Common Running Injuries Found in Distance Runners

“Most running injuries are musculo-skeletal overuse syndromes related to cumulative overload of the lower extremity. Of all running injuries, 70% to 80% occur from the knee to the foot.” says Scott Christensen the head track coach at Stillwater Area High School in Oak Park Heights, MN.

Included below are several of the most common running injuries:

I. Patellofemoral Pain Syndrome (Runner’s Knee) – Location in the Knees

Pain underneath your kneecap or patella is a sign of runner’s knee.

Symptoms:

· Generalized ache of the knee during or after running

· Pain while sitting for a long period of time

· Swelling and/or pain to the touch at the knee joint

Causes:

· Imbalance of forces at the hip, knee, and foot resulting in poor alignment of the leg

· Over pronation of the foot

· Weakness in the core

· Too much hill running

Try/Avoid:

· Try to stretch quads, hip flexors, supine hamstring, calf muscles

· Try to strengthen glutes and quads

· Try to foam roll the glutes and IT band

· Avoid hill training sessions

· Avoid deep squats and lunges

· Avoid speed work

II. Tibial Stress Syndrome (Shin Splints) – Located in the Lower Legs

Roughly 90 percent of shin splints occur in the bone. Pain along the inside of your shinbone (the tibia) or Pain along the front of your shinbone (sharp part of the tibia called the tibial spine).

Symptoms:

· Pain before and after running in the shin area on either side

· Pain along the shin bone, but not centered in one spot

Causes:

· Poor flexibility and/or weakness of the calf and soleus

· Over striding

· Too rapid of an increase in training mileage

· Worn out shoes

· Running on the same type of surface every day

Try/Avoid:

· Try to stretch the calf and soleus several times each day

· Try to foam roll the calf, soleus, and anterior tibialis each day for one minute each

· Try to improve footwear

· Avoid jumping, sprinting, and walking too long

· Avoid running for a few days. Try biking or pool running

III. Achilles Tendonitis – Located in the Lower Legs

Pain anywhere along the Achilles tendon, from your heel to your calf indicates Achilles tendonitis.

Symptoms:

· Pain may be at the top or bottom of the tendon where the calf and soleus connect to the heel

· Pain first thing in the morning, at the beginning of a run, and after a run

Causes:

· Poor flexibility and/or strength of the calf and soleus

· Worn out shoes

· Too much hill running or sprinting

· Too rapid of an increase in training mileage

Try/Avoid:

· Try to stretch calf and soleus first thing in morning

· Try to stretch hip flexors and supine hamstring/calf stretch several times during the day

· Try to do eccentric heel drops on the edge of a step or curb

· Try to foam roll the calf for at least one minute each day

· Try to improve footwear

· Avoid jumping, lunges, and intense sprinting

· Avoid increasing training mileage

· Avoid running past the point of minimal pain

IV. Stress Fractures – Located in the Feet, Hip/Pelvis, and Shins

Repeated stress or shock can eventually cause a bone to crack (stress fracture).

Symptoms:

· Pain along a bone provoked by tapping directly on the bone

· Pain that occurs sharply after a run

· Sharp pain when weight bearing, but dull pain at rest

Causes:

· Overtraining

· Poor nutrition, especially vitamin and mineral intake

· Worn out shoes

· Glute and core weakness

Try/Avoid:

· Try nothing if a stress fracture is suspected. Seek medical advice.

· Once cleared, try gentle mileage and strengthening

· Avoid all impact activities

V. Plantar Fasciitis – Located in the Feet

If you have pain along the bottom of your heel that is worse first thing in the morning as you get out of bed, you most likely have plantar fasciitis.

Symptoms:

· Pain on the bottom of the foot where the arch meets the heel

· Pain is worse with the first step in the morning

Causes:

· Poor flexibility of the calf and soleus

· Over pronation without correction

· Rapid increase in sprinting activities

· Worn out shoes high arched rigid feet

Try/Avoid:

· Try to roll a frozen water bottle or lacrosse ball under foot for five minutes each day

· Try to stretch and strengthen calf and soleus with several activities each day

· Try orthotics

· Try to strengthen the hips and core

· Try a plantar fascia self-mobilization stretch each day

· Avoid unsupported footwear like sandals

· Avoid hill training sessions

VI. Iliotibial Band Syndrome (IT Band) – Located in the Knees

Pain on the outside of your knee where the bone bulges out a bit indicates iliotibial band impingement syndrome (aka - IT band syndrome).

Symptoms:

· Pain on the outside of the knee joint

· Pain is worse after running or while going down stairs

Causes:

· Weakness in the glutes

· Poor flexibility of the hip flexor

· Over pronation

· Running downhill too much or on the same side of a crowned road

Try/Avoid:

· Try to foam roll the IT band for at least one minute several times per day

· Try to strengthen the glutes and the core

· Try to stretch the hip flexors

· Try to correct pronation

· Avoid running past point of pain

· Avoid hill work and intense sprinting

· Avoid too much running in spiked racing shoes

VII. Patellar Tendonitis (Jumper’s Knee) – Located in the Knees

If you feel pain just below your kneecap and at the top of the tibia, the big bone in your shin, you probably have patellar tendonitis.

