The Elements of Running Part 2: Common Running Injuries and Ways to Prevent Them | Element Physio

In today’s blog we are uncovering some of the most common running injuries and discussing a few more preventative tips to consider before striking the pavement.

Common Running Injuries:

Plantar Faciitis

Plantar fasciitis describes a chronic irritation of the structures located on the bottom of the foot.  The plantar fascia is a rigid structure that attaches at the heel and inserts near the forefoot.  It is designed to provide fixed stability to the arch.  Because it has no contractile properties, the plantar fascia relies on muscles to assist in foot stability.  Muscle weakness can therefore lead to stretching of the plantar fascia and subsequent pulling near its insertion on the heel.  Symptoms of plantar fasciitis may include inability to fully weight bear, burning/pain in the heel, morning pain, and in inability to walk in bare feet.

Shin Splints

“Shin Splints” is a grab-bag term to describe pain located in the front of the lower leg,  The lower leg muscles are not only involved in proper placement of the foot as it strikes the ground, but they also contract to support the arch. When these muscles become inflamed from irritation, either due to poor mechanics or weakness, tightness or pain can occur.  Shin splints can also result from a bone strain (see below) or compartment syndrome. It is also important to consider the involvement from above (hip and knee) as the whole lower extremity operates together as a chain (hip-knee-ankle).

Patellofemoral Syndrome (PFS)

Proper knee flexion and extension involves the kneecap gliding smoothly over the thigh bone or the femur. PFS is an injury in which there is incongruity in the tracking between these two surfaces, leading to pain located around the kneecap.  It can be caused by weakness in the hip musculature, which provide stability to the femur as it moves forward and backward during a running stride.  Signs and symptoms may include pain located around the kneecap and pain with weight bearing on your knees.

Iliotibial Band Syndrome

The iliotibial band is a strong band of tissue located on the outer aspect of the thigh.  The ITB has a role in adding stability to the hip and outer thigh.  If muscle imbalance is present or if flexibility has been compromised, the ITB can become irritated near its attachment at the knee joint, leading to outer knee pain with activity that is achy or burning in quality. “Movie-goer’s sign” is the inability to sit for long periods of time as the bent knee places tension on the ITB, which in turn causes knee pain.

Achilles Tendonitis

A proper running stride relies heavily on the powerful function of the calf muscles in order to propel the leg forward.  Achilles tendonitis involves a painful inflammation of the tendon attaching the calf muscles to the heel due to irritation and fatigue.

Stress Fracture

A broken bone (AKA fracture) can result from the repetitive nature of running combined with improper form and/or muscle balance.  Stress fractures involve a gradual decrease in bone strength with repeated impact, leading to a break.  Most commonly, stress fractures occur in the bones of the foot and in the lower leg.

Ways to Prevent Them:

Take it slow

Be sure to gradually introduce a new running routine.  Too much, too soon is the hallmark of overuse injuries and it is therefore important to allow your body to adapt to change.  Weekly volume (kilos/miles) should not exceed more that a 10% increase per week.  Scheduled rest days are also important to allow the body to repair and to prevent injury.

Implement cross training into your routine

Cross training is important if you want to run injury-free.  Not only does cross training give your body a break from the repetitive stress of running, it also gives you an opportunity to work on specific muscle-groups to improve your stride.  Cycling or swimming are examples of appropriate, low-impact options to maintain your cardio-vascular endurance.  Muscle strengthening can range from core stability, hip strength, to lower leg power.  A physiotherapist can help you identify your weaknesses and provide you with an individualized program to target your specific needs.

Be sure to warm up and cool down

A proper warm up and cool down are often neglected by many, but we can’t stress their importance enough!  A good warm-up increases blood flow to tissues, enhances flexibility, and elevates tissue temperature – p hysically “warming” up the body for it’s task. We recommend a dynamic warm-up that involves both movement and flexibility before a run.  After you run, cooling down involves gradual lowering of your heart rate and static, sustained stretching of specific muscle groups. It physically lowers your body temperature and facilitates muscle recovery.

Add some variety

Running injuries are fuelled by movements sustained on the body over and over again.  Because the running stride is repetitive in nature, it is important to think about mixing up your surroundings to decrease your chance of an overuse injury.  Some ideas include: running a different route, changing up the terrain (pavement, grass, gravel, etc.), and adding variety to your weekly routine with interval runs.  Intervals are short, intense exertions followed by a recovery period and are aerobically challenging in nature.  If you are considering running hills, limit it to 1-2 sessions per week with a gradual introduction.

Once again, before introducing any new exercise routine, it is important to keep in touch with a health care professional to address your unique health concerns.  Every running injury will present slightly different from the next, and the same philosophy applies to how it should be treated.  If you find yourself faced with a painful stride,  schedule an evaluation with a physiotherapist to determine your particular needs.