Common Running Injuries

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Common Running Injuries

• And When to Seek Medical Treatment!

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Types of Common Injuries

• Stress fractures
• Hamstring strain
• Iliotibial band syndrome
• Patellofemoral syndrome
• Shin splints
• Plantar fasciitis
• Achilles tendinitis

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Why Do These Injuries Occur?

• Progressing too quickly in mileage and speed
• Lack of regular stretching
• Not changing out running shoes frequently enough
• Imbalance between opposing muscle groups

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Stress fractures

• What is it?
• An overuse injury
• Occurs when muscles become fatigued and are
  unable to absorb added shock
• Fatigued muscle transfers the overload of stress
  to the bone causing a tiny crack

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Stress Fractures

• Causes
• Result of increasing the amount or intensity of
  an activity too rapidly
• The impact of an unfamiliar surface
• Improper equipment (shoes)
• Increased physical stress
• Women gt men

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Stress Fractures

• Signs and Symptoms
• Sharp pain in the weight-bearing bones of the
  lower leg and foot while running
• Mild swelling
• Tender to the touch

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Stress Fractures

• Treatment
• Rest and ice
• Engage in a pain-free activity during the six to
  eight weeks it takes most stress fractures to
  heal
• Use of a bone stimulator

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Stress Fractures

• Prevention
• Slowly increase any new sports activity
• Maintain a healthy diet, including calcium
• Do not wear old or worn running shoes
• If pain or swelling occurs, immediately stop the
  activity and rest for a few days
• If continued pain persists, see an orthopedic
  surgeon

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Hamstring Strain

• What is it?
• A tear in one of the hamstrings muscles
  (semitendinosis, semimembrinosis and biceps
  femoris)
• Can range from small micro tears in the muscle to
  a complete rupture

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Hamstring Strain

• Causes
• Frequently occur during sprinting
• Can occur during an isolated athletic activity
  (acute) or result from persistent repetitive
  stress (chronic)

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Hamstring Strain

• Signs and Symptoms
• Sudden sharp pain at the back of the leg
• Muscles going into spasm
• Swelling and bruising
• If the rupture is very bad you may feel a gap in
  the muscle

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Hamstring Strain

• Treatment
• Use a compression bandage or heat retainer until
  you feel no pain
• Ice, compress, elevate, use crutches
• Physical therapy
• Surgery for complete rupture

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Hamstring Strain

• Prevention
• Gradual conditioning program
• Incorporate a proper warm-up and stretching
  session into your conditioning program and
  athletic competition

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Iliotibial Band Syndrome

• What is it?
• Condition characterized by pain localized over
  the lateral femoral epicondyle that occurs during
  vigorous walking, hiking or running
• Pain is usually relieved by rest and by walking
  with the knee held in full extension

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Iliotibial Band Syndrome

• Causes
• Overuse may cause shortening of the ITB
• Knee goes from flexion to extension and excessive
  pressure from the ITB causes friction over the
  lateral femoral epicondyle
• This repeated motion produces inflammation of the
  underlying structures and causes pain

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Iliotibial Band Syndrome

• Signs and Symptoms
• Pain localized over lateral femoral condyle
• Discomfort initially relieved by rest
• Pain may radiate toward the lateral joint line
  and proximal tibia
• Worse if a person continues to run
• No symptoms of internal derangement
• Symptoms frequently develop during downhill
  running

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Iliotibial Band Syndrome

• Treatment
• Rest
• Ice
• Stretching of iliotibial band
• Anti-inflammatory medicine
• Orthotics (if appropriate)
• Ultrasound
• Local steroid injection

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Iliotibial Band Syndrome

• Prevention
• Adequate stretching of the IT band
• Massage therapy
• Avoid hills, shorten stride, and run on alternate
  sides of road

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Patellofemoral Syndrome

• What is it?
• The term used to describe pain on and around the
  patella or kneecap
• Common cause is damage to the surface underneath
  the kneecap
• Can be started by an impact or it gradually comes
  on from rubbing on the bone underneath

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Patellofemoral Syndrome

• Causes
• Malalignment of the patella on the femur
• Weakness of the quadriceps muscles
• Tight structures on the lateral aspect of the
  knee
• Pronation of the feet

