Common Injuries

Unfortunately, most runners know a thing or two about injuries. With up to 80% of all runners getting injured yearly, my goal is to help prevent those injuries and keep you enjoying all of your runs! Below are a few of the most common injuries a runner may encounter – and ways to prevent them. Remember, these are general suggestions for self treatment, what works for your friend may not work for you. Even people with the same injury will have different causes for that injury.

KNEE PAIN

There are different types of knee pain common in runners. Depending on the area where your knee hurts and your specific symptoms, treatment may differ.

Pain the front of your knee / Runner’s Knee

Pain in the front of your knee or under your kneecap is called Anterior Knee Pain by medical professionals. It may also be referred to as Patello-Femoral Pain Syndrome (PFPS), Chondromalacia or commonly known as Runner’s Knee.

This pain around the knee cap can have multiple causes: poor movements at the hip, knee, ankle and foot can cause increased stress and abnormal wear and strain on the front of the knee. These movements may develop from weakness, tightness, limited joint mobility or lack of proper muscle timing.

Self Treatment Suggestions

The first line of treatment you can try is RICE (relative rest, ice, compression, and elevation) – in the first 36-48 hours icing / cryotherapy can help reduce swelling and secondary injury. Ice/cryotherapy can help reduce pain and improve mobility in the acute phase of an injury, however, it’s not a long term treatment strategy.

Strengthening the muscles around your hips and increasing your flexibility in the hips and around the knees can decrease the pressure affecting your knee cap and ultimately, your pain.

Hip Flexor Stretch: Kneeling on one leg, tuck your butt under you so your low back is flat, then slightly push your pelvis forward until you feel a pull in the front of the hip of the leg that is kneeling.

Quadriceps Stretch: Standing on one leg, tuck the butt under (as described above) pull the opposite heel toward your butt, and pull the thigh behind you until you feel a stretch in the front of your thigh.

Clamshells: Lying on your side, bend your knees and hips slightly. While keeping your heels together, slowly lift your top knee as far as you can lift it without rolling at the low back, then slowly lower.

Pain the outside of your knee / IT Band Syndrome

Pain on the outside of your knee or outside lower thigh is called Ilio-tibial(I-T) Band Syndrome. It may also be referred to as Iliotibial Band Friction Syndrome (ITBFS). Research has shown now that the friction is not likely to be the source of the pain – the compression to the fat pad by the insertional area of the IT band is more likely the pain generating area. IT Band syndrome is the most common cause of pain on the outside of your knee.

This pain on the outside of your knee can have multiple causes. Poor movements at the hip, knee, ankle and foot can cause increased stress and abnormal wear and strain on the outside of the knee. These movements may develop from weakness, tightness, limited joint mobility or lack of proper muscle timing. Weakness and poor muscle firing patterns at the hip may allow your thigh to rotate inwards toward the opposite leg or poor pelvic control can place increased pressure on the IT Band and surrounding soft tissue. Training factors related to this injury include excessive running in the same direction on a track, greater-than-normal weekly mileage and downhill running.

Biomechanical / Running Gait factors will impact the stress to the IT band as well. Getting your video running gait analysis will allow me to provide you with individualized gait retraining and intervention strategies for the best outcomes.

Self Treatment Suggestions

The first line of treatment you can try is RICE (relative rest, ice, compression, and elevation) – in the first 36-48 hours icing / cryotherapy can help reduce swelling and secondary injury. Ice/cryotherapy can help reduce pain and improve mobility in the acute phase of an injury, however, it’s not a long term treatment strategy.

Strengthening the muscles around your hips and your core is recommended, addressing training errors and increasing your flexibility in the hips and getting an expert video running gait analysis with a personalized program.

HAMSTRING PAIN / STRAIN

Hamstring strains can result in pain behind your knee, pain in the back of your thigh, or even pain in the butt. Runners are more susceptible to hamstring strains due to the stress and stretch placed upon the hamstring muscles at times.

Hamstring strains can occur from: poor movements at the hip, pelvis, and trunk; weak hamstring and butt muscles; lack of flexibility; and strength imbalance between the hamstrings and quadriceps.

Self Treatment Suggestions

During the initial stages of injury icing and pain free range of motion is recommended.  Painful stretching should be avoided. The first line of treatment you can try is RICE (relative rest, ice, compression, and elevation) – in the first 36-48 hours icing / cryotherapy can help reduce swelling and secondary injury. Ice/cryotherapy can help reduce pain and improve mobility in the acute phase of an injury, however, it’s not a long term treatment strategy.

Treatment should also focus on hamstring, pelvic and core strengthening.  Flexibility training such as stretching should be continued, but should always be pain free.

Bridges: Lying flat on your back with your knees bent and feet on the ground, squeeze your glutes and then lift your hips off of the ground, then slowly lower.

Hip Flexor stretches (see above)

PIRIFORMIS SYNDROME / A Pain in the Butt

The piriformis is a muscle located in the mid buttock region. The sciatic nerve can pass above, below, or even through the piriformis.  If the piriformis is tight, or in spasm, or has fibrotic tissue from a previous injury, this can place pressure and irritation on the sciatic nerve resulting in pain that can radiate down the back of the hip to the foot/ankle.

Treatment focuses on decreasing pain, decreasing muscle spasm, and decreasing sciatic nerve irritation.

Self Treatment Suggestions

The first line of treatment you can try is RICE (or really just RI – Rest and Ice. Not sure how elevation would work here!) – in the first 36-48 hours icing / cryotherapy can help reduce swelling and secondary injury. Ice/cryotherapy can help reduce pain and improve mobility in the acute phase of an injury, however, it’s not a long term treatment strategy.

