Why it’s so important for every runner to “prehab”

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They tried to make me go to prehab, I said no, no, no? Not if leading sports doctors have their way.

When runners plan to avoid injury, they tend to focus on what they can do after they yank off their shoes (rest, stretching, etc.). But experts say that every runner who wants to stay injury-free should seriously consider a strategic “prehab.” Short for—you guessed it—prehabilitation, it’s all about sidestepping injuries before they develop into full-blown catastrophes.

Running clinics and physical therapists have long been proponents of the individualized prehab assessment, seeing it as a rare chance to ID potential weaknesses and imbalances before they take their toll. It’s a time to tackle questions like: “Should you be a forefoot runner? What’s the right stride length or cadence? What shoes should you wear—or should you go barefoot? Is stretching good or bad? What core exercises should you do?” explains Michael Fredericson, MD, director of the Stanford Runner’s Injury Clinic and a prehab guru. He’s been the Stanford University track and field team’s physician for more than two decades, so he’s seen the power that the simple analysis can have firsthand.

But even if an individualized prehab evaluation isn’t in the cards for you, every runner (or aspirant) can benefit from a focused prep routine of some kind. Do it on the regular to shore up weaknesses and become more efficient—which means you’re less likely to be injured down the (literal) road. Yes, yes, yes.

Ready to up your prehab game? Here are four steps to take right now. 

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Plank prehab
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1. Build your core strength

“I’ve never seen a runner, even an Olympic-level runner, who wouldn’t benefit from a better core strengthening program,” says Dr. Fredericson. The core is just so important, especially if you’re planning to run long distances. “As you fatigue, your form starts to break down,” he explains. “You develop your core strength and endurance so you can maintain your form.”

Any of the core-strengthening moves you’ve already got in your repertoire should work, but Dr. Fredericson is particularly into planks and squats. (Yep, they help your core, not just your bum.)

Photo: Thnkstock/Superbashnyi
Photo: Thinkstock/Superbashnyi

2. Work those hips

Weak hips are often the culprit behind knee, ankle, and foot injuries, according to Dr. Fredericson. “We generally recommend hip strengthening exercises, especially for the side hip muscles, or the adductors,” he says.

Start with simple side-lying leg lifts, then progress to more active exercises, like single-leg squats. They fire up your glutes, particularly your gluteus medius—a muscle that helps control the hips. (FYI: double-leg squats, while beneficial, do a better job of targeting your gluteus maximus muscle, according to the doc.)

Prehab ankles
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3. Don’t forget your ankles

Feet and ankles take such an obvious pounding during a run, yet they tend to be overlooked from a stretching/strengthening perspective. Dr. Fredericson recommends doing lots of calf raises on a step, concentrating on lowering down slowly. Balance exercises that require you to keep good arch position—like tree pose in yoga—can make a difference, too. “That will work all the tiny muscles that support your arch, which is really important,” he says. “You really need to have strong muscles in your feet.”

Prehab stretching
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4. Stretch, stretch, streeeeetch

Everyone has a part of their body that’s particularly prone to tightness, often because of an imbalance of some kind. “My IT band is always tight, no matter what I do,” says Dr. Fredericson. The doctor’s orders? Combine foam rolling and regular stretching (meaning, not just after a run) to help relax soft tissue and keep it supple. A good rule of thumb: Focus on your IT band, piriformis (a muscle in the butt, near the top of the hip joint), hamstring, and calf muscles. They’re some of the primary areas where runners get tight—and where a little preventive TLC can make a huge difference.

You’ve got the prehab down, now it’s all about the gear. Should you be running in super-cushioned sneakers?  Either way, you’re definitely gonna want to rock some suddenly-back-in-style running shorts

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