Running Injuries
There are two types of injuries that an athlete can encounter—one caused by an acute trauma, the other resulting from overuse. As with any injury or ailment that persists, contact a physician, physical therapist or athletic trainer for diagnosis and treatment.
The Traumatic Injury
A traumatic injury is violent and sudden; such as sprains, lacerations, torn ligaments, pulled muscles, or broken bones. These types of injuries usually cause bruising, bleeding, inflammation, and pain. Swelling, which squeezes out circulation and oxygen, can often cause additional damage to the affected body parts. Traumatic injuries usually require immediate professional treatment. If the injury causes immediate pain, swelling, the inability to use the injured body part, or severe pain that does not subside in 30 to 40 minutes, it should be examined by a professional. If the athlete hears or feels a crack, tear or pop and the pain persists, help should be sought.
The Overuse Injury
Overuse syndromes are the result of the body's inability to accommodate the physical demands placed upon it by one's training ~ thus resulting in overstrain. These injuries transpire gradually and can occur in the most commonly used muscles, ligaments, tendons or bones. Common overuse injuries affecting runners include Iliotibial Band Syndrome, Runner’s Knee, Achilles Tendonitis, Shin Splints and Plantar Fasciitis. These injuries are also adversely affected by overtraining.
Pain resulting from overuse injuries is usually not initially severe and is often ignored by the athlete. When pain persists for more than 10 to 14 days after following basic self-care treatments, such as decreasing activity levels, applying ice and/or heat, taking over-the-counter medications, or stretching, professional advice and support is recommended.
Causes of Overuse Injuries
§ Anatomical variations, such as high or low arches, can create biomechanical problems that may lead to an overuse injury.
§ Training errors and placing undue strain on body parts stresses the body. Intensive training does not allow the body adequate time to heal, adjust and recover.
§ An imbalance of hard and easy workouts.
General Self-Care for Overuse Injuries
§ Evaluate training habits.
§ Reduce distance and intensity of training or workouts for 7 to 10 days.
§ Never run through pain. If pain is severe at the beginning of and during an activity, the activity should be stopped completely. If pain is present at the beginning of activity but lessens and does not return until hours later, then the level of activity should be reduced.
§ Consider other aerobic activities to maintain cardiovascular fitness.
§ Follow the R.I.C.E. treatment method.
§ Minimize pain and inflammation with over-the-counter medication, such as Ibuprofen, Motrin, or Aleve.
§ Investigate whirlpool, massage, ice or heat therapeutic healing.
Prevention of Overuse Injuries
§ Follow guidelines for self-care.
§ Understand the effects of long-term exercise programs on bones, joints and muscles.
§ Maintain good muscle strength and flexibility.
§ Adopt conditioning programs including stretching, strengthening exercises and cross-training.
§ Take the time for proper shoe and sock selection.
§ Be aware of shoe deterioration and purchase shoes designed to correct any stride problems, such as over-pronation or over-supination.
Achilles Tendonitis
Definition
Achilles Tendonitis is an inflammation of the Achilles tendon ~ the sinew that attaches the calf muscle to the back of the heel bone. The tendon receives nutrients from the tendon sheath, so when an injury occurs to the tendon, cells from surrounding structures migrate to the tendon to provide direct blood flow and assist in repair. The Achilles tendon does not have good blood supply or cell activity, so injuries may therefore be slow to heal.
Achilles Tendonitis is one of the more common and yet difficult injuries to treat in athletes. It can involve inflammation, swelling, and the degeneration or rupture of the Achilles tendon. Achilles Tendonitis is a degenerative condition that should not be left untreated, otherwise, a complete rupture may eventually result ~ a condition that is much more difficult to treat.
Symptoms
Symptoms can include extremely piercing pain or shooting, prickly or burning pain at the back of the heel area. There can be pain when rising up on the toes and pain with stretching the tendon. Range of motion of the ankle may also be limited. When the collagen protein fibers in the Achilles tendon weaken to a point that the tendon will snap or rupture, there will also be a great deal of swelling.
Causes of Injury
The position of the tendon in the calf makes it susceptible to running injuries. The main cause of tendon damage is the sudden overstretching of tendon fibers. The Achilles tendon must be properly preconditioned to withstand sudden stretches and weight strain during activity.
