» Common Running Injuries
Achilles Tendonitis
Definition:
Inflammation of the Achilles tendon. The Achilles is the large tendon connecting the two major calf muscles, gastrcnemius and soleus, to the back of the heel bone. Under too much stress, the tendon tightens and is forced to work too hard. This causes it to become inflamed (tendonitis), and over time, can produce a covering of scar tissue, which is less flexible than the tendon. If the inflamed Achilles continues to be stressed, it can tear or rupture.
Symptoms:
- Limited ankle flexibility
- Redness or heat over the painful area
- A nodule (a lumpy build-up of scar tissue) that can be felt on the tendon
- A cracking sound (scar tissue rubbing against the tendon) with ankle movement
- Dull or sharp pain anywhere along the back of the tendon, but usually close to the heel
Causes:
- Tight or fatigued calf muscles, which transfer the burden of running to the Achilles. This can be due to poor stretching, rapidly increasing distance or over-training (excessive hill running or speed work), both of which stress the Achilles more than other types of running
- Inflexible running shoes, which, in some cases, may force the Achilles to twist
Treatment:
- Apply ice to the Achilles - for 10 minutes every 2 hours, in order to reduce the inflammation
- Avoid weight-bearing activities and keep foot elevated when possible
- Self-massage - using arnica oil or anti-inflammatory gel. Rub in semi-circles in all directions away from the knotted tissue, three times a day once the nodule is gone
- Stretch the calf muscle gently. Do not start running until you can do heel raises and jumping exercises without pain
- Return to running gradually. Full recovery is usually between six to eight weeks
Runner's Knee (Chondromalacia)
Definition:
A softening or wearing away and cracking of the cartilage under the kneecap, resulting in pain and inflammation. The cartilage becomes like sandpaper because the kneecap is not riding smoothly over the knee.
Symptoms:
- Pain beneath or on the sides of the kneecap and a grinding noise, as the rough cartilage rubs against cartilage when the knee is flexed
- Pain is most severe after hill running
- Swelling of the knee
Causes:
- Over pronation (feet rotate too far inward on impact) - can cause the kneecap to twist sideways, or cause fatigued or weak quadriceps muscle. The quadriceps muscle assists in the proper tracking of the kneecap
- Weakness, especially of the inside part of the quadriceps, can prevent the kneecap from tracking smoothly resulting from muscular imbalances between the weak quadriceps and tight hamstring/iliotibal band (ITB)
- Muscles can also affect proper tracking of tendons and ligaments, especially during hill running and on uneven surfaces
- Overtraining
Treatment:
- Stop running
- Apply ice to the shin area - for 10 minutes every 2 hours, in order to reduce the inflammation
- Stretching of the quadriceps, hamstring, iliotibial band (ITB) and gluteal muscles. (Hold each stretch for 30 seconds, relax slowly. Repeat stretches 2-3 times per day)
- Gradual progression of training program
- Incorporate rest into training program
Plantar Fasciitis
Definition:
An inflammation of the plantar fascia, a thick fibrous band of tissue in the bottom of the foot which runs from the heel to the base of toes. When placed under excessive stress, the plantar fascia stretches too far and tears, resulting in inflammation of the fascia and the surrounding tissues. The tears are soon covered with scar tissue, which is less flexible than the fascia and only aggravates the problem.
Symptoms:
- Pain at the base of the heel is most severe in the mornings on getting out of bed, and at the beginning of a run.
- The pain may fade as you walk or change running stride, in an attempt to alleviate the pain.
Causes:
- Stress, tension and pulling on the plantar fascia
- Inflexible calf muscles and tight Achilles tendon place more stress on the plantar fascia
- Excessive pronation (feet rotate too far inward on impact)
- High arches and rigid feet
- Overtraining
Treatment:
- Stop running, especially in the case of severe pain if pain is mild, then reduce training load and intensity. Take a course (5-7 days) of non-steroidal anti-inflammatory drugs (ibuprofen/voltaren/cataflam/mobic) available from your general practitioner or pharmacist
- Apply ice to the plantar fascia - for 10 minutes every 2 hours, in order to reduce the inflammation. (An efffective way of icing is to fill a plastic 500 ml Coke bottle with water, and to freeze it. Apply the ice as instructed by rolling the bottle under the foot)
- 1) Pick up marbles or golf balls with your toes 2) Pull a towel towards you with your toes. Grab some of the towel with your toes and pull, then release, grab, and pull some more to loosen the plantar fascia. Place a golf ball under the foot, and roll the foot over the ball. Start with the ball at the base of the big toe, and roll the foot forwards over the ball, then back again. Move the ball to the base of toe and repeat. Repeat for each toe. Always exert enough pressure so that you feel a little tenderness.
Shin Splints
Definition:
Inflammation of the muscle attachments and inter-osseous membranes to the tibia (shin bone) on the inside of the front of the lower leg. Note: "shin splints" is a very widely used phrase and can refer to several lower leg injuries. The focus of this description is specifically on the inflammation described above.
Symptoms:
- Pain or tenderness along the inside of the shin, usually about halfway down the shin. Pain and tenderness may extend to the knee
- Pain on palpation of the shin
- Pain is most severe at the start of a run, but may disappear during a run, as the muscles loosen up. This is different than a stress fracture, where there is pain during weight bearing activities (walking, stair-climbing)
Causes:
- Inflexible calf muscles
- Atrophied or inactive hip flexors
- Tight Achilles tendon places more stress on to the muscle attachments
- Over pronation (feet rotate too far inward on impact)
- Excessive running on hard surfaces, such as concrete pavements
- Overtraining, or a rapid increase in training load or intensity
- Beginner runners are more susceptible to this problem for a variety of reasons, but most commonly due to the fact that the leg muscles have not been stressed in such a way before they started running.
Treatment:
- Activate hip flexors prior to running (focus on lifting knees rather than pushing off heels)
- Stop running, especially in the case of severe pain. If pain is mild, then reduce training load and intensity, and avoid downhill running and on uneven surfaces
- Apply ice to the area for 10 minutes every 2 hours, in order to reduce the inflammation
- Stretching of the calf muscles. Hold for 30 seconds. Relax slowly. Repeat on opposite side. Repeate stretch 2-3 times per day.
- Strengthening of hip flexors, foot, and calf muscles
