Mind, Body & Spirit: How to Avoid Injury

Information and tips to help you avoid injury 

With the weather getting warmer and very little mud on the trails, it’s a perfect time to get out and start doing some running.  Unfortunately, most runners, and especially new runners, will have an injury at some point that will put them on the sidelines or possibly force them to go see their orthopedist.  Most of these injuries will involve the lower part of the leg, in particular the knee, shin and feet. Hip and back injuries can also occur occasionally.  Just what are the most common injuries I see from running, how are they treated …and what are some practical tips for avoiding them?

Here are the top five injuries that runners experience:  

Patella-femoral pain also known as “runners knee” or anterior knee pain. This problem will affect up to 30 percent of runners at some time. The pain is felt in the front of the knee in the area of the “knee cap”. Pain increases with activities such as going up and down stairs, getting up from a seated position, squatting and of course running. Often this occurs after a change in training methods, such as increased distance, frequency or intensity of running.  Fortunately, a combination of proper muscle strengthening – including the thigh, hip and core muscles – cross training and some rest, will usually resolve the problem.

Illiotibial band syndrome (ITBS). The ITB is a band of tissue that runs down the outside of the leg from the pelvis down to just below the knee.  This band can be quite tight and rub against bone and tissue an inch or two above the knee.  The pain can be very sharp, and usually will force the athlete to stop running. Running downhill can be especially painful.  The cause is often a sudden increase in training mileage, but muscle imbalance is also a major contributor.  Treatment will involve rest and a physical therapy program to strengthen the hip muscles and stretch the ITB.  Anti-inflammatory medication can also decrease the symptoms.

Achilles tendon injuries.  The Achilles tendon is the strongest tendon in the body. It attaches the calf muscles to the back of the heel bone. Despite this strength, it accounts for about 20 percent of running injuries.  The tendon can have several types of injuries including degeneration, inflammation, strain or even partial rupture of the tendon. The pain also can be in different locations along the tendon, from the calf muscle down to the heel.  Achilles problems usually result from putting too much stress on the area.  This can be from putting in too many miles, doing lots of hill runs or doing “speed work.”  The key to avoiding the problem is to gradually increase the workouts so the body can adapt.  Treatment includes rest, lots of ice, and therapy to stretch and strengthen both the tendon and the calf muscles. Interestingly, the movement towards “minimal shoes” or barefoot running has dramatically increased the number of runners with Achilles problems.

Shin Splints. This is a very generic term for pain at the front of the shin. This pain can come from a wide range of problems. It can be a problem with the bone itself, pain from the muscle, nerve pain or even circulatory problems. The bone problem includes stress fractures, which cause pain in one small area or inflammation of the lining of the bone, in which the pain will be much more diffuse.  The muscle problem can include inflammation of the tendons that attach to the muscles, or a build up of pressure within the muscle that occurs with exercise.  Shin pain is often triggered by an increase in running or change in running which simply overloads the muscle or bone around the shin area. A change in duration, frequency, intensity, shoe wear are just some of the potential triggers. Faulty biomechanics – the alignment of the legs and feet – should also be examined. Treatment depends on the cause and a careful exam is needed. Some causes of shin pain can be serious and therefore this pain should not be ignored.

Foot Pain. This is a very common complaint in runners. Common causes include stress fractures – especially in those trying to run in minimal shoes – plantar fasciitis, corns and blisters. Stress fractures tend to hurt during the run and pain increases as the run continues.  Stress fractures are often missed on plain x-rays, but once diagnosed usually take at least six weeks to heal.  Plantar fasciitis can hurt during the run, but also can cause pain first thing in the morning. The pain tends to be around the heel area.  Treatment of any foot pain depends on the cause, but again the key is to find out what triggered the pain, so it does not occur again.

When do you need to seek medical attention?
A medical professional should investigate any pain you experience if it lasts more than three weeks or it continues to increase with running.

Some tips for staying out of the doctor’s office

  • Start all runs at a comfortable pace and gradually increase the intensity during the course of the run. Make slow and gradual changes when increasing your runs
  • Ensure that you alternate your training days with some cross training
  • Try and run on varied terrain. Consider running on some of the great trails in the area
  • Wear appropriate shoe wear
  • Learn how to reduce the impact of running by using good running form. Check out this website for more information. 
  • Always listen to your body – do not ignore pain

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