Published on October 28, 2013
Common Running Injuries – Part 1
Run for enough years – or simply hard enough – and eventually running injuries can hamper progress. In part 1 of our guide to common running injuries RunningMonkey, with the help of physiotherapist Claire Warburton of BodySync, looks at some of the most frequent injuries encountered to help prevent a minor ‘niggle’ becoming a major problem…
The Achilles tendon at the back of the ankle, sometimes called the heel cord, is the tendon attachment of the calf muscles from the leg and knee to the heel; it is used in standing on your toes or in the ‘pushing-off’ phase of walking, running, or jumping. Achilles tendonitis is a fairly common condition amongst runners, but treated early (and correctly) is less debilitating than often feared.
Signs and Symptoms: Pain, tenderness when pressed, swelling, warmth, and redness over the Achilles tendon – often around 4cm up from the heel – are all signs of Achilles tendonitis. A rather disconcerting ‘crackling’ sound is sometimes heard when the affected area is pressed gently and pain is usually felt on the ‘push-off’ stage of running or when standing on tiptoe.
Common Causes: Increased training levels, particularly sudden, large increases, can cause Achilles tendonitis, but a failure to warm up adequately can also contribute.
Treatment: Acute onset will often improve within about six weeks if appropriately treated. Rest, Ice, Compression and Elevation (the so-called ‘RICE’ regime) form the most important factors in early treatment, with adequate rest arguably the most important part. The use of an NSAID (Nonsteroidal Anti-Inflammatory Drug) such as Ibucalm gel or Ibuprofen tablets may also help. Note, though, that oral NSAIDs have been linked to complications such as Rhabdomyolysis and other kidney complications in endurance athletes. Early physiotherapy can be very helpful and, once things are improving, stretching exercises, followed by a strengthening regime, will speed recovery. The use of a removable in-shoe heel raise might also be recommended for use.
The Physio says: ‘Achilles tendonitis has to be one of the most frustrating conditions to treat. Not because it is difficult to treat but because it can improve relatively easily which gives patients the false hope to return to their exercise – they then reinjure themselves. This vicious circle is pretty much exacerbated by all you runners out there. Physio treatment should be complemented by relative rest to let symptoms settle down and get you back on track.’
The term Shin Splint(s) is often applied to a variety of injuries and conditions where the pain appears in the lower leg or shin during exercise. It’s one of the most commonly ‘self-diagnosed’ running injuries and also one that GPs lacking in specific sports knowledge will often cite as the cause of trouble – technically it might be argued that ‘shin splint’ is a symptom of conditions that might include chronic compartment syndrome, medial tibial stress syndrome and even stress fracture.
Signs and Symptoms: A dull ache or throbbing or a tight feeling in/over the shin, often radiating out from the midpoint, but the patterns are variable, depending on the underlying condition. It’s not unusual for the pain to actually go away (or at least decrease) during running only to return, sometimes worse, afterwards.
Common Causes: Runners who overpronate (where the foot rolls inwards as it hits the ground) may be more at risk, as may those new to running or returning to running after an extended time off. A sudden increase in either speed or distance can also contribute to the underlying causes of shin splints.
Treatment: Treat early with alternating ice-packs and heat-rubs and non-steroidal anti-inflammatory creams/gels. As shin splints can indicate a wide variety of injuries it’s important not to try and ‘run through’ and to seek professional medical opinion if things don’t improve within a few days. Frequent sufferers of mild shin splint symptoms would do well to have their running style (and shoes) professionally checked, with podiatrist-recommended orthotics sometimes the answer.
The Physio says: ‘General shin pain is often self-diagnosed as shin splints. We have a bit of a fandangled name for it now, ‘Medial Tibial Stress Syndrome’. Training too much, too soon tends to be the cause of this and rest is pretty much all you can do to reduce your pain symptoms. Once recovered, get a physio to assess your biomechanics and lower limb strength in order to devise a rehab programme.
It has been suggested that ankle sprains account for about 25% of all sports injuries. Most ankle sprains occur when the foot rolls to the inside or the ankle twists, tearing or stretching the ligaments on the outer side of the ankle.
Signs and Symptoms: Usually you will know exactly when you develop an ankle sprain – it’s the moment you twist or ‘go over on’ your ankle often on uneven ground. Immediate pain when the injury occurs is inevitable and the ankle becomes painful, swollen and there may be an inability to weight-bear. Bruising, usually around the outer part of the ankle and foot, can become apparent within a day or so.
Common Causes: Lack of strength through the ankles or a generally poor running ‘style’ can contribute, but the sprains themselves are invariable caused by a trip (or partial trip) on uneven ground or even simply up/down a kerb. Inappropriate shoes – particularly road shoes on trail conditions – make a sprain more likely.
Treatment: RICE is, again, the key to immediate treatment and NSAID cream, gel or tablets can be used to help any pain. A simple over-the-counter elasticated ankle support can help things in the short-term. If there is continued tenderness over the bones of the foot and ankle, and persistent difficulty with weight-bearing then you ought to be assessed by a doctor. More serious sprains will benefit from physiotherapy assessment and a strengthening rehab regime.
Recommended Products: Physicool, Ibucalm gel, elasticated support
The Physio says: ‘When you twist your ankle you stretch the ligaments and sometimes rupture some of the fibres. When this happens the stretch receptors in those ligaments become a little deranged. They can no longer send up the correct signals to let your brain know where you are in space. Due to this any rehab protocol needs to involve balance work to retrain or reinforce these signals.’
Muscle Pulls are invariably actually muscle tears and are normally the result of a one off incident – an ‘awkward’ or unexpected movement during exercise for example – or the result of sustained over exercise.
Signs and Symptoms: Depending on the injury (and the muscle affected) sudden ‘searing’ pain in the muscle and muscle spasms (contraction or twitching) are common signs. Tenderness to the touch and the feeling a ‘knot’ in the muscle could be the sign of a more acute tear.
Common Causes: Sprinting or running much faster that normal training pace can result in tears and are therefore often associated with races, although training in colder than normal conditions can also be a factor. Stretching and carefully considered warm-downs after exercise can help to prevent pulls/tears.
Treatment: Rest, Ice, Compression and Elevation (RICE) form the most important factors in early treatment again, and the use of an NSAID is helpful for controlling pain. Some gentle self-massage can help ease things out in less serious cases (consider some sports-specific massage oil too) and alternating between the ‘Ice’ element of RICE and a heat pack (or heat rub) can help. If pain/symptoms continue or worsen always seek professional advice from a doctor or physiotherapist who can suggest a regime of strengthening to prevent a reoccurrence.
The Physio says: ‘A muscle strain versus a muscle tear determines rehab time. Even with a low level strain some bleeding (bruising can occur). Where there is bleeding there is the need for healing and by healing I mean time. Going back too soon can cause worsening symptoms in terms of pain and also in damage to the muscle fibres. ‘
Part 2 of the RunningMonkey guide to Common Running Injuries online soon…
Please note: Opinions on symptoms, causes and treatments can vary; the above is intended for general guidance only and is not intended to supersede the advice of your own medical practitioner(s). If in doubt always seek the advice of your GP, physiotherapist or other healthcare professional.