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

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