Common Running Injuries …And When to Seek Medical Treatment!

Common Running InjuriesCommon Running Injuries

……And When to Seek Medical And When to Seek Medical Treatment!Treatment!

Types of Common InjuriesTypes of Common Injuries

Stress fracturesStress fractures

Hamstring strainHamstring strain

Iliotibial band syndromeIliotibial band syndrome

Patellofemoral syndromePatellofemoral syndrome

Shin splintsShin splints

Plantar fasciitisPlantar fasciitis

Achilles tendinitisAchilles tendinitis

Why Do These Injuries Occur?Why Do These Injuries Occur?

Progressing too quickly in mileage Progressing too quickly in mileage and speedand speed

Lack of regular stretchingLack of regular stretching

Not changing out running shoes Not changing out running shoes frequently enoughfrequently enough

Imbalance between opposing muscle Imbalance between opposing muscle groupsgroups

Stress fracturesStress fracturesWhat is it?What is it?

– An overuse injury An overuse injury – Occurs when muscles Occurs when muscles

become fatigued and become fatigued and are unable to absorb are unable to absorb added shock added shock

– Fatigued muscle Fatigued muscle transfers the overload transfers the overload of stress to the bone of stress to the bone causing a tiny crack causing a tiny crack

Stress FracturesStress Fractures

CausesCauses

– Result of increasing the amount or Result of increasing the amount or intensity of an activity too rapidlyintensity of an activity too rapidly

– The impact of an unfamiliar surface The impact of an unfamiliar surface – Improper equipment (shoes)Improper equipment (shoes)– Increased physical stress Increased physical stress – Women > menWomen > men

Stress FracturesStress FracturesSigns and SymptomsSigns and Symptoms

– Sharp pain in the Sharp pain in the weight-bearing bones of weight-bearing bones of the lower leg and foot the lower leg and foot while runningwhile running

– Mild swellingMild swelling– Tender to the touchTender to the touch


TreatmentTreatment

– Rest and iceRest and ice– Engage in a pain-free activity during the Engage in a pain-free activity during the

six to eight weeks it takes most stress six to eight weeks it takes most stress fractures to healfractures to heal

– Use of a bone stimulatorUse of a bone stimulator


PreventionPrevention– Slowly increase any new sports activity Slowly increase any new sports activity – Maintain a healthy diet, including Maintain a healthy diet, including

calciumcalcium– Do not wear old or worn running shoes Do not wear old or worn running shoes – If pain or swelling occurs, immediately If pain or swelling occurs, immediately

stop the activity and rest for a few days stop the activity and rest for a few days – If continued pain persists, see an If continued pain persists, see an

orthopedic surgeon orthopedic surgeon

Hamstring StrainHamstring StrainWhat is it?What is it?

– A tear in one of the A tear in one of the hamstrings muscles hamstrings muscles (semitendinosis, (semitendinosis, semimembrinosis and semimembrinosis and biceps femoris) biceps femoris)

– Can range from small Can range from small micro tears in the muscle micro tears in the muscle to a complete ruptureto a complete rupture

Hamstring StrainHamstring Strain

CausesCauses

– Frequently occur during sprintingFrequently occur during sprinting– Can occur during an isolated athletic Can occur during an isolated athletic

activity (acute) or result from persistent activity (acute) or result from persistent repetitive stress (chronic)repetitive stress (chronic)


Signs and SymptomsSigns and Symptoms

– Sudden sharp pain at the back of the leg Sudden sharp pain at the back of the leg – Muscles going into spasm Muscles going into spasm – Swelling and bruising Swelling and bruising – If the rupture is very bad you may feel a If the rupture is very bad you may feel a

gap in the muscle gap in the muscle


TreatmentTreatment

– Use a compression bandage or heat Use a compression bandage or heat retainer until you feel no pain retainer until you feel no pain

– Ice, compress, elevate, use crutches Ice, compress, elevate, use crutches – Physical therapyPhysical therapy– Surgery for complete ruptureSurgery for complete rupture