Symptoms:

· Mild pain from the bottom of the patella to the top of the tibia (shinbone)

· Mild pain with running and jumping activities

· Mild pain when forcefully straightening the knee

· Localized tenderness over the patella tendon

· Often the tendon feels very stiff first thing in the morning.

· Pain that is only present during physical activity

· The inability to climb stairs or stand up from a sitting position

Causes:

· Intense, frequent, and repeated physical activity

· Rapid increase in amount of training

· Sudden increase in training intensity

· Training on rigid surfaces

· Weak quad muscles and inflexible quadriceps, hamstring, and calf muscles

· Muscle imbalances – If some of the muscles in your leg get a better workout than others, the stronger muscles might pull more on your patellar tendon, causing pain and ultimately, patellar tendonitis

Try/Avoid:

· Try exercises that strengthen the quadriceps and stretch the quadriceps, hamstring, and calf

· Try to perform an adequate aerobic or cardiovascular warm-up before activity

· Try resting from painful activities

· Try applying ice

· Avoid activities that involve extending your knee (climbing stairs, squatting, cycling, and walking downhill)

· Avoid explosive leg movements (jogging, weightlifting, jumping, and sprinting)

VIII. Ankle Sprain – Located in the Feet

An ankle sprain is an injury that occurs when the ankle rolls, twists, or turns in an awkward way.

Symptoms:

· Pain right away at the site of the tear

· Pain, especially when you bear weight on the affected foot

· Tenderness when you touch the ankle

· Swelling

· Bruising

· Restricted range of motion

· Instability in the ankle

· Popping sensation or sound at the time of injury

Causes:

· Making a rapid shifting movement with your foot planted

· A fall that causes your ankle to twist

· Landing awkwardly on your foot after jumping or pivoting

· Walking or exercising on an uneven surface

· Another person stepping or landing on your foot during a sports activity

Try/Avoid:

· Try using ice and elevate ankle to reduce swelling (don’t ice for more than 15 minutes at a time)

· Try taping your ankle or wear a brace during exercise, so you can help protect your ankle

· Try to walk or put weight on your foot

· Try stretching, strength training, and balance exercises (calf and Achilles tendon stretching)

· Try wearing stable shoes that give your ankle proper support

· Try keeping the ankles strong and flexible

· Avoid activities that cause pain, swelling or discomfort

· Avoid any holes, obstacles, or uneven surfaces

Other Injuries:

· Osgood-Schlatter condition (formerly known as Osgood-Schlatter's disease) - is a painful condition characterized by tiny, microfractures of the bony bump in the lower leg bone (tibia) where the ligament from the kneecap (patella) is inserted into the tibia. For kids and teenagers who play sports, it’s one of the most common causes of knee pain. (Located in the Knees)

· Metatarsal Stress Reaction - is a reaction that the soft tissue and bone can demonstrate prior to an actual fracture being seen in the foot. Basically, Swelling and inflammation which is called edema in the soft tissue surrounding the metatarsals - It’s a prequel to a metatarsal stress fracture. (Located in the Feet)

· Adductor (Groin) Strain – is a strain of the adductor muscle along your inner thigh, where it attaches to the pelvic bone. (Located in the Groin)

· Hamstring Strain – occurs when you strain or pull one of your hamstring muscles — the group of three muscles that run along the back of your thigh. (Located in the Upper Leg)

· Posterior Tibial Tendonitis - is a problem that occurs to one of the tendons on the inner side of the ankle. (Located in the Ankle)

· Peroneus Tendonitis - is an overuse injury that affects the tendons that run along the outside of your ankle and lower part of your calf. (Located in the Ankle)

· Iliac Apopysitis - is irritation, inflammation, and/or microtrauma of the tendons that originate off the front of the pelvis, above the hip. (Located in the Hip/Pelvis)

In conclusion, you need to have an understanding or knowledge of what causes running injuries. Let’s review a few causes of injuries: a lack of endurance, not doing a proper warm-up or cool-down, not doing preseason stretching or technique drills, running form, poor flexibility, over striding, too rapid of an increase in training mileage, worn out shoes, running on the same type of surface every day, running on uneven surfaces, sudden increase in training intensity, over pronation, poor nutrition, not getting the proper amount of sleep, weakness in the core, and not paying attention to pain. I hope you now know how critical injury prevention and treatment are to a runner’s performance.

"The glory of sport comes from dedication, determination and desire. Achieving success and personal glory in athletics has less to do with wins and losses than it does with learning how to prepare yourself so that at the end of the day, whether on the track or in the office, you know that there was nothing more you could have done to reach your ultimate goal." ~ Jackie Joyner-Kersee

Ultimately, your goal as a distance runner should be to stay injury-free. But more importantly, I hope as an athlete you have fun running…Isn’t this why we do this sport?

This article is for informational purposes only. RunWV does not provide medical advice, diagnosis or treatment. You should consult a physician before beginning any treatment.

Submitted by Coach McMillion (08/11/17)

Sources: WebMD, Scott Christensen (head track coach at Stillwater Area High School in Oak Park Heights, MN), Melinda J. Flegel (certified athletic trainer), and Dr. Jordan Metzel (sports medicine physician)