§ Improper warm-up or cool-down for the activity.
§ A lack of flexibility in the calf muscles.
§ Over-pronation and/or over-supination.
§ Heel bone deformities.
§ Excessive uphill running.
§ A dramatic increase in the amount or intensity of an activity or training program that doesn’t incorporate enough rest.
§ Footwear that is ill-fitting or badly worn and constant rubbing of the shoe against the tendon.
§ Frequently wearing high heels at work and then switching to lower-heeled running shoes.
Short-Term Treatment
§ Stretch calf muscles and Achilles tendons before exercise. If you have tight Achilles tendons or calf muscles, stretch them twice a day whether or not you are doing any sports activities.
§ Rest the tendons, aside from flex-stretching and heel lifts.
§ Decrease mileage and intensity for 7 to 10 days and never run through pain.
§ Avoid running up and down hills during recovery.
§ After activities, apply an ice treatment for 15 minutes, twice daily, to reduce pain and inflammation.
§ Minimize pain using over-the-counter anti-inflammatory medication, such as Ibuprofen, Motrin, or Aleve.
Long-Term Treatment
§ Consult your physician for more effective anti-inflammatory medication or if the injury persists for more than two weeks.
§ Consult a sports injury professional or sports physiotherapist for stretching exercises.
§ Control any biomechanical abnormalities, such as over-pronation or over-supination.
§ Investigate custom made orthotics designed for this condition.
Iliotibial Band Syndrome
Iliotibial Band Syndrome is one of the leading causes of lateral knee pain in runners. The iliotibial band is a superficial thickening of tissue on the outside of the thigh, extending from the outside of the pelvis, over the hip and knee, and reinserting just below the knee. The band is crucial to stabilizing the knee during running, moving from behind the femur to the front during the gait cycle. The continual rubbing of the band over the bone, combined with the repeated flexion and extension of the knee, may cause the area to become inflamed or the band itself may become irritated.
Symptoms
The symptoms range from a stinging sensation just above the knee joint on the outside of the knee or along the entire length of the iliotibial band, to swelling or thickening of the tissue at the point where the band moves over the femur. Pain may not occur immediately, but will worsen during activity when the foot strikes the ground if you overstride or run downhill, and may persist afterward. A single workout of excessive distance or a rapid increase in weekly distance can aggravate the condition.
Causes of Injury
Iliotibial Band Syndrome is the result of poor training habits and anatomical abnormalities.
§ Running on a banked surface, such as the shoulder of a road or an indoor track, causing the downhill leg to bend inward and extreme stretching of the band against the femur.
§ Inadequate warm-up or cool-down activities.
§ Running excessive distances or increasing distances too quickly.
§ Leg and feet abnormalities, such as bowlegs, tightness about the iliotibial band, uneven leg length or high/low arches.
Short-Term Treatment
§ Examine what may have caused the injury. Both structural and functional problems need to be considered when treating Iliotibial Band Syndrome.
§ Alternate running directions on pitched surfaces.
§ Stretch to make sure that the iliotibial band does not become taut.
§ After activities, apply ice treatment for 15 minutes, twice daily, to reduce pain and inflammation.
§ Decrease mileage and intensity and never run through pain.
§ Minimize pain using over-the-counter anti-inflammatory medication, such as Ibuprofen, Motrin, or Aleve.
Long-Term Treatment
§ Consult your physician for more effective anti-inflammatory medication.
§ Consult a sports injury professional or sports physiotherapist for stretching exercises.
§ Control any biomechanical abnormalities, such as over-pronation or over-supination.
§ In extreme cases, surgery to relieve tightness in the band.
Plantar Fasciitis
Plantar Fasciitis, also known as "policeman's heel", is a painful inflammatory condition caused by excessive wear to the plantar fascia of the foot. The plantar fascia is a fibrous, tendon-like structure that stretches the entire length of the bottom of the foot, beginning at the heel bone and extending to the base of the toes. Plantar Fasciitis is commonly associated with long periods of excessive weight-bearing or jobs that require a lot of walking on hard surfaces. This overuse affects the sole or flexor surface (plantar) of the foot. A Plantar Fasciitis diagnosis means you have inflamed the tough, fibrous band of tissue (fascia) connecting your heel bone to the base of your toes. Plantar Fasciitis is more common in athletes who have a high-arch, rigid type of foot or a flat, pronated foot.
