Injury Prevention for Trail Runners
Author: Dr. Eric Ewald
Trail running in Tahoe offers amazing scenery, varied terrain, high-altitude training, and a strong community. To enjoy these trails all season long, it’s important to focus on injury prevention.
A proper warm-up is one of the best ways to prepare for a run. Warming-up helps your muscles and joints get ready for movement. Start with 5–10 minutes of brisk walking or light jogging. Then add dynamic movements such as leg swings, lunges, hip circles, and agility drills. These active stretches warm up your joints and muscles with sport-specific motion, supporting flexibility, improving performance, and reducing strain.
Research supports the value of a structured warm-up. The FIFA 11+ study showed that warm-ups incorporating strengthening, balance, plyometrics, and agility drills reduced overall injuries by 33% and overuse injuries by 55%. Static stretching is best saved for after your run.
Cross-training with strength exercises is also key for staying healthy on trails — strength training helps you build muscle, improve endurance, and support bone density. Whether you are lifting weights or using body-weight exercises, incorporate exercises which target your lower body, core, and feet/ ankle to reduce your chance of injury.
Studies show strength training can make a significant difference. The Run RCT study in 2024 showed that hip/core exercises can lower the risk of lower extremity injury by 34% and overuse injury by 52%. The key here is to be consistent and incorporate strength training 2–3 times a week. Another study from 2018 study found that runners who consistently followed a strength and foam rolling routine were 85% less likely to get injured and remained injury-free an average of 57 days longer.
Gait retraining is another proven injury-prevention strategy. This uses real-time visual feedback to help runners reduce impact loading to “land softer.” A 2018 study found that a two-week gait retraining program reduced injury risk by 62% at 12 months. Consider working with a physical therapist or trainer who is certified in gait analysis for runners.
Another important habit is making gradual progress. Avoid rapid increases in distance, time, or terrain difficulty. Doing too much too soon can lead to injury. A 2025 study found runners who experienced large spikes in training distance had significantly higher rates of overuse injuries. Build slowly and include rest and recovery days in your routine, especially after longer runs.
Without strength training, gradual progression, and recovery days, runners may develop common overuse injuries including Achilles tendinopathy, which causes stiffness or pain near the heel; shin splints, which cause pain along the shin; and fifth metatarsal stress fractures, which cause pain on the outside of the foot. Paying attention to early signs of discomfort can help prevent more serious problems.
Trail running in Tahoe is a fun and fulfilling activity — focus on consistent, small habits including warm-ups, strength-training, and gradual progression to stay on the trails this summer.
Listen to your body and seek care if you are experiencing ongoing pain or stiffness. There are a variety of ways to support your return to the trail.
Eric Ewald, MD is a board-certified physician who specializes in sports medicine and non-surgical orthopedic treatment, including management of arthritis, regenerative therapies, and non-operative fracture care. He also provides team medical coverage for the Tahoe Knight Monsters. Dr. Ewald sees patients at Barton Sports & Physical Medicine in Incline Village, NV; call 775.589.8915 to make an appointment.
