Running (Care of the Young Athlete)

Running, as a sport, can involve a number of different forms, including the following:

Cross-country. A sport in which teams of runners compete on long-distance road running courses.
Track and field. A sport that includes track events, like sprints, distance running, hurdles, and relays, and field events that involve throwing and jumping.
Marathon. A long-distance (about 26 miles) road running event.
Triathlon. A 3-part event that includes swimming, cycling, and running. Distances vary depending on the age of the athletes.

Running injuries are common and there can be a variety of causes. Running injuries can be caused by improper training (for example, doing too much too fast), mechanical problems (for example, high arch or flat foot), or previous injuries. Other causes may be the environment (for example, uneven or hilly terrain; hot or cold weather conditions) or previous injuries. While not all injures can be prevented, the risk of injuries can be reduced.

The following is information from the American Academy of Pediatrics about how to prevent running injuries. Also included is a list of common running injuries.

General injury prevention and safety tips

Sports physical exam. Athletes should have a preparticipation physical evaluation (PPE) to make sure they are ready to safely begin the sport. The best time for a PPE is about 4 to 6 weeks before the beginning of the season. Athletes also should see their doctors for routine well-child checkups.
Fitness. Athletes should maintain a good fitness level during the season and off-season. Preseason training should allow time for general conditioning and sport- specific conditioning. Also important are proper warm- up and cool-down exercises.
Technique. Athletes should learn and practice safe techniques for performing the skills that are integral to their sport. Athletes should work with coaches and athletic trainers on achieving proper technique.
Nutrition. Eating healthy and the right amount of calories is important. A good rule to follow is to eat an extra 100 calories for every mile run.

Cross-country/track injuries and prevention and safety tips

Injury	Tips
Blisters	Running shoes should fit properly. (See “Foot type.”) Running shoes should be changed every 6 months or 300 to 500 miles.
Overuse Injuries Shin splints (lower leg pain) Stress fractures of the lower leg or foot Tendonitis of the knee and ankle Severe’s disease (an inflammation of the growth plate that causes pain in the heel) Plantar fasciitis (a common cause of heel pain under the arch of the foot)	Athletes should begin a strengthening program that works on the hips, buttocks, abdominal, knee, and ankle muscles. Cross-train with other activities such as water jogging and elliptical trainers. Athletes should begin a stretching program that works on the hips, thighs, calves, and back of the legs. Balancing exercises should be incorporated. Athletes should run on soft, even surfaces whenever possible (flat dirt or grass surfaces are best). Athletes should increase their weekly mileage by no more than 10% (for example, if you currently run 20 miles, only increase to 22 miles the next week). Limit speed work to 1 to 2 days per week.
Exercise-associated diarrhea	Limit how much fiber is eaten 24 hours before an event.

Injury

Tips

Blisters

Running shoes should fit properly. (See “Foot type.”)
Running shoes should be changed every 6 months or 300 to 500 miles.

Overuse Injuries

Shin splints (lower leg pain)
Stress fractures of the lower leg or foot
Tendonitis of the knee and ankle
Severe’s disease (an inflammation of the growth plate that causes pain in the heel)
Plantar fasciitis (a common cause of heel pain under the arch of the foot)

Athletes should begin a strengthening program that works on the hips, buttocks, abdominal, knee, and ankle muscles.
Cross-train with other activities such as water jogging and elliptical trainers.
Athletes should begin a stretching program that works on the hips, thighs, calves, and back of the legs.
Balancing exercises should be incorporated.
Athletes should run on soft, even surfaces whenever possible (flat dirt or grass surfaces are best).
Athletes should increase their weekly mileage by no more than 10% (for example, if you currently run 20 miles, only increase to 22 miles the next week).
Limit speed work to 1 to 2 days per week.

Exercise-associated diarrhea

Limit how much fiber is eaten 24 hours before an event.

Marathon and triathlon injuries and prevention and safety tips

Injury	Tips
Burnout	Triathlon participation by children and teens should be limited to shorter, age-appropriate distances. Children and teens should not be encouraged to participate in marathons, and youth records should not be kept to avoid encouragement.
Heat or cold injuries	Proper hydration with cool water and sports drinks is important. Athletes should determine their individual sweat rate, then replace every pound lost with 16 to 20 ounces of fluid. Sweat rate=Pre-workout weight - Post 1-hour workout weight. Athletes should not run, bike, or swim in extreme hot or cold environments. Proper calorie intake is important. In addition, runners should get 1,300 mg of calcium per day (1,500 mg for females with no menstrual period).
Menstrual irregularities in female athletes	Female athletes should keep track of their menstrual periods. They should see a doctor if they start to miss menstrual periods.

Injury

Tips

Burnout

Triathlon participation by children and teens should be limited to shorter, age-appropriate distances.
Children and teens should not be encouraged to participate in marathons, and youth records should not be kept to avoid encouragement.

Heat or cold injuries

Proper hydration with cool water and sports drinks is important. Athletes should determine their individual sweat rate, then replace every pound lost with 16 to 20 ounces of fluid.

Sweat rate=Pre-workout weight - Post 1-hour workout weight.

Athletes should not run, bike, or swim in extreme hot or cold environments.
Proper calorie intake is important. In addition, runners should get 1,300 mg of calcium per day (1,500 mg for females with no menstrual period).

Menstrual irregularities in female athletes

Female athletes should keep track of their menstrual periods. They should see a doctor if they start to miss menstrual periods.

Foot type

To determine your foot type, wet the bottom of your foot and step on a piece of cardboard. Match the imprint with the choices in the table below.

Foot	Problem	Shoe
Flat foot	Overpronation	Motion control
Normal arch		Stability
High arch	No shock absorption	Cushioned

Foot

Problem

Shoe

Flat foot

Overpronation

Motion control

Normal arch

Stability

High arch

No shock absorption

Cushioned

< Back to all sports articles

Measles update

February 12, 2026

There have been cases of measles in NC, with exposures in Chapel Hill, Durham, and Wake County. We can give the MMR dose early to families who want it. This applies to infants 6-12 months who have not gotten a dose yet or kids under 4-5 years who have not gotten their second MMR dose. At this time, the NC DHHS and health departments are not recommending this unless traveling or living in an area with sustained transmission. Two doses of the MMR vaccine are highly effective (97%) at preventing measles infections. At CHCAC, children receive their first dose at 12 months of age and a second dose at 4 years of age, ensuring they are fully protected as soon as possible, in accordance with the most up-to-date AAP recommendations. Some infants aged 6 months to 11 months who travel internationally or in high-prevalence areas may need a dose to protect them; however, they still require the 1-year and 4-year-old doses as well. If you are ever concerned about a possible exposure to measles, please CALL before entering our office. DO NOT ENTER the office. NC DHHS keeps a list of areas with measles exposures here . This is a highly contagious illness, and special precautions must be taken to prevent spread. The virus can be present in the air for 2 hours after an infected person is in the room, and 90% of susceptible patients can be infected. As always, if you have questions, we are here to help make sense of it all!

919-967-0771