Run Strong, Run Smart: Staying Injury-Free on the Trails

Trail running is an incredible test of endurance, strength, and technique. Unlike road running, it presents constant challenges—uneven terrain, steep ascents and descents, and unpredictable surfaces—all of which demand a well-prepared body. While the rewards are immense, the risks of injury are higher if training, recovery, and fueling aren’t approached strategically.

Understanding how to prevent common trail running injuries and how to train effectively can make a significant difference in both performance and longevity in the sport.

Common Trail Running Injuries and Why They Happen

The varied terrain of trail running places stress on muscles, tendons, and joints in ways that road running doesn’t. Some of the most common injuries include:

• Ankle Sprains – Uneven ground increases the risk of rolling an ankle, especially if there’s weakness or instability in the lower limb / core.

• ITB Syndrome & Patellofemoral Pain Syndrome – The repetitive motion of running, combined with steep uphill & downhill sections, can irritate tissue along the outside and / or front of the knee. Poor glute activation and utilisation will usually be a factor.

• Achilles Tendinopathy – Steep climbs put added strain on the Achilles tendon, particularly if there is a lack of calf strength or mobility.

• Proximal Hamstring Tendinopathy and Piriformis Over-Utilisation – Running uphill requires a strong posterior chain. Your glutes and their proper activation are pivotal to propelling you forward whilst trail running. Weakness and poor activation in these muscles can lead to pain.

• Plantar Fasciitis – Constant impact on uneven terrain stresses the plantar fascia. Combine this with weakness further up the chain and / or accumulative tightness in muscles such as the calves can potentially lead to chronic foot pain.

• Falls on Technical Trails – Uneven surfaces, tree roots, and steep descents make falls a real risk, particularly if a runner lacks stability, agility, or proprioception.

Most of these injuries stem from muscular imbalances, poor biomechanics, or a lack of structured training and recovery rather than simply from the demands of the sport itself.

Screening for Weaknesses and Imbalances: The Role of Physiotherapy

Preventing injuries isn’t just about training smarter—it’s also about identifying underlying weaknesses before they become a problem. A comprehensive physiotherapy screening can highlight:

• Left/right imbalances – Strength or mobility differences between limbs can lead to compensations that increase injury risk.

• Suboptimal biomechanics – Poor running technique, particularly on hills and descents, can place excessive load on joints and soft tissues.

• Joint restrictions and muscle weaknesses – Limited mobility or underdeveloped stabilising muscles can compromise efficiency and stability on the trails. Poor plyometric power will leave you vulnerable to injury, especially when training load ramps up.

By addressing these issues early through targeted strength exercises, mobility drills, and gait retraining, runners can significantly reduce the likelihood of injury and improve their overall efficiency.

Building Strength for Resilient Running

Strength training plays a crucial role in preventing injuries and improving performance. A well-designed program should target key areas for trail runners:

• Single-leg strength – Exercises like split squats, step-ups, and single-leg deadlifts help improve balance and stability on uneven terrain.

• Core and hip stability – Strong glutes and core muscles provide better control and efficiency, reducing unnecessary strain on joints.

• Plyometrics and agility drills – Bounding, box jumps, and single-leg hops prepare the body for quick reactions to unpredictable terrain.

Regular strength work, performed 2–3 times per week, not only reduces injury risk but also enhances power and endurance on technical trails.

The Role of VO2 Max Testing in Optimising Training

The body doesn’t recognise pace, only stress – This is particularly important for trail runners who constantly encounter varied terrain and elevation changes. Unlike road runners, who can train based on pace, trail runners must train based on effort, ensuring they stay within the correct physiological zones.

Uphill performance is dictated by ventilation control – We only have three primary ventilation points, meaning there are only three real physiological intensity zones to work within. The three-zone model (easy, moderate, and hard) is a far better template for trail runners than the traditional five-zone system used by many road runners or cyclists.