Strengthening the muscles around your hips and your core is recommended, and increasing your flexibility in the hips and using a foam roller can help relieve tightness and release soft tissue restrictions. Focus on good postural position:  avoid crossing legs when in seated position; avoid sitting on wallets in back pockets.

SACRO-ILIAC (SI) JOINT DYSFUNCTION / Another Pain in the Butt

The SI Joint is formed by the Sacrum and Ilium (Pelvis). SI joint pain is more common in females and is often caused by a torsion stress or repetitive strain to the SI Joint. Torsion stress can be related to a backward rotation of the Ilium on the Sacrum that can occur with activities such as heavy lifting, stepping off a curb and landing quickly with the leg extended, running or muscle imbalances. Torsion stress can also be related to a forward rotation of the Ilium on the Sacrum, from muscle imbalances. SI joint pain can be a result of too much or too little mobility at the joint.

Self Treatment Suggestions

The first line of treatment you can try is RICE (or really just RI again – Rest and Ice. Not sure how elevation would work here!)  – in the first 36-48 hours icing / cryotherapy can help reduce swelling and secondary injury. Ice/crythotherapy can help reduce pain and improve mobility in the acute phase of an injury, however, it’s not a long term treatment strategy.

Strengthening the muscles around your hips and your core is recommended, and increasing your flexibility in the hips and using a foam roller can help relieve tightness and release soft tissue restrictions. Similar to piriformis syndrome, focus on good postural position:  avoid crossing legs when in seated position; avoid sitting on wallets in back pockets.

PLANTAR FASCIITIS 

Pain in the bottom of your foot or in your arch is possibly Plantar Fasciitis. This thick band of tissue on the bottom of the foot connects the heel bone to the toes, helping create the arch of the foot.  Poor movements at the knee, ankle and foot can cause increased stress and abnormal wear and strain on the plantar fascia. Poor flexibility and foot structure along with too much or too little motion at the arch may cause abnormal motion at the shin and place increased pressure on the plantar fascia and soft tissue.

Self Treatment Suggestions

Strengthening the muscles in your foot and increasing your flexibility in the foot, calf and knees can decrease the stress affecting your foot and ultimately, your pain.

SHIN SPLINTS / MEDIAL TIBIAL STRESS SYNDROME (MTSS) / POSTERIOR TIBIALIS TENDON DYSFUNCTION (PTTD)

Shin splints are relatively common in runners and athletes that are involved in hopping sports. It is caused by too much stress on the tibia (main shin bone) causing an imbalance between bone break down and formation. In normal, healthy bone, stress to the bone from exercise promotes bone strength. The muscles that attach to the tibia can cause the overload of stress on the bone.

Pain is primarily localized to the middle or lower third of the inner shin.  Shin splints can arise from too flexible or weak of a foot, too stiff or tight of an arch or calf muscles or poor training.

Treatment focuses on decreasing pain through rest as well as specific ankle/foot strengthening exercises to improve leg mechanics / running form. Manual interventions help reduce the pain and return the athlete to running.

The first line of treatment you can try is RICE (relative rest, ice, compression, and elevation) – in the first 36-48 hours icing / cryotherapy can help reduce swelling and secondary injury. Ice/cryotherapy can help reduce pain and improve mobility in the acute phase of an injury, however, it’s not a long term treatment strategy.

Self Treatment Suggestions

Calf stretching: Lean forward (or push against a wall) with your legs staggered. The rear leg is the one you are stretching. With the back knee straight, you will feel a stretch higher in the calf / behind the knee (Gastrocnemius). With the rear leg bent, you will feel the stretch lower in the calf (Soleus).

Single Leg Heel Raises: Standing on one leg and holding your balance with a hand, slowly raise as far as you can on one toe and then slowly lower back down.

ACHILLES TENDONOPATHY / TENDONITIS

Pain in your calf or in the back of the heel may be due to overuse of the achilles tendon. Training factors including running technique, footwear and running surface can all play a role in achilles tendonitis. Other factors such as muscle weakness, decreased flexibility, and arch type can lead to achilles tendon pain.  Increased tightness of the calf and weakness of the ankle can cause altered mechanics of the foot, such as excessive flattening or pronation, which requires the calf to perform more work while running. Many of these factors combine to cause over-activation of the calf muscles while running, therefore causing pain.

Self Treatment Suggestions

The first line of treatment you can try is RICE (relative rest, ice, compression, and elevation) – in the first 36-48 hours icing / cryotherapy can help reduce swelling and secondary injury. Ice/crythotherapy can help reduce pain and improve mobility in the acute phase of an injury, however, it’s not a long term treatment strategy.

Strengthening the muscles around your hips, knees and calves and increasing flexibility of the ankle and calf can decrease the stress to your achilles. Pain should never last longer than a day after running.

See Single Leg Heel Raise, above. To modify the single leg heel raise for Achilles Tendonopathy, raise up on both legs, and slowly lower on the painful side. To make this more difficult: raise up on both legs on a stair step and slowly lower down on the painful side so it stretches below the step height.

WHEN TO SEE YOUR RUNNING SPECIALIST

If your pain has persisted for more than 1 week after attempting the exercises above, there are other treatment options. Going through a video running gait analysis will allow me to assess exactly how your biomechanics are impacting your risk of injury and current injury status. A personalized video running gait analysis will give us the information needed to provide an individualized program for you. Modifying how you run (gait retraining) can improve muscle control, movement patterns and decrease the stress on the tender area. In addition to changing your running technique, hands-on care including manual intervention and an individualized treatment program can ultimately get you back to running pain free. Contact Dr. Brown Budde to see how we can prevent the pain from getting worse and get you back to running!

Kari@RefinedRun.com