Dubai, UAE- Injuries are common amongst runners & triathletes due to the repetitive loading combined with high impact to muscles & joints making them more susceptible to certain injuries. Here are some the most frequent running related injuries I encounter as Physiotherapist at UPANDRUNNING.
Iliotibial band syndrome (ITBS)
ITBS is pain experienced on the outside of your knee caused by frictioning of the ITB near it’s attachment to the bone. This painful condition can stop runners in their tracks and experience severe, sharp pain when bending the knee. This is caused by too much tension being placed on the ITB often due to poor running biomechanics when the hip rotates in and the arch of the foot will drop causing the knee to deviate inwards.
Immediate treatment includes rest from running, ice application to the painful site for 20 minutes and non-steroidal anti-inflammatory medicines. The long-term treatment often includes stretching the tight muscular structures and strengthening the core and gluteal muscles to ensure good lower limb alignment when running. In some cases, new footwear or orthotics are advised following a physio led run assessment.
The Achilles is a strong fibrous tendon that connects the calf muscles to the heel. With repetitive running or an increase in training load micro-tearing of the tendon can occur. If left untreated, over time this could result in a rupture. Runners with this condition initially complain of pain in the tendon when running but this can evolve to continuous pain, especially worse first thing in the morning.
Early diagnosis is essential and treatment initially consists of rest from running, ice application and release of any tight muscular structures. Placement of heel wedges in the shoe can help to offload the tendon in the early stages and a loading exercise programme for the Achilles starting with static holds progressing to heel drop exercises.
Read more on stress fractures HERE
The pain experienced with plantar fasciitis is often described to me by patients as like ‘walking on glass’. The pain is located at the attachment of the fascia onto the heel and/or along the arch of your foot. The plantar fascia is a thick band of fibrous tissue that connects your heel bone to your toes and acts as a support for the arch of your foot and a shock absorber. When this thick band becomes overstretched due to too much pressure on your feet or an increase in loading activities it can become inflamed. Plantar fasciitis is not always attributed to one specific event but can develop over time with repetitive running.
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Immediate treatment consists of ice, a nice way is to roll a frozen water bottle under the arch of your foot, non-steroidal anti-inflammatory drugs and taping to offload the plantar fascia. Once a diagnosis has been made the Physiotherapist will instruct on exercises to stretch tight muscles and strengthen other areas of weakness to improve overall biomechanics. In some cases, we may recommend shockwave therapy which is available with Sports medicine specialist Dr Stephan Jacolino
Anterior knee pain
Anterior knee pain also referred to as patella femoral joint pain, is an umbrella term referring to pain experienced at the front of the knee. This could be the result of inflammation to the quadriceps or patella tendon which attach the large thigh muscles to the kneecap and shin. Pain when running at the front of the knee may also be caused due to an imbalance of a tight iliotibial band at the outside of the knee and weakness of the inner quadriceps muscle causing what refer to as maltracking of the patella.
Ice, anti-inflammatories and rest are the immediate treatment modalities for anterior knee pain to allow the acute inflammation and pain to settle. An assessment by a Physiotherapist will then be able to diagnose the exact cause of the pain and instruct on the correct treatment plan to ensure a return to pain-free running. Taping techniques which the physiotherapist can instruct you on may also be part of the treatment plan.
Running can result in forces applied to the bone and joints in excess of 6-8 times an athlete’s body weight. Over extended periods of time, and without proper recovery between workouts, these forces can result in stress fractures, most commonly in the pelvis, leg, and foot.
The precipitating factors of stress fractures are multiple but typically result from repetitive high impact activities, such as running, especially when there has been a sudden increase in intensity, duration, or frequency of workouts without proper recovery.
Training errors such as poor running mechanics, improper shoe selection, and muscular fatigue can also predispose a runner to fractures. Each of these factors can cause excessive mechanical forces to be concentrated at key locations in the lower extremities, thereby exceeding the stress-bearing capacity of the bone. Other factors can also predispose an athlete to stress fractures. Hormonal and nutritional imbalances are thought to be responsible for the high rate of these injuries found in female athletes. Read more on stress fractures HERE
Once diagnosed, the first step in treating stress fractures is to identify the cause. Hormonal imbalances and nutritional issues must be resolved. Training and equipment errors should also be addressed. Shoe selection, training conditions, workout intensity and volume should all be analyzed by an experienced trainer or coach! Most cases are directly related to overuse and poor recovery. In these cases, strict avoidance of impact activity, dialling back your workout schedule, and using non-impact cross-training exercises to maintain fitness is usually successful in allowing the body to heal & recover.
Calf strains are amongst the most common, but strains also can be seen in the large hamstrings or quadriceps muscles. Strains can occur with a sudden acceleration of speed or with repetitive striding over a long run. A muscle strain can occur anywhere within the muscle and is described as a sharp pain especially on movement.
Like with most acute injuries ice is the go-too initial treatment strategy for the first 48 hours and rest to reduce any further injury such as a full rupture. With milder strains, there may be no bruising or swelling, unlike moderate to severe strains. In this case compression such as tubigrip and elevation is important to reduce the swelling. With muscle strains the tissues need to heal and so evidence now discourages the use of anti-inflammatory medicines as this reduces the inflammatory cells which are needed for acute tissue repair. Ice and paracetamol are recommended for pain relief following muscle strains.
With all the above-described injuries it is Important to seek a medical professional to get an accurate diagnosis of the condition to ensure correct treatment plan and advice on returning to running. At UPANDRUNNING we have a great team of Sports medicine specialist Doctors who can provide you with a correct diagnosis and treatment plan to get you back running & racing as soon as possible.
Injury worry? To book an appointment with a Sports medicine specialist, Click HERE or use the Live Chat/Message feature on the web or Call 04 518 5400
Read Rebecca Monk’s next article – ‘Runners- 7 tips to prevent injury‘