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Common Running Injuries and How To Prevent Them

January 21, 2013

Living in Central Florida is great for runners. The weather is nice, the terrain is flat and there are many beautiful parks and neighborhoods to explore. However, that being said, running on a regular basis year-round can have its drawbacks. Much of what I see in my practice is secondary to overuse and poor running technique. Even for runners, cross training and taking time off is important for preventing injuries. Equally important is a pair of good running shoes that are replaced on a regular basis.

Runner's knee
What is it: An aching pain around or behind the kneecap that can occur while running, climbing stairs or performing squatting and lunging exercises. Runner's knee is commonly associated with overuse, malalignment of the knees (e.g., being knock-kneed) or foot issues, such as flat feet (overpronation).
What to do for it: Ease up on exercises or long distances that cause the pain. Ice your knee after activities and use over-the-counter anti-inflammatories, such as Aleve or Motrin. You can also perform physical therapy exercises that will strengthen the hip and glute muscles. If malaligment or overpronation is the issue, tape the kneecap or wear orthotics in your shoes.
Warning signs: pain that is there in the morning when you wake up and will not improve as the day goes on. Pain that is worsening over time despite rest and other conservative treatments.
Prevention: run on a variety of surfaces. Increase your mileage or time running slowly. Keep and maintain a healthy weight. Listen to your body!

Iliotibial (IT) band syndrome
What is it: inflammation and pain on the outside of the knee when running caused by friction and rubbing of a tight IT band where it inserts below the knee. May cause a sharp or burning type pain that can even go down the leg.
What to do for it: rest and compression wrapping of the knee; ice and or foam roller massage and over the counter anti-inflammatories; Patellar taping and physical therapy exercises to stretch the IT band and ultrasound treatment.
Warning signs: pain that is there in the morning when you wake up and will not improve as the day goes on. Pain that is worsening over time despite rest and other conservative treatments.
Prevention: avoid running downhill. Run on a variety of surfaces. Increase your mileage or time running slowly. Keep and maintain a healthy weight. Listen to your body!

Trochanteric bursitis
What is it:
lateral (outside) hip pain when running caused by inflammation of the trochanteric bursa from overuse or by a fall directly onto the outside of the hip. This pain may also go down the outside of the leg. Lying on the side of the hip is also painful.
What to do for it: rest; Ice packs to the hip; over the counter anti-inflammatories and physical therapy exercises to stretch and strengthen the muscles around the hip joint. If severe, a corticosteroid injection.
Warning signs: pain that is constant and worsening over time despite rest and antiiflammatories. Pain at rest when not lying on the hip.
Prevention: avoid running up and down hills. Stretch the hip well after every run. Increase your mileage or time running slowly. Keep and maintain a healthy weight. Listen to your body!

Shin splints
What is it: also called medial tibial stress syndrome (MTSS), shin splints are a dull, achy pain on the inside front of the lower legs (usually both) associated with running caused by muscular imbalance. Usually occurs with overtraining, going up to quickly in mileage or time, or an abrupt change in running surface . Runners are usually able to “run through the pain.”
What to do for it: rest, icing the shins, taking over the counter antiiflammatories and shin compression sleeves. Arch supports for the shoes. Physical therapy exercises to stretch and strengthen the muscles of the lower leg.
Warning signs: not being able to “run through the pain.” A very acute onset of pain (over a week or few days) usually just on one side. One spot on the shin that hurts worse than any other place. These could be signs of a stress fracture which is much more serious and needs medical attention.
Prevention: wear good supportive shoes. Dynamic warm up stretches before a run. Running on softer surfaces (trails, grass rather than concrete). Scale back on mileage and time increases in your long runs. Keep and maintain a healthy weight. Listen to your body!

Plantar fasciitis
What is it: inflammation of the bottom of the foot between the ball of the foot and the heel usually worse first thing in the morning as you get out of bed. The symptoms resolve over the course of the day. Can be caused by overuse from running but can be exacerbated by wearing high heels on a daily basis. Women with high arches are also at greater risk of developing plantar fasciitis.
What to do for it: rest, ice massage by rolling a frozen water bottle under your foot, over the counter anti-inflammatories and physical therapy exercises that stretch and strengthen the muscles and tendons around the foot. Heel cup orthotics or night splints may also be another option. For extremely painful and longstanding cases, immobilization or steroid injections may be necessary.
Warning signs: foot pain that does not improve throughout the day or pain that is worsening over time with rest and other conservative measures.
Prevention: appropriately fitting shoes with additional orthotic support if necessary. Stretching the foot on a daily basis multiple times per day. Scale back on mileage and time increases in your long runs. Keep and maintain a healthy weight. Listen to your body!

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