Running Injuries - April 2010

Following on from the previous topic about running and getting started, this newsletter focuses on running injuries. We hope the information will help you avoid any injuries or if not, enable to you identify problems before they become too severe and seek help or advice.

Running is an excellent way of maintaining or improving fitness. Whether you are an elite athlete or merely running for fun, care must be taken to avoid injury.

There are two types of injury that a runner can sustain: acute trauma, which occurs suddenly such as a torn ligament, muscle, or broken bone, and the more common overuse injuries which tend to be more chronic. The latter of these types of injury can arise from simple things such as poor footwear when running and over-training. A sensible training programme incorporating rest days and a gradual build up in distance and intensity is a good way to reduce the likelihood of injury. Ensuring proper supportive footwear is also important in reducing injury as it can affect the way your feet, ankles and lower limbs work at each step taken.

Regardless of the injury, listening to your body is important whilst running – pain is a warning sign, and shouldn’t be ignored. Some of the most common running injuries are outlined below:

Plantar Fasciitis is caused by the connective tissues on the bottom of the foot being stretched. This occurs where the tissues attach into the heel of the foot and can radiate pain towards the ball of the foot, making the foot feel tender especially early in the morning and on movement. To avoid this, stretch regularly, focussing on the Achilles tendon and the calf muscles.

Bursitis is irritation of the bursa (fluid filled sac that sits under the tendon), which can cause tendonitis (inflammation of the tendon where the muscle attaches into the bone) due to friction, pressure or trauma. Symptoms start with pain and stiffness on movement, with no visible swelling at first, however as the injury worsens, swelling increases. The most commonly affected areas are ankles, knees and hips.

Achilles tendonitis affects one of the most powerful muscle groups in the body – the calf. The biggest contributor to Achilles tendonitis is ignoring pain in the Achilles when it starts and running through the pain.

Runners knee is softening of the kneecap cartilage. Portions of the cartilage come under too much or too little pressure, resulting in deterioration of the inner part of the kneecap. Pain in usually felt after sitting for long periods of time with the knees bent.

Shin splints can result from poor footwear, fallen arches (hyper-pronation of the feet), insufficient warm up, muscle fatigue, exercising on hard surfaces, and poor running mechanics. Pain is felt on the front and/or sides of the shins. This can be prevented by good footwear with shock absorbing features, heel/toe landing for minimum impact, and proper calf stretches.

Stress fractures occur due to excessive stress or an increase in running intensity or distance, resulting in gradual breakdown of the bone. Symptoms include pain in the foot and lower leg, more so on weight bearing activities. X-rays can appear negative initially, however, fractures become visible up to two weeks after the initial injury due to callous formation (normal bone healing process).

Ankle sprains are more likely to happen when running on uneven surfaces such as when doing cross country running, trial running and stepping in pot-holes, and happen when the supporting ligaments are over stretched causing a tear in the fibres. As with tendonitis, treatment with RICE should be the first approach.

 Iliotibial band syndrome is pain on the outer part of the thigh and/or knee, occurring usually at the middle part or end of the run. Training on track/ uneven surfaces is often a contributing factor.

Treatment should initially follow the RICE principle: rest, ice, compression, and elevation to reduce the inflammation and irritation at the tendon. Depending on the reason for the tendonitis, your Chiropractor may want to treat the affected joint, or joints above and below to help restore normal joint function.

Your Chiropractor will advise and may be able to help you manage the above conditions. Note that stretching properly before and after running is vital to reduce injuries, especially in the frequently affected muscle groups such as calves and hamstrings.

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