Common Running Injuries - How To Treat & Avoid

Pain relief for common running injuries begins with a little knowledge.

Runners often suffer niggling injuries over time. Many are not debilitating and with some determination won't prevent you from skipping your after work jog. However, if you can identify more accurately what the issue may be you are in a better position to self treat it so it doesn't get worse.

Here is a brief overview of some of the more common running injuries, associated pains and initial steps you can take to self treat. Remember that if the pain is severe or persists for more than 3-5 days it is advisable to seek a professional assessment and treatment from your Physiotherapist.

You will notice a pattern of repeated recommendations that every runner should be aware of so I list them here for easy reference:

PRICE - Self treating minor injuries using ice therapy 

Biomechanical assessment - A Lower Limb Assessment - How & Why?

Shoe Insole Support - Orthotics and suitable support structured shoes 

The common runners injuries:

Shin splints

Shin splints is a result of inflammation at the attachment of certain muscles and tendons covering the shinbone and is typically the injury that nearly every runner will suffer at some point.

Tibialis Posterior Shin Splints
This condition feels like a dull pain on the inside of your shin and typically the pain will increase the more you run on it. Excessive stress on this point could cause further complications on the shin bone such as a potential stress fracture. If you reach the point of moderate to severe sharp/achy pain which comes on while running, does not settle and leaves you in pain after, then it's time to visit the Physiotherapist.

Tibialis Anterior Shin Splints
The pain is on the outside of your shin this time and usually caused by your foot biomechanics which may include tight calf muscles. Beginner runners are more prone to this injury because their muscles are not used to the strain of the movement.

In both cases, it's best to reduce your running distances. You would be wise to ice (see guidelines) the area every day if you can. Avoid stretching an inflamed muscle. Remember, if the pain is not settling within 3-5 days, best to get the injury assessed by a Chartered Physiotherapist which would include a full foot and lower limb assessment
to establish whether foot orthotics may help with recovery and reduce your risk of suffering shin splints in the future.

Runner’s knee

(A.K.A patellofemoral pain syndrome or ‘runners knee’) is a vague pain behind or around the kneecap and usually caused by repetitive pounding on hard surfaces, strain of downhill running and potential muscle imbalances. If you are a runner's knee sufferer consider choosing flatter and softer running surfaces. If the pain is intense cut back on your distances temporarily and allow inflammation and irritation to reduce naturally. If its not settling within an acceptable period of time, we would recommend having a Chartered Physiotherapy assessment to determine if there are biomechanical or muscle imbalance issues preventing recovery.

Achilles tendonopathy

The Achilles tendon complex are the tissues that connect the heel to lower leg muscles and due to many factors can become inflamed – known as a ‘reactive tendon’. Issues such as incorrect footwear, over tight calf muscles, or increasing your running distance too quickly can all cause Achilles tendonopathy.

If the problem is allowed to persist without correct treatment, the tendon may start to ‘break down’ as a result of degenerative changes which can occur over time. Once this occurs, the rehabilitation period is longer and usually requires a prolonged period off running while the integrity of the tendon is restored.

To help prevent Achilles tendonopathy it's good practise to warm up slowly and perform calf muscle stretches AFTER your run. Wearing shoes with suitable arch support is also very important. If you're suffering pain in this area then you can do yourself a favour by following the PRICE protocol - see 'Heat & Cold Therapy' section on our website.
However if the pain is not settling please don’t delay seeking Chartered Physiotherapy treatment as this will only delay recovery and make the problem more difficult to treat.

Patellar tendonopathy

Patellar tendonopathy is another overuse injury resulting in tiny tears in the patellar tendon (the tendon that connects the kneecap to the shinbone). Over-pronation, over-training, and too many hill drills are likely causes of this painful condition.

When pain starts, reduce the training load and try some home cold therapy. If the pain persists get the injury fully assessed by a Chartered Physiotherapist. When fit and healthy again make sure you continue to work on some strength training as good preventative measures.

Plantar fasciosis

This tissue on the bottom of your foot can cause pain due to inflammation, irritation, or tearing. Pain will start out as stiffness and or stabbing pains in the arch of the foot. Again, excessive pounding on hard surfaces and not wearing the correct footwear are the usual causes.

Rest is the best solution for this one but also the toughest - how do you rest the bottom of your foot while still needing to move about? Just take it easy for a while. Avoid cushion-less shoes (sandals) and if you haven't already go and get a foot and limb assessment done and a decent pair of orthotics and or suitable arch support shoes. In some cases, local treatment to the injured structures by a Chartered Physiotherapist may also be required.

Iliotibial band syndrome

Usually a condition suffered by longer distance runners, ITBS causes pain on the outside of the knee.

The Iliotibial band is a thick tendon like structure that stretches from the pelvic bone down the outside of the thigh to the knee area. It is an important muscle for hip rotation and knee stabilisation and again can cause pain through inflammation caused by excessive distance running, too much strain on the knee from downhill running or incorrect footwear to suit your biomechanics.

Due to the ITB being such a thick structure there is debate as to whether stretching it has any positive effect. Strength training of the gluteal muscles as well as a lower limb biomechanic assessment is often required.

Stress fracture

If the repeated pressure and strain on the leg bones become too great to handle a stress fracture can occur - tiny cracks in the bone.
This one will certainly have you resting off your feet for a while and will definitely require some Physiotherapy to get you back to full form and function.

Ankle sprain

The caveat to seeking softer off road surfaces is often the increased risk of uneven surfaces such as tree roots, rocks or slippery wet patches. An unfortunate landing leading to an in or outward rolling of the ankle can stretch a ligament to the point of pain and injury.

Rest, offload and icing is the first thing you should do. Gentle strengthening exercises should be included eventually to help you regain full foot strength. When you want to get out running on it again the first time it may be a good idea to use an ankle brace or tape it to avoid a repeat of the strain. Your Physiotherapist can advise on best techniques for your condition.

Pulled muscles

The more common muscle pulls for runners are the calf and hamstring. Forgetting to warm up and over use can cause the fibres and tendons to overstretch and cause a pulled muscle.

Return to the PRICE protocol once again and ensure proper warm ups and cool down routines are added to every future run.

If you haven't yet committed to that post run - cool down stretch routine chances are you're not familiar with a good range of stretching positions.

Here's a useful resource over at at coolrunning.com - 12 runners stretch positions

Happy running!

by Simon.