Common Running Injuries

Common Running Injuries …And When to Seek Medical Treatment!

Types of Common Injuries • Stress fractures • Hamstring strain • Iliotibial band syndrome • Patellofemoral syndrome • Shin splints • Plantar fasciitis • Achilles tendinitis

Why Do These Injuries Occur? • Progressing too quickly in mileage and speed • Lack of regular stretching • Not changing out running shoes frequently enough • Imbalance between opposing muscle groups

Stress fractures • What is it? • An overuse injury • Occurs when muscles become fatigued and are unable to absorb added shock • Fatigued muscle transfers the overload of stress to the bone causing a tiny crack

Stress Fractures • Causes • Result of increasing the amount or intensity of an activity too rapidly • The impact of an unfamiliar surface • Improper equipment (shoes) • Increased physical stress • Women > men

Stress Fractures • Signs and Symptoms • Sharp pain in the weight-bearing bones of the lower leg and foot while running • Mild swelling • Tender to the touch

Stress Fractures • Treatment • Rest and ice • Engage in a pain-free activity during the six to eight weeks it takes most stress fractures to heal • Use of a bone stimulator

Stress Fractures • Prevention • Slowly increase any new sports activity • Maintain a healthy diet, including calcium • Do not wear old or worn running shoes • If pain or swelling occurs, immediately stop the activity and rest for a few days • If continued pain persists, see an orthopedic surgeon

Hamstring Strain • What is it? • A tear in one of the hamstrings muscles (semitendinosis, semimembrinosis and biceps femoris) • Can range from small micro tears in the muscle to a complete rupture

Hamstring Strain • Causes • Frequently occur during sprinting • Can occur during an isolated athletic activity (acute) or result from persistent repetitive stress (chronic)

Hamstring Strain • Signs and Symptoms • Sudden sharp pain at the back of the leg • Muscles going into spasm • Swelling and bruising • If the rupture is very bad you may feel a gap in the muscle

Hamstring Strain • Treatment • Use a compression bandage or heat retainer until you feel no pain • Ice, compress, elevate, use crutches • Physical therapy • Surgery for complete rupture

Hamstring Strain • Prevention • Gradual conditioning program • Incorporate a proper warm-up and stretching session into your conditioning program and athletic competition

Iliotibial Band Syndrome • What is it? • Condition characterized by pain localized over the lateral femoral epicondyle that occurs during vigorous walking, hiking or running • Pain is usually relieved by rest and by walking with the knee held in full extension

Iliotibial Band Syndrome • Causes • Overuse may cause shortening of the ITB • Knee goes from flexion to extension and excessive pressure from the ITB causes friction over the lateral femoral epicondyle • This repeated motion produces inflammation of the underlying structures and causes pain

Iliotibial Band Syndrome • Signs and Symptoms • Pain localized over lateral femoral condyle • Discomfort initially relieved by rest • Pain may radiate toward the lateral joint line and proximal tibia • Worse if a person continues to run • No symptoms of internal derangement • Symptoms frequently develop during downhill running

Iliotibial Band Syndrome • Treatment • Rest • Ice • Stretching of iliotibial band • Anti-inflammatory medicine • Orthotics (if appropriate) • Ultrasound • Local steroid injection

Iliotibial Band Syndrome • Prevention • Adequate stretching of the IT band • Massage therapy • Avoid hills, shorten stride, and run on alternate sides of road

Patellofemoral Syndrome • What is it? • The term used to describe pain on and around the patella or kneecap • Common cause is damage to the surface underneath the kneecap • Can be started by an impact or it gradually comes on from rubbing on the bone underneath

Patellofemoral Syndrome • Causes • Malalignment of the patella on the femur • Weakness of the quadriceps muscles • Tight structures on the lateral aspect of the knee • Pronation of the feet

Patellofemoral Syndrome • Signs and Symptoms • Pain may be felt behind or around the knee cap • Grinding noises may be heard during bending or straightening the leg • The knee may feel like it gives-way without any particular reason • Pain occurs while going up and down stairs, as well as after prolonged periods of sitting

Patellofemoral Syndrome • Treatment/Prevention • Anti-inflammatories • Ice/heat • Strengthening the quadriceps • Stretching the hamstrings

Shin Splints • What is it? • The name given to pain at the front of the lower leg • Also known as medial tibial stress syndrome • Inflammation of the periostium of the tibia (sheath surrounding the bone)

Shin Splints • Causes • Weak anterior leg muscles • Hard running surface • Recent increase in running speed or distance • Unsupportive shoes • Fallen arches

Shin Splints • Signs and Symptoms • Tenderness over the inside of the shin • Lower leg pain • Occasional swelling • Lumps and bumps over the bone • Pain when the toes or foot are bent downwards • A redness over the inside of the shin

Shin Splints • Treatment • Ice 10-15 minutes for 2-3x per day • Anti-inflammatory drugs • Active rest - participate in activity that does not stress the affected area but maintains cardiovascular fitness, such as bike riding

Shin Splints • Prevention • Keep anterior leg muscles strong • Correct pronation with the use of custom made or over-the-counter orthotics • Run on a forgiving surface, such as a treadmill • Increase speed and distance gradually

Achilles Tendinitis • What is it? • Inflammation of the large tendon at the back of the ankle which connects the large calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus)

Achilles Tendinitis • Causes • Sudden increases in running • Excessive hill running or a sudden addition of hills and speed work • Excessive tightness of the posterior leg muscles • Soles of shoes too stiff, or excessive heel cushioning of the heel

Achilles Tendinitis • Signs and Symptoms • Pain in the tendon during exercise • Swelling over the Achilles tendon • Redness over the skin • You can sometimes feel a creaking when you press your fingers into the tendon and move the foot

Achilles Tendinitis • Treatment • Anti-inflammatories • Begin ice after exercise • Use small heel lift in shoe • Rest for two weeks after the aggravating activity • Begin stretching regimen for gastrocnemius and soleus complex

Achilles Tendinitis • Prevention • Regularly stretch the posterior calf muscles • Increase training gradually • Correct pronation

Plantar Fasciitis • What is it? • Inflammation of the strong tissue that runs along the bottom of the foot and connects the heel to the base of the toes

Plantar Fasciitis • Causes • Weak foot muscles • Tight Achilles tendon • Flat or high arches • Poor shoe support • Sudden increase in activity level • Sudden increase in weight

Plantar Fasciitis • Signs and Symptoms • Heel pain that is worse in the morning with the first few steps • Since it is difficult to rest the foot, this problem gradually worsens • Pain may start interfering with activities of daily living

Plantar Fasciitis • Treatment • Temporary decrease in training • Gentle Stretching of calf muscles • Check shoes for flexion stability • Perform 20 seconds of "toe curls" to strengthen your foot muscles. • Ice 15 minutes, 10 minute break x 2 each day • Consider rolling your foot over frozen water bottle • Do not go barefoot in your house or at any other time for 6 weeks. • Try over the counter orthotics

Plantar Fasciitis • Prevention • Wear orthotics to prevent excess pronation and prevent lengthening of the plantar fascia and continued tearing of the fascia • Stretch regularly

Summary • Most mild conditions will resolve with conservative treatment as outlined above • For conditions that persist or are refractory to conservative treatment, evaluation and treatment by a professional may be warranted

Questions?

Common Running Injuries