The last 2 laws of the 10 laws of running injuries brings together the past few postings focused on Tim Noakes' philosophies and thoughts on running injuries.

The 8 laws covered up to know are:

  1. Running injuries are not an act of God
  2. Each injury progresses through 4 grades
  3. Injury means the athlete has reached the point of breakdown
  4. Almost all true running injuries are curable
  5. X-rays and other sophisticated investigative tools are seldom necessary to diagnose injuries
  6. Treat the cause of the injury and not the effect
  7. Rest is seldom the best treatment
  8. Never accept as final the advice of a non-runner
Today will conclude the series by looking at the final 2 laws of the 10.

Law 9: Avoid the knife

Dr Noakes believes that the only injuries where surgery should be considered from the start are:
  • Compartment Syndromes
  • Interdigital Neuromas
  • Chronic Achilles Tendonitis that has lasted for 6 or more months.
  • Back pain from Prolapsed disc
  • Ilio Tibial Band Syndrome (but only when all other traetment options have been attempted and have been unsuccessful).

It is also important that the injury fall into the Grade III or Grade IV category.

The primary concern with having surgery is that it is irreversible, once done, it is final!

Law 10: There is no definitive evidence that running causes osteoarthritis in runners knees whose knees were normal when they started running.

If you started your running career with healthy and normally functioning knees, it is very unlikely you will go on to develop osteoarthritis as a result of running.



Individuals who develop osteoarthritis are typicaly those who have had knee surgery or have suffered some other trauma or injury to knee (footbal players, Soccer players etc) or those who have abnormal knee function or anatomy.

There have been numerous studies performed on long distance runners of all levels, and the findings have seldom proven running causes oastearthirtis of the knee.

The best method to steer clear of injury is to always pay close attention to your body and the messages and signals it is sending you. To ignore them, will surely lead to breakdown.

Here's to you remaining injury free running.

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 MyPypeline.com, and has starred in a number of multisport specific fitness videos.
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