Remember last week I discussed the fact that Running injuries are not an act of God, but rather the result of a rational, and often identifiable cause?

I also explained the difference between Extrinsic and Intrinsic injuries, and this leads me onto Tim Noakes' second law of running injuries: Running injuries progress through 4 grades.

Unlike Extrinsic injuries, running injuries are predominantly Intrinsic in nature, meaning they have a gradual onset, and have the potential to progressively worsen over time.

There are 4 Grades (stages), through which most Intrinsic injuries pass through, starting with least severe being classified as a Grade 1 injury, and the most severe receiving the Grade 4 classification.

Grade 1 injury: This presents a few hours after the activity has been terminated, and is tolerable. There is no need for panic, remember after a long run, the body has taken a bit of a pounding, and your body might well feel a little worse for wear

Grade 2 injury: You will start to feel a slight discomfort during your activity, however, it is not sufficient to reduce your training or your performance. It is more of a niggle, but keep close tabs on it, you do not want it to progress to a Grade 3 injury.

Grade 3 injury: At this point, the pain sets in, and you feel extreme discomfort whilst doing your activity. You will find that your training now become limited and the pain interferes with your racing performance. The time has arrived to seek professional help.

Grade 4 injury: Your ability to run is now severely limited. If you have reached this point, and have not sought out professional assistance, now is the time to face the fact that there is a problem and you can no longer "train through" the pain.

There is always the fear that when a Grade 1 injury is detected, it will suddenly escalate and become a Grade 3 or Grade 4 injury. Well, the chances of this occurring are extremely small.

Be level headed when assessing your "injury status", meaning that a Grade 1 "ache" will not require surgery, and a Grade 4 injury will not improve on its own.

Also consider a few explanations for the issues you are experiencing. The goal of this self analysis is to take proactive steps to ensure there is no progression from Grade 1 to Grade 4.

Consider the following:
  1. Do you require new running shoes? Are your running correct for your foot type?
  2. Has your training volume and intensity drastically increased in the past weeks?
  3. Have you incorporated anything new into your routine? Training on a new surface?
  4. Are you maintaining muscular flexibility / elasticity by stretching regularly, administering self myofascial release or incorporating Yoga into your routine.
  5. Do you include strength training in your weekly training routine? Not only does it strengthen the muscles, but it helps the body prevent injuries from occurring (Prehabilitation)
These points (there are a number of others too) play a part in preventing injury or can be a cause of the onset of the injury.

The take away from this is that injuries generally advance over a fairly lengthy time period, allowing you ample time to respond and adjust your training strategy.

James Greenwood is a competitive tri and multisport athlete currently training for Ironman Canada 2009. A level 1 Triathlon Coach, he holds a post graduate degree in Exercise Science, and is a Certified Strength and Conditioning Specialist through the NSCA. James is also currently the resident health and fitness programs expert at, and has starred in a number of multisport specific fitness videos.
blog comments powered by Disqus