Symptoms
Pain is usually felt on the underside of the heel and is often most intense with the first steps of the day. Likewise, during athletic activity, the pain will occur in the beginning of the exercise routine and subside as activity continues.
Causes of Injury
If you don't treat Plantar Fasciitis, it can become a chronic condition.
§ A sudden increase in the amount or intensity of activity.
§ Physical activity overload from excessive long-distance running or walking.
§ Being flat-footed, having a high or low arch or an abnormal pattern of walking which can adversely affect the way weight is distributed.
§ Improper shoe selection or when the foot and gait type are not properly assessed.
§ Stiff-soled shoes or shoes that do not fit properly.
§ Thin-soled or loose shoes which lack arch support or the ability to shock-absorb.
§ Frequently wearing high heels which cause the tendons to contract and shorten.
Short-Term Treatment
§ Examine and eliminate the cause of the injury.
§ Give your feet a rest. Decrease activities and allow for your body to heal.
§ Avoid walking or running on hard surfaces.
§ Do calf stretches several times a day ~ especially first thing in the morning.
§ After activities, apply ice treatment for 15 minutes, twice daily, to reduce pain and inflammation.
§ Minimize pain using over-the-counter anti-inflammatory medication, such as Ibuprofen, Motrin, or Aleve.
§ Attend physical therapy involving whirlpool and ultrasound treatments.
§ Wear shoes with good shock absorption and arch support.
§ Complete a medical history analysis, pedal examination, gait analysis and x-rays to check for heel spurs.
Long-Term Treatment
§ Consult your physician for more effective anti-inflammatory medication, or cortisone injections to alleviate severe pain in acute cases (and only as a last resort in chronic cases).
§ Investigate custom made orthotics that correct biomechanical problems and alleviate stress and strain on the plantar fascia.
§ Consult and sports injury professional or sports physiotherapy for strengthening exercises.
§ Control any biomechanical abnormalities, such as pronation when running, which causes excessive rubbing.
Shin Splints
Shin splints is a general term used to refer to a painful condition caused by small tears in the muscles where they connect to the shins. It is often caused by running or jumping, and may be very slow to heal. There are two types of shin splints:
1. Anterior shin splints ~ occur in the front portion of the shin bone (tibia).
2. Posterior shin splints ~ occur on the inside (medial) part of the leg along the tibia.
Symptoms
The pain may begin as a dull aching sensation after running. Aching may become more intense and develop into lower leg pain or pain in the toes or foot when bent downwards. Tenderness may be apparent around the inside of the shin as well as small bumps along either side of the shin bone.
Causes of Injury
§ An overload on the shin bone and the connective tissues, often caused by specific activities, such as running downhill, on slanted or uneven surfaces or engaging in sports with frequent starts and stops.
§ Not stretching and warming up your muscles before exercising.
§ Overpronation, causing muscles to tear where they attach to the tibia from an increased demand on the muscle over the front of the leg.
§ Tightness in the posterior muscles (which propel the body forward) placing additional strain on the muscles in the front of the lower leg.
§ Training too hard, too fast or for too long or a rapid increase of speed or distance.
§ Toe running which causes stress to the lower leg muscles when the runner lands only on the balls of the feet and without normal heel contact.
§ Worn or improper footwear.
Short-Term Treatment
§ Reduce distance and intensity for 7 to 10 days and never run through pain.
§ Avoid hard and uneven surfaces when jogging, running and walking.
§ Gentle stretching of the posterior leg and thigh muscles.
§ After activities, apply ice treatment for 15 minutes, twice daily, to reduce pain and inflammation.
§ Minimize pain using over-the-counter anti-inflammatory medication, such as Ibuprofen, Motrin, or Aleve.
§ Proper footwear with ample rear-foot cushioning and shock features.
§ Shoes with shin splints, extra arch support and/or a varus wedge to support the inside of the foot and reduce pronation.
Long-Term Treatment
§ Strengthening to correct muscle imbalance, done only in the absence of pain.