Common Running Injuries

Runners, by the very nature of what they do, are at risk of picking up injuries.  These can be from intrinsic factors (internal factors, those which relate to the body itself such as biomechanics) and extrinsic factors (external factors, such as footwear and the environment). It is important to remember that each individual has their own mechanics, some of whom are more prone to break down than others, and everyone has their own recovery rate, or threshold to injury.  Regardless of your mechanics or fitness level, with the correct equipment, a sensible training program and good nutrition most people find they can enjoy running....some more than others!

Common injuries for runners

• Runners Knee (Iliotibial Band Syndrome);  The Iliotibial band (ITB) is a sheath of thick fibrous connective tissue, like a taught elastic band which originates from the area at the front of your hip(on the iliac crest and tensor fascia latae) running down the outside of the thigh and inserting onto the shin (lateral aspect of tibia).  Its role is to help straighten the knee and abduct (move out) the hip.  It is prone to increased friction at various points, especially over the outer edge of the knee (lateral epicondyle) which the ITB passes back and forth over at 20-30degrees of knee flexion.  This is approximately the angle of the knee when the runners’ foot makes contact with the ground, and so can lead to increased friction.  Runners may experience some of the following symptoms;  Lateral (outer aspect) knee pain, ITB tightness, pain aggravated by running, especially downhill, weak hip abductors, pain on knee bending and straightening the knee.
• Shin Splints;  Shin splints is a term used to describe pain felt at the front inside aspect of the shin bone, which arises from a number of causes, most commonly inflammation of the periostium (the membrane which lines the outer surface of the bones) of the tibia which is caused by traction forces from the muscles of the lower limb.  Runners may complain of pain along the inside lower third of the shin, this can ease during exercise but will often be felt more intensely afterwards. There can be some swelling and lumps/bumps can be felt along the inside aspect of the shin.
• Achilles Tendinopathy; The Achilles Tendon attaches the gasrocnemius and soleus (calf) muscles to the calcaneus (heel), these provide the power in the push off phase of gait (walking, running). This tissue can degenerate, losing its normal structure and reducing how efficiently it can perform its role.  This can be either an acute (new) or chronic (older or longer term) injury, but symptoms are commonly pain the Achilles Tendon area, especially on palpation, pain worsens with activity and eases with rest, swelling or thickening around the tendon.
• Plantar fasciitis; The plantar fascia is a broad band of tissue that runs from the heel, along the length of the sole of the foot, to the base of the toes.  Similar to Achilles tendinopathy, pain can occur when the collagen fibres which make up the tissue, degenerate close to the attachment into the heel.  Runners may complain of pain under the inside aspect of the heel, worse on palpation and upon rising from resting as the fascia tightens up.  The most common cause of plantar fasciitis is tight calf muscles which lead to prolonged and / or high velocity pronation of the foot. This in turn produces repetitive over-stretching of the plantar fascia leading to possible inflammation and thickening of the fascia. As the fascia thickens it loses flexibility and strength.
• Patelofemoral Pain Syndrome (PFPS) or Anterior Knee Pain; This is a generic term used to describe pain over the front of the knee which presents and worsens over a period of time.  As the knee is bent and straightened the patella should move or track in a straight line in the intercondylar groove (formed by the femur and tibia).  When structures controlling this become tight, or weak, the patella fails to move correctly, so causing irritation to other surrounding structures and tissues, causing pain.  For example, the outer edge structures (ITB, Vastus lateralis and lateral retinaculum) may be tight, and the inside muscle, Vastus Medialis Oblique (VMO muscle) may be weak, so allowing the patella to track laterally as the pull from the tight structures is greater than that which can be generated by the weak muscles.  As a general rule, runners with this condition may complain of aching in the front of the knee joint and under the patella, pain on descending hills or stairs, tight muscles or ITB, aching on prolonged sitting, occasional swelling after activity.

Common Causes of Running Injuries;

• Recent change in footwear or unsuitable footwear
• Recent increase or change in training program (interval training, hill work, increased mileage, increased frequency of training or reduced recovery times).
• Change in training surface (tarmac/trail/track/ treadmill)
• Return to previous level of running after a period of time off through sickness/holiday
• Running on a cambered surface
• Insufficient recovery/rest time
• Insufficient warm up or cool down
• Insufficient stretching (see our review of common stretches).

If you have any concerns that you may have some of the symptoms detailed above or any pain either during or after running, then please seek the advice of your physiotherapist.  It would be very helpful if, before your visit, you consider whether you may have recently changed anything related to your training, as outlined above, as this will contribute towards making an accurate diagnosis and formulating a successful treatment program for you.