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Patellofemoral Syndrome

• Signs and Symptoms
• Pain may be felt behind or around the knee cap
• Grinding noises may be heard during bending or
  straightening the leg
• The knee may feel like it gives-way without any
  particular reason
• Pain occurs while going up and down stairs, as
  well as after prolonged periods of sitting

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Patellofemoral Syndrome

• Treatment/Prevention
• Anti-inflammatories
• Ice/heat
• Strengthening the quadriceps
• Stretching the hamstrings

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Shin Splints

• What is it?
• The name given to pain at the front of the lower
  leg
• Also known as medial tibial stress syndrome
• Inflammation of the periostium of the tibia
  (sheath surrounding the bone)

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Shin Splints

• Causes
• Weak anterior leg muscles
• Hard running surface
• Recent increase in running speed or distance
• Unsupportive shoes
• Fallen arches

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Shin Splints

• Signs and Symptoms
• Tenderness over the inside of the shin
• Lower leg pain
• Occasional swelling
• Lumps and bumps over the bone
• Pain when the toes or foot are bent downwards
• A redness over the inside of the shin

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Shin Splints

• Treatment
• Ice 10-15 minutes for 2-3x per day
• Anti-inflammatory drugs
• Active rest - participate in activity that does
  not stress the affected area but maintains
  cardiovascular fitness, such as bike riding

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Shin Splints

• Prevention
• Keep anterior leg muscles strong
• Correct pronation with the use of custom made or
  over-the-counter orthotics
• Run on a forgiving surface, such as a treadmill
• Increase speed and distance gradually

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Achilles Tendinitis

• What is it?
• Inflammation of the large tendon at the back of
  the ankle which connects the large calf muscles
  (gastrocnemius and soleus) to the heel bone
  (calcaneus)

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Achilles Tendinitis

• Causes
• Sudden increases in running
• Excessive hill running or a sudden addition of
  hills and speed work
• Excessive tightness of the posterior leg muscles
• Soles of shoes too stiff, or excessive heel
  cushioning of the heel

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Achilles Tendinitis

• Signs and Symptoms
• Pain in the tendon during exercise
• Swelling over the Achilles tendon
• Redness over the skin
• You can sometimes feel a creaking when you press
  your fingers into the tendon and move the foot

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Achilles Tendinitis

• Treatment
• Anti-inflammatories
• Begin ice after exercise
• Use small heel lift in shoe
• Rest for two weeks after the aggravating activity
  
• Begin stretching regimen for gastrocnemius and
  soleus complex

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Achilles Tendinitis

• Prevention
• Regularly stretch the posterior calf muscles
• Increase training gradually
• Correct pronation

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Plantar Fasciitis

• What is it?
• Inflammation of the strong tissue that runs along
  the bottom of the foot and connects the heel to
  the base of the toes

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Plantar Fasciitis

• Causes
• Weak foot muscles
• Tight Achilles tendon
• Flat or high arches
• Poor shoe support
• Sudden increase in activity level
• Sudden increase in weight

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Plantar Fasciitis

• Signs and Symptoms
• Heel pain that is worse in the morning with the
  first few steps
• Since it is difficult to rest the foot, this
  problem gradually worsens
• Pain may start interfering with activities of
  daily living

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Plantar Fasciitis

• Treatment
• Temporary decrease in training
• Gentle Stretching of calf muscles
• Check shoes for flexion stability
• Perform 20 seconds of "toe curls" to strengthen
  your foot muscles.
• Ice 15 minutes, 10 minute break x 2 each day
• Consider rolling your foot over frozen water
  bottle
• Do not go barefoot in your house or at any other
  time for 6 weeks.
• Try over the counter orthotics

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Plantar Fasciitis

• Prevention
• Wear orthotics to prevent excess pronation and
  prevent lengthening of the plantar fascia and
  continued tearing of the fascia
• Stretch regularly

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Summary

• Most mild conditions will resolve with
  conservative treatment as outlined above
• For conditions that persist or are refractory to
  conservative treatment, evaluation and treatment
  by a professional may be warranted

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Questions?