Common Running Injuries | Total Performance Physical Therapy

Common Running Injuries

February 2, 2012

With the new year upon us, people are trying to hold to their New Year’s Resolutions, of which many people include ‘getting in shape’ as one of theirs.  For whatever reason people tend to begin running.  People underestimate the amount of core and leg strength it actually takes to run.  Without this strength people “run” (no pun intended) the risk of injury and right about now is when I see many people starting to become injured by the repetitive stress of running.

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What most people fail to understand is the incredible amount of stress that running puts on the joints.  I am not anti-running but if you do not come into see me already being a runner then I generally do not encourage beginning running.  Running puts an incredible amount of stress on the joints.  When your one foot hits the ground in running it can produce forces 700x your body weight.  Your whole body, from you ankle, knee, hip and abdominals need to be able to handle those forces and transmit them up the chain.  A weak link anywhere in this chain causes even great amount of stress to be placed on a body part therefore causing injury.

There are a few injuries that quite a few runners encounter.  One of them is iliotibial band tendinitis.

The picture depicts how every time you bend and straighten your knee, like when you run, the iliotibial band rubs against the knee.  When this band becomes tight due to lack of stretching or weakness or overcompensation, then that bands rubs up against the knee more strenuously causing it to inflame and develop into a tendinitis.  Most often the cause of this iliotibial tendinitis is weakness, specifically of the hip muscles that allow this muscle to be placed at a disadvantage and will cause iliotibial band tendinitis.

Treatment of iliotibial band tendinitis depends on when you seek treatment.  If you catch it early enough it will take a few treatments in physical therapy.  You can expect manual therapy to loosen the trigger points located in the iliotibial band, exercises to strengthen the hip and it would be recommended that you purchase a foam roller.  The recommendation to purchase a foam roller, comes from the fact that research shows that there is not real way to stretch out the iliotibial band.  The only way to have any effect on the iliotibial band length is to roll it out on a foam roller.  In order to do this you lay on the affected side with the foam roller resting on the hip.  Now since the iliotibial band is a very long muscle, going almost all the way from hip to knee, you run the foam roller from the hip to the knee.  You should try to do this for a period of time, like 5 minutes, in order to get maximum length from the iliotibial band.  Sometimes, albeit, rarely iliotibial band tendinitis can become so bad it will require surgery.  Click on the following link to read more about illiotibial band syndrome as it relates to surgery.

Another common injury runners can be sometimes faced with is plantar fasciitis.  Plantar fasciitis is an inflammation of the plantar fasciitis, which is located on the bottom of your foot.  This pain is commonly described as heel pain.  And most often people will be able to a point on the bottom of the foot on the heel in the beginning stages of plantar fasciitis.  This pain may spread to the entire bottom of the foot as the inflammation spreads.

This is the Achilles tendon as it goes into the plantar fascia. The plantar fascia will run the whole bottom of the foot

Most commonly people will feel pain in the heel when first waking up.  If this is left untreated, that pain will spread to the entire bottom of the foot.  Some people have found sleeping with night splints helpful but these are a temporary cure and the cause of why you are having this irritation needs to be discovered.  Cortisone shots may also be given, however, these are often more painful then the actual disease and may not cure anything.  When you first begin to feel the heel pain, the best thing to do is freeze a plastic bottle.  Then run that underneath your foot 15 minutes, at least 1 time a day.  Then you should consult a physical therapist if the pain is not almost always gone after 2 weeks.  Treatment will often include manual therapy to reduce the shortened muscle length and exercises that will often focus on strengthening and some stretching.

One of the other injuries commonly affected by runners is posterior tibialis tendinitis.  Sometimes this can be confused with shin splints because of the pain and the location of it but it is different than shin splints.  However, both can be occurring simultaneously so you could have both going on at the same time and it just manifesting itself into one pain.

This depicts the location of the posterior tibial tendon. When pain initially starts, it will most often be felt in the instep of the foot. As the inflammation progresses, it can be felt all the way up into the muscle belly.

This type of injury most often results from improper foot wear and overuse.  When initially noticing pain in the instep, it is recommended to begin treatment immediately as as this progresses it can become extremely painful and has ended some running careers.  Treatment for this most often includes rest, ice and then a manual therapy component to help create balance in the muscle.

The final common type of injury that I am going to discuss is shin splints as everyone who seems to have taken a running step has had shin splints.  The medical name for shin splints is medial tibial stress syndrome.    It is often felt as pain along the front of the shin.  You have to be careful when diagnosing shin splints on your own as it can also be compartment syndrome or a stress fracture, both of which require more immediate medical attention.

Shin splints is often caused from muscle imbalances.  Some muscles being too inflexible and some muscles being too weak.  After obtaining an accurate diagnosis, if it does in fact turn out to be shin splints, then some of the treatments may include exercises to properly correct the muscle imbalances such as stretching the gastroc and strengthening the tibialis anterior (muscle in the front, on the shin).  Determining proper footwear may also be a large component in overcoming shin splints.

With any of these injuries, attending physical therapy is the best treatment method.  Trying to treat them on your own will only lead to more problems and more compensations that will force you to have even more injuries.  Physical therapy, especially a hands on component, will allow the muscles to return to normal length in order to be able to function correctly.  Physical therapy will also strengthen the muscles appropriately so that there will be no more overuse and the muscles will not have to work as hard.  The sooner that physical therapy is initiated, the quicker you will be able to get back to running.  For more information regarding physical therapy services go to www.totalperformancept.com.

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