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How to Prevent Cross Country Running Injuries ## More alert details # How to Prevent Cross Country Running Injuries Contributor Christopher J. Couture, MD Sep 6, 2024 7 minute read - [Bone & Joint Conditions](https://www.massgeneralbrigham.org/en/about/newsroom.topic=Bone%20&%20Joint%20Conditions) - [Patient Care](https://www.massgeneralbrigham.org/en/about/newsroom.topic=Patient%20Care) - [Exercise & Fitness](https://www.massgeneralbrigham.org/en/about/newsroom.topic=Exercise%20&%20Fitness) - [Health & Wellness](https://www.massgeneralbrigham.org/en/about/newsroom.topic=Health%20&%20Wellness) - [share on facebook](https://www.massgeneralbrigham.org/en/about/newsroom/articles/cross-country-injuries) - [share on linkedIn](https://www.massgeneralbrigham.org/en/about/newsroom/articles/cross-country-injuries) - [share on X, formerly known as Twitter](https://www.massgeneralbrigham.org/en/about/newsroom/articles/cross-country-injuries) - [share by email](https://www.massgeneralbrigham.org/en/about/newsroom/articles/cross-country-injuries) - print article  The return to school for many youth, high school, and collegiate runners also means a return to the trails and woods for cross country season. “For most runners, cross country is a uniquely demanding discipline. Having to run on a variety of surfaces, maintaining a steady pace while navigating rocks, roots, mud, sharp turns, and hills requires intense effort and concentration,” says [Christopher J. Couture, MD](https://doctors.massgeneralbrigham.org/provider/christopher-j-couture/1707872?unified=Couture&sort=relevance%2Cavailability_density_best%2Cname&from=search-list), a Mass General Brigham sports medicine doctor. “While speed might win the race, being able to maintain focus and coordination over a challenging course is often the difference between finishing near the front or near the back.” Dr. Couture describes the most common injuries for cross country runners and tips to help prevent injuries during race season and offseason training. ## Common cross country injuries “If you’ve let your physical conditioning slip over the summer, anticipating the challenges of the upcoming season and developing a comprehensive training plan can be the difference between a fun, successful season or one that ends in disappointment, or worse, an injury.” Cross country runners are at risk for several [overuse injuries](https://www.massgeneralbrigham.org/en/about/newsroom/articles/preventing-overuse-injuries-in-youth-sports), including: - Iliotibial (IT) band syndrome - [Runner’s knee or patellofemoral syndrome](https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/knee/patellofemoral-pain-syndrome) - Shin splints - Calf [strains](https://www.massgeneralbrigham.org/en/about/newsroom/articles/sprains-and-strains) - [Ankle sprains](https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/foot-ankle/ankle-sprain) - [Achilles tendinitis](https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/foot-ankle/achilles-tendon-rupture) - [Plantar fasciitis](https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/foot-ankle/plantar-fasciitis) - [Stress fractures](https://www.massgeneralbrigham.org/en/about/newsroom/articles/bone-stress-injuries) > It’s easy to neglect proper recovery and nutrition, but a body that is not properly fueled and rested will not be able to handle the challenges of a cross country season. Christopher J. Couture, MD Sports Medicine Doctor Mass General Brigham ## Cross country injury prevention tips It’s important to minimize the risk of injury while enjoying the season. To develop a good routine to help reduce your chances of injury, here’s what you can do: - [**Stretch**](https://www.massgeneralbrigham.org/en/about/newsroom/articles/how-to-build-strength-with-resistance-bands). Diligently stretch [hip flexors](https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/hip), [hamstrings](https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/knee/hamstring-injuries), and calves help runners navigate quick turns, stops, and starts. - **Build core strength**. Pay attention to core strength and stability to provide a solid foundation for running over uneven terrain. - **Balance**. This goes together with core stability. Being able to land each step solidly and without wobbling prevents the ankle from rolling, which can quickly become a nasty sprain. - [**Practice speed drills**](https://www.massgeneralbrigham.org/en/about/newsroom/articles/sprinter-training-increase-power). Practicing speed drills on a variety of surfaces and elevations translates to greater success than training on a straight asphalt or rubberized track. - [**Develop stamina**](https://www.massgeneralbrigham.org/en/about/newsroom/articles/strength-training-and-blood-pressure). Develop leg power and stamina by running up and down hills and through soft surfaces such as sandy, muddy, or grassy areas. Athletes who are successful at cross country make running a part of their lives year-round. ### How to prepare for cross country season Just as important as learning how to train is learning how to take care of your body when you’re not exercising. “It’s easy to neglect proper recovery and nutrition, but a body that is not properly fueled and rested will not be able to handle the challenges of a cross country season,” says Dr. Couture.  