It’s not unusual to see a few brave souls wrapped in gloves and balaclavas jogging along the Charles or through Cambridge Common in the snow. But for most of us, running outdoors is a fair-weather sport. 

It’s also a dangerous one. Injury statistics vary, but research shows that each year, roughly half of all runners experience an injury serious enough to sideline them for a period of time. Adam Tenforde, a Harvard Medical School associate professor of physical medicine and rehabilitation at Spaulding Rehabilitation hospital and a specialist in sports medicine, offered safety tips for runners who are new to the sport or just rusty.

What are some good tips for someone who hasn’t run recently and wants to start a regular outdoor running practice? 

Running is a great outdoor activity, especially during the warmer times of the year. For those easing back into running, this should be done gradually to allow the musculoskeletal system to adapt. 

There are many “couch to 5K” programs available for those starting running or who have taken longer times away from regular running. Running coaches can also be helpful in incorporating training plans. Having an identified race can be motivational and help to build a routine toward a goal. 

In general, changing training variables can include frequency, duration, or intensity, and modifying one variable at a time can help to monitor response to increased efforts. As with any new form of exercise, those with underlying health concerns should consult a medical provider to ensure they can safely add new physical activities such as running.

How can new or returning runners reduce their risk of injury? 

In general, the 10 percent rule is often recommended for increasing total training volume each week. However, there’s not strong science to support this.

I often recommend runners to think about training efforts gradually increasing each week and dropping the volume of training by one-third every third week. Having regular running shoes and alternating two pairs of training shoes can allow the shoes to recover from humidity and moisture, with a reminder to replace shoes if they appear worn or every 300-500 miles. 

Regular sleep of at least seven hours per night may reduce injury risk and improve recovery between training sessions. I also advise regular strength training two to three times per week, including lower-body exercises such as calf raises, leg lifts, balance exercises, abdominal and foot core strengthening, and standing exercises such as single-leg squats that mimic running form to improve strength.

How should runners think about nutrition before and after a run? 

Nutrition is critically important. Ensuring adequate energy intake, including sufficient carbohydrates, allows for an appropriate response to exercise and avoiding risk factors for running injuries, as described by the Female and Male Athlete Triad and Relative Energy Deficiency in Sport. I do not recommend fasting, as having sufficient fueling throughout the day allows for performing running with sufficient ability to recover and avoid injury. 

Within 15-30 minutes after a run, having a post-exercise snack with carbohydrates and protein is really important to recover muscle glycogen — chocolate milk has actually been shown to be an ideal recovery drink.

In female runners, menstrual periods can be helpful to track and ensure they are not becoming further apart or stopping due to inadequate fueling. Similarly, male athletes should monitor for signs of fatigue or other markers of lower testosterone levels that can be related to under-fueling. 

What gear do you recommend for new runners?

It’s easy to be overwhelmed with the number of options for gear and technology. The fun part about running is the ability to perform this activity with a pair of comfortable running shoes and clothing that is appropriate for the environment, including good skin protection, and don’t forget sunscreen. A watch and monitoring training effort through tracking your resting heart rate each morning can help to monitor distance and how you are recovering. 

The performance footwear of AFTs [advanced footwear technology] are exciting to improve your running speed but should be used gradually to allow your body to adapt to new running mechanics, particularly if you have a history of a prior running-related injury. If you use other technology, be sure to ensure you are also monitoring perceived effort and whether you are recovering from training efforts. 

What are the health benefits of a regular running practice?

Running has a number of health benefits both for physical health and mental well-being. The Exercise Is Medicine initiative recommends at least 150 minutes of moderate exercise per week along with strength training. If you love to run, keep doing it, and find healthcare providers who understand the unique needs of runners to identify strategies to perform the sport safely.