Hamstring StrainHamstring StrainPreventionPrevention

– Gradual conditioning Gradual conditioning program program

– Incorporate a proper Incorporate a proper warm-up and stretching warm-up and stretching session into your session into your conditioning program conditioning program and athletic competition and athletic competition

Iliotibial Band SyndromeIliotibial Band SyndromeWhat is it?What is it?– Condition characterized by Condition characterized by

pain localized over the pain localized over the lateral femoral epicondyle lateral femoral epicondyle that occurs during vigorous that occurs during vigorous walking, hiking or running walking, hiking or running

– Pain is usually relieved by Pain is usually relieved by rest and by walking with rest and by walking with the knee held in full the knee held in full extension extension

Iliotibial Band SyndromeIliotibial Band SyndromeCausesCauses– Overuse may cause shortening of the Overuse may cause shortening of the

ITB ITB – Knee goes from flexion to extension and Knee goes from flexion to extension and

excessive pressure from the ITB causes excessive pressure from the ITB causes friction over the lateral femoral friction over the lateral femoral epicondyle epicondyle

– This repeated motion produces This repeated motion produces inflammation of the underlying inflammation of the underlying structures and causes pain structures and causes pain

Iliotibial Band SyndromeIliotibial Band SyndromeSigns and SymptomsSigns and Symptoms– Pain localized over lateral femoral Pain localized over lateral femoral

condyle condyle – Discomfort initially relieved by rest Discomfort initially relieved by rest – Pain may radiate toward the lateral joint Pain may radiate toward the lateral joint

line and proximal tibia line and proximal tibia – Worse if a person continues to run Worse if a person continues to run – No symptoms of internal derangement No symptoms of internal derangement – Symptoms frequently develop during Symptoms frequently develop during

downhill running downhill running

Iliotibial Band SyndromeIliotibial Band Syndrome

TreatmentTreatment– Rest Rest – Ice Ice – Stretching of iliotibial band Stretching of iliotibial band – Anti-inflammatory medicine Anti-inflammatory medicine – Orthotics (if appropriate) Orthotics (if appropriate) – Ultrasound Ultrasound – Local steroid injection Local steroid injection

Iliotibial Band SyndromeIliotibial Band SyndromePreventionPrevention

– Adequate stretching Adequate stretching of the IT bandof the IT band

– Massage therapyMassage therapy– Avoid hills, shorten Avoid hills, shorten

stride, and run on stride, and run on alternate sides of alternate sides of roadroad

Patellofemoral SyndromePatellofemoral Syndrome

What is it?What is it?– The term used to describe pain on and The term used to describe pain on and

around the patella or kneecap around the patella or kneecap – Common cause is damage to the surface Common cause is damage to the surface

underneath the kneecap underneath the kneecap – Can be started by an impact or it Can be started by an impact or it

gradually comes on from rubbing on the gradually comes on from rubbing on the bone underneath bone underneath

Patellofemoral SyndromePatellofemoral Syndrome

CausesCauses

– Malalignment of the patella on the Malalignment of the patella on the femur femur

– Weakness of the quadriceps muscles Weakness of the quadriceps muscles – Tight structures on the lateral aspect of Tight structures on the lateral aspect of

the knee the knee – Pronation of the feetPronation of the feet

Patellofemoral SyndromePatellofemoral SyndromeSigns and SymptomsSigns and Symptoms– Pain may be felt behind or around the Pain may be felt behind or around the

knee cap knee cap – Grinding noises may be heard during Grinding noises may be heard during

bending or straightening the leg bending or straightening the leg – The knee may feel like it gives-way The knee may feel like it gives-way

without any particular reason without any particular reason – Pain occurs while going up and down Pain occurs while going up and down

stairs, as well as after prolonged periods stairs, as well as after prolonged periods of sittingof sitting

Patellofemoral SyndromePatellofemoral SyndromeTreatment/PreventionTreatment/Prevention

– Anti-inflammatoriesAnti-inflammatories– Ice/heatIce/heat– Strengthening the Strengthening the

quadricepsquadriceps– Stretching the Stretching the

hamstringshamstrings

Shin SplintsShin SplintsWhat is it?What is it?

