The other day, I realised that 4 out of 5 of my City patients had running injuries and 2 of them are due to run in the Nike Run to the Beat half marathon. So, I thought I better put some tips down in the blog. If you are training for a race or just a recreational runner, here are my top 5 Running Injuries and advice on how to avoid or resolve them.
1. RUNNERS KNEE.
Also known as Patella Femoral Pain Syndrome (PFPS), this condition is an inflammation of the cartilage on the underside of the Patella (knee cap). This can cause noticable swelling, but in many cases there is none. Patients described the pain as central to the knee and is aggravated on running and stairs.
There are several reasons for PFPS;
The patella is attached to the Quadricep muscle and glides up and down a groove in the femur on contraction and relaxation of the muscle. If there is an imbalance in Quadriceps, then the patella can be pulled over to one side causing increased friction on the corresponding side of the patella cartilage. Typically, there is a weakness of the Vastus Medialis, allowing the dominant Vastus Lateralis to pull the patella laterally. Strengthening the Medialis involves focusing on the final few degrees of knee extension. This can be done by placing a rolled up towel under the knee and pushing the back of the knee into the towel or doing a few reps on the last few degrees of movement on a leg extension machine at the gym.
Reduced flexibility of the Quads
As you exercise a muscle, it becomes toned and shortened. Stretching lengthens the muscle again to prevent injury. However, some people neglect their stretching routine, especially post run, which leads to pain and injury in the long term. If the Quads become too tight the patella is held very high and tight in the patella-femoral groove, causing irritiation of the cartilage. The answer, stretch, stretch, stretch.
Over pronated feet
Commonly known as fallen arches or flat feet, this can be of sudden onset or hereditary. Dropped arches cause the knees to rotate inwards, leading to mal-alignment of the patella in the femoral groove. Making sure you have the correct footwear, strengthen your gluts to prevent the knees from dropping into rotation and strengthening exercises for the arches of the foot if the condition is not hereditary.
2. ACHILLES TENDONITIS
This presents as pain with or without swelling over the Achilles tendon. Pain can ease during the intial stages of a run, but becomes quite acute after the run and following periods of inactivity, i.e. sitting for a while. Generally it is caused because of poor foot mechanics, either an over pronated foot, lack of mobility of the transverse arch or chronic hypertonia (tightness) of the calf muscle. To avoid this, make sure you have correct footwear for your type of foot and stretch before and after a run.
Ice, rest, gentle stretching of the calf and hamstring will help to alleviate the pain.
3. PLANTAR FASCIITIS
Plantar fasciitis affects 10% of runners. The pain is over the sole of the foot, but can be isolated to the heel or arch of the foot. The plantar fascia is a tough band of connective tissue, which supports the arch and keeps all the tendons and ligaments of the foot in place. The pain is due to inflammation or micro tears of the fascia and is worse 1st thing in the morning, when getting out of bed, or after a period of inactivity.
Causes can be linked to over pronation, incorrect footwear, altered gait, glut weakness and chronic tightness of the calf muscles.
Rolling your foot over a soft drinks bottle, filled with water and frozen, reduces inflammation and provides self massage. For chronic cases, there are also supports that can be worn in bed, which keep the foot in flexion thereby maintaining a passive stretch to the plantar fascia.
4. HAMSTRING INJURIES
These can range from a strain, to an inflammation of the hamstring insertion point or the more serious injury, tears. Strains and tears are usually felt in the belly of the muscle, midway down the thigh, however inflammation of the insertion point causes pain in the base of the buttocks, especially on sitting.
Lack of flexibility of the Hamstring is the most common reason for strains and inflammation, especially with the sedentary working life of an office worker. The hamstring is often neglected in a stretching routine, but not only causes local problems, it can lead to groin strains, pelvic imbalances and low back pain.
Make sure that you stretch the hamstring out once a day, especially after a run, and aim for every day. If you do get an injury, ice and rest with gentle stretching will help to resolve it.
5. SHIN SPLINTS
This manifests as a pain over the shin (tibia) and is due to inflammation or micro-tears of the Tibialis Anterior muscle, which inserts directly into the bone. It commonly occurs with over training, or when the mobility of the ankle or arch of the foot is restricted. Making sure you increase your training programme progressively, will ensure that you avoid pain. However, if the pain is due to mechanical over compensation, then look at changing your footwear and seek treatment to address the root cause of the problem.
All the above injuries will cause, not only local pain, they will influence your gait. This in turn affects your running efficiency and can cause pains in other areas, i.e. the low back. If you feel any niggles, it is best to consult an Osteopath who deals with sports related injuries. Treatment will not only speed up recovery time and improve performance, it will also identify possible distal causes and advise on a good stretching programme.
Hope you find this information of use and good luck to all of you taking part in events this season.Share