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By Dr. Christopher Couture, Wentworth Health Partners Seacoast Orthopedics & Sports Medicine

Summertime. Long, sunny, warm days away from the stress of school but also from the training habits you’ve established with your sport. Maybe you have a summer job, attend a camp (or two), or take a vacation with your family. But as the calendar inevitably flips to July and then to August, the upcoming return to school brings with it a return to an athletic training routine. And if you’re a runner, your focus turns to the trails and the woods as you prepare for the 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. 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. And 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 common injuries, including:

• Iliotibial (IT) band syndrome

• “Runner’s knee”/patellofemoral syndrome

• Shin splints

• Calf strains

• Ankle sprains

• Achilles tendinitis

• Plantar fasciitis

• Stress fractures

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It is important to minimize the risk of injury while enjoying the cross-country season. A good routine involves attention to several areas beyond simply racking up the miles:

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:

  • Nutrition: Lean protein, 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 and snacks, especially on race day.
  • Water and salt: Because cross-country preseason training and competitions often take place in the heat of the summer, it is vitally important to avoid heat stress. Acclimatization to exercising in the heat 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: Students who do not get enough sleep are 1.7 times more likely to experience an injury. Adolescents who get at least 8 hours of sleep a night can also be expected to perform up to 10% better than those who do not.
  • Shoes: 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.

Lastly, 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. Ask questions about anything you don’t understand or want to learn more about.

Enjoy your summer, but don’t let the upcoming school year and cross-country season sneak up on you! Plan for success, and you’ll be more likely to have a fun and injury-free season.


Dr. Couture is certified in Family Medicine and Sports Medicine by the American Board of Family Medicine, and is a member of the American Medical Society for Sports Medicine. He specializes in the evaluation and non-surgical treatment of musculoskeletal injuries, as well as the full range of non-musculoskeletal sports medicine conditions. He is also proficient in the use of ultrasound for musculoskeletal diagnosis and procedures, and is Registered in Musculoskeletal Sonography.

Dr. Couture serves as Head Team Physician at the University of New Hampshire. He is also the Head Team Physician for United States Nordic Combined, providing medical coverage for the team’s World Cup events and monitoring the athletes’ health and well-being.

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