VO2 Max testing provides:

• Accurate Heart Rate Zones – Rather than guessing effort levels, VO2 Max testing establishes precise training zones (three-zone model) to improve endurance and efficiency, especially when training on undulating terrain.

• Pace Zone Correlation – Knowing the speeds at which you hit each zone allows for more structured training on the flats, ensuring easy runs remain easy and hard sessions are truly effective.

• Optimised Aerobic and Anaerobic Development – By training in the correct zones, runners can improve both endurance and high-intensity performance without unnecessary fatigue or burnout.

Without this data, many runners either train too hard on easy days or not hard enough in quality sessions, leading to stagnation, overtraining, or injury. VO2 Max testing takes the guesswork out of training and helps ensure every session serves a purpose. Book your test at www.upnadamptphysio.com

The Role of Periodised Training in Injury Prevention

Many running injuries occur not from the act of running itself but from progressing too quickly or training inconsistently. A periodised training plan accounts for these factors by gradually building endurance, strength, and speed while allowing the body to adapt and absorb the running stimuli. Key principles include:

• Building an aerobic base with easy, controlled mileage.

• Gradual progression in volume and intensity to prevent overload.

• Incorporating speed, hill work, and strength sessions at the right times in a training cycle.

• Cyclically deloading and tapering to avoid burnout and ensure optimal training sessions are completed.

Ignoring periodisation often leads to overuse injuries, fatigue, and stagnation in performance—all of which can be avoided with a structured approach.

Fueling for Performance and Recovery

Trail running places high energy demands on the body, making proper nutrition a crucial part of training. Without adequate fueling, runners may experience energy crashes, muscle breakdown, and prolonged recovery times. Important considerations include:

• Carbohydrates as the primary fuel source – Running relies predominantly on carbohydrates for energy, so these need to be replaced throughout long runs to maintain performance and assist recovery.

• Hydration and electrolytes – Sweat losses deplete both fluid and essential salts like sodium, which must be replenished to prevent dehydration and muscle cramps. Sweat tests performed by our dietitians, can give you a more accurate measure of your individual electrolyte loss.

• Post-run recovery – A combination of protein and carbohydrates aids in muscle repair and glycogen replenishment.

A well-fueled runner not only performs better but also recovers faster and reduces the risk of injury.

Recovery: The Often-Overlooked Key to Longevity in the Sport

One of the biggest mistakes runners make is underestimating the importance of rest and recovery. The body needs time to absorb training stress and adapt to become stronger. Without proper recovery, injuries become more likely, and performance plateaus. Effective recovery strategies include:

• Adequate sleep – The most effective way for the body to repair and rebuild.

• Active recovery – Light movement, mobility work, or easy cross-training sessions can help circulation and reduce stiffness.

• Strength training adjustments – Modifying training loads to match recovery needs rather than pushing through fatigue.

• Scheduled rest days – Essential for preventing overuse injuries.

Ignoring recovery often leads to chronic fatigue, persistent niggles, and preventable injuries, which can derail progress.

A Smarter Approach to Trail Running

Trail running is an incredible sport that requires more than just logging k's. Strength, structured training, proper nutrition, physiotherapy screenings, and adequate recovery all play vital roles in keeping runners injury-free and performing at their best.

By understanding these elements and integrating them into training, runners can enjoy the trails stronger, more efficiently, and for longer.

The Up N Adam Performance Training and Physiotherapy team takes pride in being at the forefront of running performance, continuously striving to help runners optimise their training, prevent injuries, and reach their full potential.

This is APA Sports Physiotherapist, Darren Glendenning, signing off for now!

You can book an appointment with Darren or Newcastle Knights Physiotherapists Katie or Hayd'n at www.upnadamptphysio.com

Bookings also available on our website for:

• Dietitian - to optimise your training & race day nutrition and fueling

• VO2 Max testing - to discover more effective ways to train efficiently

• Run Specific Strength Programs - contact us via the website or email us at upnadamptphysio@gmail.com

• Remedial Massage - to relieve accumulative muscle tightness from training & racing that could lead to injury.