The tragic death of a healthy young man and the hospitalization of some 80 other people in the recent Tel Aviv Marathon have resulted in blame games and questions over how well prepared the authorities and the runners were. Whatever the outcome of official investigations, all participants should be aware that long-distance running is a grueling sport and carries risks, especially for the unprepared. Here are 10 tips for injury prevention when running.

1)     Pace yourself

Experts agree that "training errors” are the number one cause of training injuries — doing too much, too fast, too soon. Our bodies are excellent at adapting to change. However, adaptation takes time and is best done slowly. Training errors can result in repetitive strain injuries, including ITB, Achilles tendinopathy and planter fasciitis to name just a few.

A good rule to follow is the 10% rule — build your mileage by no more than 10% per week. A 3% or 5% increase is also sufficient. There are so many training variables you can change to challenge yourself, such as incline, speed and distance. Just don’t change them all at once.

2)     Have a rest day

Build at least one rest day into your training schedule. Beginners should alternate training and rest days. Exercise causes muscle tissue breakdown, depletion of energy stores (muscle glycogen) as well as fluid loss.  Recovery allows the body to replenish energy stores and repair damaged tissue. Without sufficient time to repair and replenish, the body will continue to break down from intensive exercise, resulting in injury.

3)     If you have taken time off, return slowly

After taking time off due to injury or for any other reason, don’t start training at the same intensity that you were at when you stopped. The body deconditions quickly and loses adaptations much faster than it gains them. Research shows that the time it takes to get back to your fitness levels depends on how fit you were. The fitter you are the quicker you will return to your training fitness. However, it’s always best to pace yourself, especially at the beginning of your return, to avoid injury.

4)     To stretch or not to stretch

The evidence of whether stretching actually prevents injury is inconclusive, with some studies showing that it does and others showing that stretching is actually detrimental to performance. I generally advise patients to stretch regularly to maintain flexibility. However, this does not need to be before or after an exercise session.

5)     Invest in the right shoes

The big question among runners today is which is better — barefoot or running shoes? The short answer is that we don’t know yet. Not enough research has been done since the barefoot media frenzy took hold in 2010. According to podiatrist Ian Griffith, comfort is the most important variable when it comes to choosing a running shoe. In fact, comfort has been linked to injury frequency reduction. So if it feels good to run in, it’s the shoe for you. As for the frequency of changing shoes, Runner's World recommends changing shoes every 400-500 miles (640-800 kms).

6)     Variety is the spice of life

Running is a repetitive movement in which each foot comes into contact with the ground 75 to 100 times per minute. Running on the same route at the same speed for the same distance without any variety may lead to overload of musculoskeletal structure resulting in repetitive strain injury. Varying your runs (longer ones, shorter ones, interval training) may not only add some excitement to your routine, but also vary the stresses on your body. Just make sure that any changes to your routine are done slowly and carefully.

7)     If it hurts, treat it

Many people ignore injuries and continue to run in pain. This results in an increase inrehabilitation time and more time off running — a prognosis that runners hate to hear. If it hurts and it doesn’t go away, have it treated. Physiotherapy tends to help speed the healing process and can often result in a quicker return to sport. A good physiotherapist will not only treat the symptoms but also identify the root cause of the problem, thereby preventing a relapse.

8)     Get a good night's sleep

According to the British Medical Journal, insufficient sleep leads to a deterioration of performance, attention, motivation and mental concentration, all of which lead to an increased risk of error and injury. Sleep is also good for healing. During deep sleep, the production of growth hormone is at its peak. Growth hormone speeds the absorption of nutrients and amino acids into your cells, and aids the healing of tissues throughout your body. Growth hormone also has a stimulatory affect on your immune system.

9)     Eat enough protein

Our musculoskeletal tissues are strongly affected by what we eat. Adequate protein intake is important for muscle maintenance, growth and repair. According to Livestrong.com, it is imperative for injury prevention to eat enough calories every day. Without enough calories, your muscles will enter a catabolic state in which lean muscle tissue is converted into fuel. As a result, your muscles will be more prone to injury and less capable of repairing injuries that occur during physical activity.
10) Stay hydrated

Dehydration causes muscle fatigue and cramping. Muscle fatigue can in turn lead to injury. To stay hydrated, drink throughout the day, especially on days when you exercise. This article (http://www.runnersworld.co.uk/nutrition/rws-complete-guide-to-hydration/1780.html) by Runner’s World suggests that you drink 1 liter of water for every 1,000 calories you burn. Always start a run hydrated. Drink 500ml of fluid (water energy drinks) two hours before you run and another 150ml just before you run.