While many of us are gearing up to run Ottawa Race Weekend, it’s common to see an influx of running injuries at the clinic as runners increase their mileage.
We’ve all been there, that little tweak in the knee as finish your run, that ache in your heel that you ignore. You tell yourself it will go away on its own, but as your mileage increases the symptoms become more persistent.
There are 5 common running injuries that plague many runners at some point during their running career. In this guest blog, Dr. Joanna Taylor, a renowned Ottawa chiropractor, owner of Kinetic Edge, and co-owner of Recover RX, will go through how to recognize, prevent, and treat them before they become a chronic condition.
5 Common Running Injuries & How To Prevent Them
Runner’s knee: AKA Patellofemoral pain syndrome
Many runners come into our clinic complaining of pain around or behind the kneecap. One tell tale sign is pain while going down the stairs or pain when running downhill. Patellofemoral pain syndrome is typically caused by abnormal mechanics at the level of the hips including weak glute medius and inner quad muscle referred to as VMO. These muscles help to support the knee joint by insuring it tracks properly along the femoral groove. Think of the knee cap as running along a train track. When there is more tension pulling in one direction, it will slide off the track causing friction against other structures resulting in pain.
Poor foot mechanics may also contribute to patellofemoral pain. A foot that pronates, or flattens, too much can lead to misalignment of the lower extremities, knees and produce symptoms of patellofemoral pain. On the flip side, a foot that doesn’t pronate enough, or supinates, can also lead to problems due to poor shock absorption and pressure distribution which can result in more stress being placed on the knee.
Whether your knee pain is as a result of top down weakness or bottom up foot mechanics, proper assessment is key to appropriate treatment. Treatment often includes strengthening hip and quadriceps muscles and improving hamstring and hip mobility. Appropriate footwear and custom foot orthotics may also be of benefit in order to offload irritated structures, promote better alignment and mitigate gait pathologies that may be contributing to symptoms.
ITB syndrome
The IT Band is a thick band of connective tissue from the outside of the hip to the outside of the knee. ITB syndrome results when the band becomes inflamed, usually due to overuse. ITB syndrome is one of the common running injuries we see, characterized by pain on the outside of the knee joint, typically presenting 5 minutes into a run. Unlike more serious knee injuries, like a tear, ITB syndrome does not typically have any swelling or clicking. The underlying cause of ITB syndrome is usually weak glut and core muscles (these help to support the IT band), or repeated track or downhill running.
A good warm up, as well as addressing any underlying weakness in the core and glute muscles, are great places to start addressing the IT band. Bottom up foot mechanics can also be predisposing factors which can sometimes be addressed with orthotics (off the shelf vs. custom made) and proper footwear selection. If doing a lot of track work, runners should also be sure to change their direction of running. Deep tissue massage for the lateral quadriceps and hamstrings where the IT band fibres converge can also help to relieve discomfort.
Achilles Tendonitis
The Achilles is the common tendon which connects the 2 major calf muscles: the gastrocnemius (gastrocs) and the soleus. With running, the Achilles tendon can become thickened and develop scar tissue, making the tendon less flexible. Symptoms include a sharp pain anywhere along the tendon, but especially at the base of the tendon close to the heel, as well as limited ankle mobility. Some runners will develop a nodule, commonly referred to as a growth, in the Achilles tendon which is a thickening of the scar tissue. This is one of the common running injuries, and is often caused by tight and fatigued calf muscles, an increase in hill running or a long stride length. Runners who present with excessive rearfoot motion, either pronation or supination, may also be more susceptible to Achilles tendonitis.
In some instances, custom orthotics and footwear designed to control midfoot and rearfoot motion may be beneficial. Achilles tendonitis can be prevented by shortening your stride length, improving calf and ankle mobility and foam rolling the calf muscles. A detailed gait analysis could be useful with this condition to reveal the underlying cause of the Achilles pain.
Hamstring Tendonitis
High hamstring injuries are one of the common running injuries seen among long distance runners. They often go misdiagnosed, as the runner confuses it for a glute injury. High hamstring strain is characterized by deep glute pain as well as pain with acceleration (sprinting) while running. It is an inflammation of the common attachment site of the 3 hamstring heads. High hamstring injuries are especially prevalent in runners who suffer from lower back pain or sciatic nerve pain. A history of sciatic nerve pain or lower back injury can cause weakness in the hamstring muscles, resulting in changes to the running gait.
With high hamstring strains, lower back injuries should first be ruled out. A temporary pause from running might be necessary as you focus on cross training and improving strength in the gluts, hips and calfs. Deep tissue massage therapy to release tension in the hamstring as well as Shockwave therapy for high hamstring tendinitis can also be helpful for recovery.
Pain In The Arch: Plantar Fasciitis
This is one of the most common running injuries and is characterized by intense heel pain the first few steps upon waking or after sitting. Plantar fascia is the connective tissue that runs from the heel bone to the toes. It shares a common attachment site with the calf muscles in the heel bone. Tightness and tension in the calf muscles can lead to plantar fasciitis as it pulls on the common attachment site. Plantar fasciitis often occurs with an increase in running mileage or intensity. As a general rule, try not to increase your mileage more than 10% per week. Plantar fasciitis can be treated by releasing tension in the calf muscles as well as treating the attachment site of the heel. Research shows that shockwave therapy and custom orthotics can be effective treatment methods for plantar fasciitis.
If you are new to running, or suffer from persistent injuries, you might benefit from a professional gait analysis. A gait analysis can be helpful in identifying biomechanical abnormalities in the gait cycle. It can also provide you with valuable information on what areas to strengthen in order to avoid injuries. During the gait analysis, a professional will evaluate your running mechanics and assess for asymmetries and pronation patterns using specialized software. This assessment can provide valuable information on footwear recommendations and help guide your rehab. The Ottawa Orthotic Lab provides comprehensive biomechanical assessment and gait analysis and can help you determine if your symptoms are related to poor foot function, structure or biomechanics and whether or not you’re a good candidate for custom orthotics.
Additionally, if you think you might be suffering from one of these common running injuries, the team of experts at Kinetic Edge can help. Kinetic Edge offers sports physiotherapy for runners, including shockwave therapy, dry needling and active rehabilitation programs. Additionally, offering deep tissue massage therapy for athletes as well as Rolf method of structural integration, which helps to realign the fascia and correct imbalances related to running. Don’t suffer through your running injuries. Book an assessment with the professionals.