Preventing Sprains and Strains

Avatar photo

Sprains and strains are sometimes part and parcel of any active lifestyle. Garrett Van Oirschot outlines some of the more common mountain-running injuries, and their management

Many runners look to add a bit of variety into their running routine. Some runners train in new locations or enter races in far-off destinations. Some will join running groups or start training informally with friends. Some runners will look for new areas in which to run – a step away from the typical footpath.

Ireland offers a host of trails for those willing to step further into nature. Trail running has surged in popularity and offers additional benefits that may not be found in traditional road running. Trail running challenges balance, coordination, and attention but also offers the chance to truly escape into the wilderness. From my perspective as a chartered physiotherapist, these are all great reasons to trail run, keeping in mind that it is a slightly different sport. As with any activity, trail running comes with its own unique set of issues around footwear, strength and conditioning, and injury prevention/management. Certain injuries are more common in trail running compared to traditional road running. It is important to highlight a few of the most common ones.

Ankle Sprains

Encountering more uneven terrain means that the foot is going to land on various bumps and dips in the trail surface as opposed to the perfectly flat road surface. While this can be great training for the leg and ankle muscles, there is a higher risk of rolling your ankle. To prevent such an occurrence, it is important for beginners to ease into trail running. When starting out, avoid doing too much too soon. Give yourself a rest day between runs so that you minimise the risk of fatigue. Fatigue can reduce your balance or reaction time and make it easier to roll an ankle on the uneven surface. If you are unlucky and you do end up rolling your ankle, it can cause overstretching of the ligaments on the outside of the ankle. It can sometimes result in a fracture, but your chartered physiotherapist can determine if an X-ray is required. Even if the bone isn’t fractured, severe ligament sprains can cause swelling and bruising that will delay your return to running. Let this injury settle for a few days but you should still try to keep walking and moving, and start some rehabilitation. Studies have shown this provides for an easier recovery compared to that experienced by those who avoid moving the ankle, allowing it to stiffen.

Calf Strains

Trail running demands more work from your leg muscles, especially the calf muscle. It is normal to feel some additional soreness or tightness in the calves when you take up trail running. Be patient and as long as you allow for sufficient rest between runs to let the muscle soreness subside, your calf muscles will adapt, and you will eventually notice some improvement.

If you feel the calf muscles are not adapting or you feel the calf pain is feeling more sharp or severe, then your chartered physiotherapist can identify which strength and conditioning exercises should be included in your cross-training programme. In such cases, you need to build up the strength of your calves to help get you running again. Generally speaking, strength training over four to eight weeks will result in improvements in strength and you should start to notice a difference in your symptoms.

Anterior Knee Pain

‘What goes up must come down’ – this is never so true as it is in mountain running – but it is the coming down part that can create problems for your knees. The front of the knee can become sore in these instances and anterior knee pain is a condition that makes it difficult not only to run downhill, but also to squat, jump, or use the stairs.

Running downhill places demands on your knee joint and your gluteal and quadriceps muscles. Provided you gradually build up the amount of hills in your programme, your joints and muscles will adapt. Should your knee pain interfere with your running performance, then you will require rehabilitation for the knee that typically involves some form of strengthening for any or all of the calf, gluteal, and quadriceps muscles. Then a gradual return to running will be needed.


Keep in mind that your normal road running shoes will usually have more give in the soles and trail runners may be slightly stiffer. This means that you should ensure you do some basic walking and break in your trail runners before taking them for a run. This gives your feet a chance to adapt to the new runners and helps to avoid blisters.


Garett Van Oirschot is a chartered physiotherapist who treats runners at Premier Physiotherapy in Ballinteer, Dublin 16. He is also the incoming committee chair of the Chartered Physiotherapists in Sports & Exercise Medicine (CPSEM). For more information or to find your local chartered physiotherapist visit

Irish Runner logo

The Runner’s Connect