The prevailing attitude of many exercisers is that injuries are a normal part of running, and most injuries just magically appear. “Not so,” says Dr. George Tsatsos, Medical Director of the anklenfoot.com Clinics in Chicago.
“Research clearly shows that the majority of injuries can be tracked to a certain cause—such as over-training—and with little planning runners can avoid most common sports injuries.
In fact, research indicates that running not only does not increase a person’s risk of developing arthritis, even those with arthritis are not injuring themselves further by running.”
The most commonly injured areas include the arch and heel region, lower leg, knee, Achilles tendon, and forefoot. Running injuries are usually caused by overuse, faulty biomechanics, and lack of flexibility.
The majority of aches and pains are overuse injuries. Each running step requires your body to absorb three to four times its weight, and the repetitive stress of this shock can lead to breakdown and injury.
Luckily, overuse injuries can be prevented with proper training. Following these guidelines can help reduce your risk of overuse injury:
- Build mileage slowly. Increase by no more than 10% a week or 20% every two weeks.
- Follow hard days with easy recovery days.
- Do not routinely increase your weekly mileage Plan easy and hard weeks.
- Replacing a day of running with swimming, bicycling, in-line skating,
or stair climbing will give you an aerobic workout while resting your running muscles.
- Your risk of overuse injuries rises dramatically as your weekly mileage goes above 40 to 50 miles. Maintain this level only if you can do so relatively–pain-free.
- Racing places enormous stress on your body. Plan a racing schedule that allows enough recovery between events. Run easy at least one day for each mile of a race.
The relationship of muscles and joints to how you run is called biomechanics. Faulty biomechanics greatly increase your risk of injury. The most common example is pronation of the joint below the ankle, which may be noticed as partial or complete collapsing of the arch and rolling in of the ankle as your foot lands.
To determine if you have improper biomechanics, look for abnormal shoe wear patterns. Wearing shoes on the inside signifies excessive pronation. Have a friend watch you run and note from behind if the insides of your ankles roll inward.
If so, you probably over-pronate. If you feel you have faulty biomechanics and are often injured, see a sports-medicine podiatrist for an analysis of your running style and shoe wear.
Running has many benefits, but increased flexibility is not one of them. In fact, as running strengthens your leg muscles, it also shortens and tightens them. Tight muscles and tendons restrict your range of motion. Stretch before and after running.
Let’s now take a closer look at some of the more common aches and pains of running.
ACHES AND PAINS
Pain in the heel or arch area is often plantar fasciitis, or heel spur syndrome. This is an inflammation of a fibrous band of tissue which stretches from the heel to the toes. Pain may be present in the morning, after rest, and after running; it’s usually worse upon waking and at the start of a run.
Chronic plantar fasciitis may lead to the formation of heel bone spurs. Flat feet and high-arch feet are prone to this injury. Treatment may include a combination of rest, stretching, taping, different shoes, arch supports or custom orthotics, and anti-inflammatories.
One common knee injury is patella-femoral compression syndrome (also known as chrondromalacia of the patella). This occurs when the knee cap slams into the femur, the bone behind the kneecap. Patella-femoral compression syndrome is often caused by excessive pronation or muscle weakness around the knee.
Rest and icing should reduce temporary pain. If it is caused by pronation, shoe inserts may help to reduce further flare-ups. Strengthening your quadriceps will help if it is caused by weakness around the knee.
Another common cause of knee pain is iliotibial band syndrome (ITBS), which causes pain on the outside of the knee. The onset of pain is usually slow and occurs after running a certain distance.
The major causes of ITBS are excessive internal rotation of the leg and pronation of the sub-talar joint. Both cause the ITB to be stretched over a bony prominence of the femur (the bone in your thigh), which leads to irritation and subsequent pain. Treatment includes rest, icing, eliminating over-pronation, and stretching the ITB.
Tight calf muscles, poor stretching habits, and too much running on hard surfaces and hills may result in Achilles tendinitis. This is a progressive degeneration and weakness of the tendon, usually just above its attachment to the heel bone. It is often necessary to stop running until the injury is healed.
Heel lifts, icing, and anti-inflammatories in conjunction with rest often speed healing. Achilles tendinitis can often be avoided with good stretching habits.
Muscle and tendon weakness in the front or inside of the lower leg may result in sharp pain in these areas, often called shin splints. Stress fractures may occur if shin splints are left untreated.
Excessive pronation, increasing mileage too fast, running on hard surfaces, and downhill running are leading causes. Beginning runners are also susceptible to shin splints because of the new stress placed on the lower legs.
Initial treatment consists of rest, icing, and anti-inflammatories. To prevent shin splints, strengthen the muscles of the lower leg.
Many problems develop in the forefoot because of improper and excessive weight transfer during the propulsion phase of running, including bunions, hammertoes, black toenails, and metatarsal stress fractures. If swelling is present with pain in the forefoot, suspect a stress fracture and stop running. Seek the opinion of a specialist before resuming running.
TREATING RUNNING INJURIES
Injuries often respond quickly if treated early and properly. Rest and icing are your first line of defense. If you have acute pain or pain that alters your normal running motion, stop running and don’t resume training until the pain is gone. If you have minor aches which don’t affect your running motion, reduce your running and apply ice to painful areas for 10 to 15 minutes after a run. If you have swelling, apply compression and elevate the affected leg.
Self-treatment has its limits. If you have acute pain which does not respond to rest, see a sports-medicine specialist. Also see a specialist if you have a chronic injury to a given body part, because this probably means you have an underlying condition that needs to be corrected, such as a problem with pronation or lack of flexibility.
For more answers to your specific injury questions, contact AnkleNFootCenters.com at 312 612-5000