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RUNNING
Running is a very common activity whether it be for pleasure, general fitness, weight loss or competitions, clocking up the mileage on the road can have consequences if runner’s do not take care of their bodies adequately. Injuries are usually a result of overuse rather than trauma and generally involve the lower limbs.
THE 5 MOST COMMON RUNNING INJURIES ARE:
- Achilles tendonitis - see Foot pain
- Chondromalacia - Runner's Knee see knee pain
- Iliotibial band (ITB) syndrome
- Plantar Fasciitis - see Foot pain
- Shinsplints
Iliotibial band Syndrome
 ITB syndrome is described as pain and inflammation on the outside of the knee, where the iliotibial band (a muscle on the outside of the thigh) becomes tendinous, and results in a friction syndrome by rubbing against the femur (thigh bone) as it runs alongside the knee joint.
SYMPTOMS
- Initially, a dull ache 1-2 kilometres into a run, with pain remaining for the duration of the run.
- The pain disappears soon after stopping running
- Later there may be a severe sharp pain which prevents running
- The pain is worse on running downhills, or on cambered surfaces
- Pain may be present when walking up or downstairs
- There will be local tenderness and inflammation on the outside of the knee
CAUSES
- Anything that causes the leg to bend inwards thereby stretching the ITB against the femur
- Overpronation (feet rotate too far inward on impact)
- Tightness of the ITB muscle due to lack of stretching
- Incorrect or worn shoes
- Excessive hill running (especially downhills) and running on cambered surfaces
- Overtraining
TREATMENT
- Stop running, especially in the case of severe pain. If pain is mild, then reduce training load and intensity, and avoid downhill running and running on cambered surfaces.
- 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 knee (for 10minutes every 2 hours) in order to reduce the inflammation
- Self-massage, using arnica oil or an anti-inflammatory gel, to the muscle only (along the outside of the thigh). Do not massage the side of the knee where you feel the pain, as this will only aggravate the friction syndrome stretching of the ITB.
- Stretch the ITB well - see our page on stretching
- Return to running gradually
- Full recovery is usually between three to six weeks
- If pain is not improving within 1-2 weeks, then visit your physiotherapist for an accurate assessment of your problem and treatment to reduce the inflammation and to identify and minimise the cause of the problem.
- You may need to visit a podiatrist/orthotists for orthotics depending on what is causing the problem.
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Shinsplints
 Shinsplints is defined as inflammation of the muscle attachments and interosseous 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 to a stress fracture, where there is pain during weight bearing activities (walking, stair-climbing)
CAUSES
- Inflexible calf muscles and tight Achilles tendons which places more stress on to the muscle attachments
- Overpronation (feet rotate too far inward on impact) excessive running on hard surfaces, such as concrete pavements
- Incorrect or worn shoes
- 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
- Stop running, especially in the case of severe pain. If pain is mild, then reduce training load and intensity, and avoid downhill running and running on cambered surfaces
- 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 shin area - for 10 minutes every 2 hours, in order to reduce the inflammation
- Self-massage, using arnica oil or an anti-inflammatory gel, to the muscle only (along the inside of the shin).
- Stretching of the calf muscles see stretching
- Return to running gradually
- Full recovery is usually between two to four weeks
- See your physiotherapist if injury does not respond to treatment above within 1-2 weeks.
- Orthopaedic surgeon - if injury does not respond to physiotherapy treatment, a bone scan, diagnostic ultrasound or X-ray may be necessary to check for a stress fracture.
PREVENTION
- Stretching of the calf muscles.
- Strengthening of foot and calf muscles.
- Correct shoes, specifically motion-control shoes and orthotics to correct overpronation
- Always apply ice after running
- Run on soft surfaces
- Avoid overstriding, which places more stress onto the shins
- Gradual progression of training programme
- Incorporate rest into training programme
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