Runner stays hydrated to help prevent cross country injuries. Here are things you can do off the trails: - [**Follow a healthy diet**](https://www.massgeneralbrigham.org/en/about/newsroom/articles/sports-and-nutrition). Lean [protein](https://www.massgeneralbrigham.org/en/about/newsroom/articles/how-much-protein-when-working-out), healthy fats, carbohydrates in the form of fresh fruits and vegetables nourish a runner’s muscles and provide the fuel necessary for intense workouts. Avoid processed, fatty, and fried foods as well as [sugary and acidic sodas](https://www.massgeneralbrigham.org/en/about/newsroom/articles/sugary-drinks-liver-disease) and snacks, especially on race day. - **[Stay hydrated](https://www.massgeneralbrigham.org/en/about/newsroom/articles/tips-for-staying-hydrated) and eat salty foods after exercising**. Because cross country preseason training and competitions often take place in the heat of the summer, it’s vitally important to avoid heat stress. Getting acclimated to [exercising in the heat](https://www.massgeneralbrigham.org/en/about/newsroom/articles/prevent-overheating-during-workouts) is essential. Drinking lots of cold water before and after runs is necessary to maintain body fluid levels. Modest salting of foods after running helps replace salt lost in sweat, which helps maintain fluid balance. - **Rest and [sleep](https://www.massgeneralbrigham.org/en/about/newsroom/articles/how-to-sleep-better)**. Students who don’t get enough sleep are more likely to experience an injury. Adolescents who get at least 8 hours of sleep a night can perform better than those who don’t. - **Wear proper shoes**. [Foot pain](https://www.massgeneralbrigham.org/en/about/newsroom/articles/why-you-shouldnt-ignore-foot-pain) is common among runners. Running shoes should be comfortable and provide the right balance of support and cushioning. Consider having a specialist recommend the right shoe for your foot type. Avoid “breaking in” a new pair of shoes in the middle of a season. Rather, use the preseason to slowly ease into new shoes as your training progresses. Remember to maintain open lines of communication with your parents, coach, and athletic trainer. “Speak up about any soreness, aches or pains you experience as you train,” says Dr. Couture. “Ask questions about anything you don’t understand or want to learn more about.” *** Learn about Mass General Brigham Sports Medicine services [Sports Medicine services](https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine) *** ## Contributor [Christopher J. 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The return to school for many youth, high school, and collegiate runners also means a return to the trails and woods for cross country season. “For most runners, cross country is a uniquely demanding discipline. Having to run on a variety of surfaces, maintaining a steady pace while navigating rocks, roots, mud, sharp turns, and hills requires intense effort and concentration,” says [Christopher J. Couture, MD](https://doctors.massgeneralbrigham.org/provider/christopher-j-couture/1707872?unified=Couture&sort=relevance%2Cavailability_density_best%2Cname&from=search-list), a Mass General Brigham sports medicine doctor. “While speed might win the race, being able to maintain focus and coordination over a challenging course is often the difference between finishing near the front or near the back.” Dr. Couture describes the most common injuries for cross country runners and tips to help prevent injuries during race season and offseason training. “If you’ve let your physical conditioning slip over the summer, anticipating the challenges of the upcoming season and developing a comprehensive training plan can be the difference between a fun, successful season or one that ends in disappointment, or worse, an injury.” Cross country runners are at risk for several [overuse injuries](https://www.massgeneralbrigham.org/en/about/newsroom/articles/preventing-overuse-injuries-in-youth-sports), including: - Iliotibial (IT) band syndrome - [Runner’s knee or patellofemoral syndrome](https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/knee/patellofemoral-pain-syndrome) - Shin splints - Calf [strains](https://www.massgeneralbrigham.org/en/about/newsroom/articles/sprains-and-strains) - [Ankle sprains](https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/foot-ankle/ankle-sprain) - [Achilles tendinitis](https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/foot-ankle/achilles-tendon-rupture) - [Plantar fasciitis](https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/foot-ankle/plantar-fasciitis) - [Stress fractures](https://www.massgeneralbrigham.org/en/about/newsroom/articles/bone-stress-injuries) ## Cross country injury prevention tips It’s important to minimize the risk of injury while enjoying the season. To develop a good routine to help reduce your chances of injury, here’s what you can do: - [**Stretch**](https://www.massgeneralbrigham.org/en/about/newsroom/articles/how-to-build-strength-with-resistance-bands). Diligently stretch [hip flexors](https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/hip), [hamstrings](https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/knee/hamstring-injuries), and calves help runners navigate quick turns, stops, and starts. - **Build core strength**. Pay attention to core strength and stability to provide a solid foundation for running over uneven terrain. - **Balance**. This goes together with core stability. Being able to land each step solidly and without wobbling prevents the ankle from rolling, which can quickly become a nasty sprain. - [**Practice speed drills**](https://www.massgeneralbrigham.org/en/about/newsroom/articles/sprinter-training-increase-power). Practicing speed drills on a variety of surfaces and elevations translates to greater success than training on a straight asphalt or rubberized track. - [**Develop stamina**](https://www.massgeneralbrigham.org/en/about/newsroom/articles/strength-training-and-blood-pressure). Develop leg power and stamina by running up and down hills and through soft surfaces such as sandy, muddy, or grassy areas. Athletes who are successful at cross country make running a part of their lives year-round. ### How to prepare for cross country season Just as important as learning how to train is learning how to take care of your body when you’re not exercising. “It’s easy to neglect proper recovery and nutrition, but a body that is not properly fueled and rested will not be able to handle the challenges of a cross country season,” says Dr. Couture.