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Six Physioblog

Common Running Injuries @runABCsouth

Jan 13th, 2016 / Nicki Chick

Jon Grayson explains the 4 most common running injuries and how to combat them @RunABC Jan 2016

If you’re concerned about an injury, it’s important to get assessed and see a running specialist. A tailored strength and conditioning program along with simple running technique tips can also go a long way.

The two best predictors of likely running injury are previous injury and consecutive days running (accumulative over training). 50% of running injuries are reoccurrences, and if you’ve been injured before you’re likely to get injured again. It’s also proven that keeping the same weekly volume over less consecutive days reduces injury rates

The top most common running injuries are overuse injuries. They reoccur. If you have reoccurring sore spots in the front (runners knee) or outside (ITB irritation) of your knee, front or inside of your shin (shin splints or MTSS), around your Achilles’ tendon (Achilles tendinopathy) or under the sole of your foot (plantarfasciitis), that don’t ease within 48hrs…then it’s likely you’ve got a top running injury!

Top running injuries:

‘Shin splints’ or to give it it’s fancy medical term, medial tibial stress syndrome (MTSS), is one of the most common running injuries, and is an overuse injury that is rarely a short term issue and is usually persistent and recurrent. Usually a dull, nagging soreness, on the inside of the shin bone spreading down towards the ankle (medial tibial stress syndrome) or on the front of the shin bone (anterior tibial stress syndrome). This is usually evident at the start of the run, tends to ease once into the run as you warm up, but then intensifies. Depending on how intense this can reach a level causing runners to have to stop early into the run, and then stick around for the next few days when walking if very irritable.

There are many common biomechanical, neuromuscular and technique faults that result in the shins getting overloaded. Every time you land on 1 foot during running, a force up to x2.5 body weight will be going through the leg!! For a 4hr marathon runner, running at an average pace of 155 steps per minute, that’s 37,200 steps. That’s a lot of force…and it needs control!!!

Therefore, the key message is GET ASSESSED!! Use a running specialist. When treating a runner with pain we will use video analysis of to assess the technique, then break this down to screen for mobility, strength and control. A tailored strength and conditioning program along with simple running technique tips can go a long way.

The usual ‘PRICE’ treatment, taping, correcting footwear, or orthotics are only a short term, symptom reliever. It will not get rid of the problem.Common technique faults include slow step rates, and over striding. Adjusting your step rate towards the more desired level  (170-190 steps per min) can always help reduce the overload on landing. A quicker, shorter step rate is what you should aim for. I’d strongly recommend using a running specialist to help with this.

Calf, quads and glut strengthening are essential to any runners strength and conditioning. For example, You should be able to perform 25-30 single calf raises on a step (well)!

ITB friction syndrome is an overuse injury that is rarely short term. Short term ‘PRICE’ treatment, taping, correcting footwear and rolling can help but again…GET ASSESSED! There are several reasons why this problem might occur, and you need to work out what is causing the problem – whether it be a pure mobility issue, strength, control or simple technique fault. Usually a dull, nagging soreness on the outside of the knee. This can be tight at the start of the run, ease once warmed up then intensify again once reaching a certain distance, or if pushing intensity (e.g. sprint intervals or hills). Again, this can stop a runner early in their run if irritated, and hang around for a few days, especially stiffening up when trying to move after sitting for long periods.

Typically this can be caused when landing too flexed at the knee or due to a dynamic knee valgus or hip drop when landing during running. As a result, lateral glut strengthening, hamstring mobility work, and checking step rate again can aid pain relief.

Plantarfasciitis creeps into the top running injuries. Again, the same principles apply. Short term ‘PRICE’ treatment, correcting footwear, orthotics and heel gel pads can provide some relief. GET ASSESSED! Constant soreness feeling underneath the pad of the heel and inside of the heel when irritable. Typically occurs when landing onto the heel during foot strike, walking and running. Especially worse during the first few steps of walking in a morning or after sitting for a while. Common with over striding, heel strikers with a slower step rate, and flat footed runners. Calf weakness and intrinsic foot control tend to be poor with these runners. Therefore, high load calf strengthening and isometrics for foot control can be very useful.

Runner’s knee occurs when the stress of running causes an irritation where the kneecap (patella) sits on the thigh bone (femur). The common causes of runners knee include overuse due to repeated bending and loading to the knee joint, direct trauma e.g. a fall, misalignment of the kneecap and a muscular imbalance of the thigh muscles which can lead to a disproportionate load on applied the knee cap. It is often due to an ITB injury. An ITB injury could be caused by a mobility issue, strength, control or simple technique fault. It’s important to see a specialist to work out which of these factors are causing the band to rub over the knee so forcefully enough to cause pain in the first place.

Symptoms of runner’s knee may include pain behind or around the kneecap, especially where the thighbone and the kneecap meet, pain when you bend the knee e.g. when walking, squatting, kneeling, running, or even rising from a chair. It may also be painful when walking downstairs or downhill, and it is common to experience a popping or grinding sensation behind the kneecap.

In the initial stages of pain it is important to rest the knee for a few days, with elevation, compression and regular application of ice if the knee is swollen. Taking anti-inflammatory medication may also be required if the pain and swelling is moderate to severe. Exercises recommended for runner’s knee include the use of a foam roller to release the ITB, quads, hip

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