Runners Beware


Preventative Tips for Common Injuries

Why are runners some of my most frequent patients? Up to 80% of runners are injured every year, and since I truly love running, I wanted to try to help them learn how to prevent injuries. Below are the top five running injuries that I see in the clinic and how to prevent them. Below you will learn how to identify the injury, what to do about it, the biomechanical cause, and some prevention tips.

1) Shin Splints (Medial Tibial Stress Syndrome): If you experience pain along the inside of the shin, typically on the lower third of the bone, this may be a sign of shin splints. Pain is usually just with running, but patients can experience pain with walking if there is a lot of swelling or if the symptoms have been going on for a while. If you have been experiencing symptoms for sometime, I would suggest that you see a professional. Shin Splints can become a more serious injury to the bone, and many runners wait until they develop a stress fracture before getting treatment. Shin splints are usually caused by hip or foot dysfunctions and are often related to excessive loading. To prevent shin splints, listen to your body and avoid overtraining. If you are training for longer runs, such as marathons, make sure that you roll out your calves, glutes, and hamstrings, hips and stretch at the end of each run! Use a Trigger Point (TP) kit before and after workouts and I also encourage massage one or two times month for those of you who run 20-50 miles per week. Your muscles and connective tissues need to heal. Each time you run, you stress so you need to take time to take care of it. If symptoms persist, the cause may be related to your hips or feet, and you may need some treatment and evaluation to help you keep putting one foot in front of the other.

2) IT Band Syndrome (Iliotibial Band): If you have pain on the outside of the knee that gets worse when it is cold outside, when you run downhill or down stairs, or after a certain distance, you may have inflammation of the IT Band. The IT band is a band of connective tissue that starts at the hip and runs down the outside of your thigh and inserts in the outside of the knee area. Your pain may develop anywhere from the hip to the knee. IT band syndrome is more common in women because of their typically wider hips but may also be caused by foot or hip dysfunction. If you have these symptoms and they are recurrent or preventing you from running further, more often there are likely some adhesions and you would benefit from ART (Active Release Therapy). An evaluation of your hips and feet may also show causes. Different exercises to strengthen weak areas often help in addition to fixing the injure tissue. IT Band Syndrome is mostly an excessive repetition injury. Prevention involves regular stretching, strengthening exercises, and being disciplined with your rolling.

3) Plantar Fasciitis: Pain along the arch of the foot and/or in the small toe flexor muscles of the foot may be a sign of plantar fasciitis, that is a inflammation of the plantar fascia. Many patients feel pain first thing in the morning and at the beginning of a run. If you have these symptoms, it is important to start treatment as soon as possible. Plantar fasciitis can become chronic and prevent you from running. Treatment involves ART, Graston of the foot and calf muscles. Tightness in the calves can develop into pain as those tissues become those of the foot. Sometimes an adjustment to the big toe can also release the restrictive tissue and relieve the symptoms temporarily. Plantar fasciitis can also be caused by foot or hip dysfunction and is related to an excessive load and/or repetition. Evaluation of these factors may be necessary. You can prevent plantar fasciitis by doing regular foot exercises, TP kit or foam rolling followed by stretching your gluteus, piriformis, hamstring, quads, gastrocnemius, soleus, and foot muscles. I encourage you to start a yoga class once or twice a week to improve your balance, flexibility and foot strength.

4) Patellofemoral Pain Syndrome (PFPS): If you have pain in the front of your knee or around your knee cap when going down stairs, running, or even after prolonged sitting, you may have PFPS. The patella tendon is the tendon that runs through the knee cap. Sometimes the tendon and knee cap do not track correctly, leading to inflammation and irritation. The hip is responsible for patella tracking problems, but there are many factors that can contribute to PFPS, such as biomechanical dysfunction, muscle imbalance, reduced flexibility, and hip or foot dysfunctions. PFPS can result from excessive repetition, range of motion, and load injury. If you have these symptoms, I recommend that you get evaluated to see what is causing the pain and how to prevent it from getting worse. Prevention involves weight training and yoga as well as band exercises to strengthen the hips.

5) Achilles Tendinopathy: If you have pain along the Achilles tendon or in the back of the ankle when you first get out of bed, when you first start running or running up hill, you might have Achilles tendinopathy. Again, typically this injury is caused by hip or foot dysfunction and is due to lack of range of motion. If you have these symptoms, increase the stretching time for your calves and ankles. Roll your Achilles on the TP roller as often as you can. Roll and stretch the muscles of the lower extremity. If you notice any swelling of your Achilles, make an appointment to see a professional.