. But also don't want to run through the pain.

Active Solutions for Runners

On that note: active running solutions are a great idea in general. I love to keep my injured runners moving while they recover. (That's why I may send you on a pool jog if I think training on land could risk your recovery.)

But guess what? Active recovery isn't the only way to move your way to safer runs. Because I also want you to get more active when you warm-up for training. That's why I want everyone to give up on static stretches like toe touches before they log some miles. Instead, I want you all to try a warm-up that embraces dynamic stretching. (Here's what that looks like. And why it works.)

Of course, we can try all the fancy warm-ups and training ideas. But you still may get hurt. (Although, we can also fit you with custom running orthotics. To add one more protective tool to your injury-preventing arsenal.)

Even so, running sometimes hurts. So I'm always here to help reduce pain and return to safe training. Do you have concerns about other running injuries? Or do you just want to make sure that your training regimen is keeping you safe and helping you get tthe results you want? Schedule an appointment for a running consultation today! I'll explore everything from your gait to your shoes and your training schedule. Then, together, we'll make any tweaks you need. So you can run longer, faster and with much fewer risks for injuries.