– The name given to The name given to pain at the front of pain at the front of the lower leg the lower leg

– Also known as medial Also known as medial tibial stress syndrometibial stress syndrome

– Inflammation of the Inflammation of the periostium of the tibia periostium of the tibia (sheath surrounding (sheath surrounding the bone)the bone)

Shin SplintsShin Splints

CausesCauses

– Weak anterior leg muscles Weak anterior leg muscles – Hard running surface Hard running surface – Recent increase in running speed or Recent increase in running speed or

distance distance – Unsupportive shoes Unsupportive shoes – Fallen arches Fallen arches


Signs and SymptomsSigns and Symptoms– Tenderness over the inside of the shin Tenderness over the inside of the shin – Lower leg painLower leg pain– Occasional swelling Occasional swelling – Lumps and bumps over the boneLumps and bumps over the bone– Pain when the toes or foot are bent Pain when the toes or foot are bent

downwardsdownwards– A redness over the inside of the shinA redness over the inside of the shin


TreatmentTreatment

– Ice 10-15 minutes for 2-3x per day Ice 10-15 minutes for 2-3x per day – Anti-inflammatory drugs Anti-inflammatory drugs – Active rest - participate in activity that Active rest - participate in activity that

does not stress the affected area but does not stress the affected area but maintains cardiovascular fitness, such maintains cardiovascular fitness, such as bike ridingas bike riding


PreventionPrevention– Keep anterior leg muscles strongKeep anterior leg muscles strong– Correct pronation with the use of Correct pronation with the use of

custom made or over-the-counter custom made or over-the-counter orthoticsorthotics

– Run on a forgiving surface, such as a Run on a forgiving surface, such as a treadmilltreadmill

– Increase speed and distance graduallyIncrease speed and distance gradually

Achilles TendinitisAchilles TendinitisWhat is it?What is it?

– Inflammation of the Inflammation of the large tendon at the large tendon at the back of the ankle back of the ankle which connects the which connects the large calf muscles large calf muscles (gastrocnemius and (gastrocnemius and soleus) to the heel soleus) to the heel bone (calcaneus) bone (calcaneus)

Achilles TendinitisAchilles Tendinitis

CausesCauses– Sudden increases in runningSudden increases in running– Excessive hill running or a sudden Excessive hill running or a sudden

addition of hills and speed work addition of hills and speed work – Excessive tightness of the posterior leg Excessive tightness of the posterior leg

muscles muscles – Soles of shoes too stiff, or excessive Soles of shoes too stiff, or excessive

heel cushioning of the heelheel cushioning of the heel


Signs and SymptomsSigns and Symptoms– Pain in the tendon during exercisePain in the tendon during exercise– Swelling over the Achilles tendonSwelling over the Achilles tendon– Redness over the skin Redness over the skin – You can sometimes feel a creaking when You can sometimes feel a creaking when

you press your fingers into the tendon you press your fingers into the tendon and move the footand move the foot


TreatmentTreatment– Anti-inflammatoriesAnti-inflammatories– Begin ice after exercise Begin ice after exercise – Use small heel lift in shoe Use small heel lift in shoe – Rest for two weeks after the aggravating Rest for two weeks after the aggravating

activity activity – Begin stretching regimen for Begin stretching regimen for

gastrocnemius and soleus complex gastrocnemius and soleus complex

Achilles TendinitisAchilles TendinitisPreventionPrevention

– Regularly stretch Regularly stretch the posterior calf the posterior calf musclesmuscles

– Increase training Increase training graduallygradually

– Correct pronationCorrect pronation

Plantar FasciitisPlantar FasciitisWhat is it?What is it?

– Inflammation of the Inflammation of the strong tissue that strong tissue that runs along the runs along the bottom of the foot bottom of the foot and connects the and connects the heel to the base of heel to the base of the toes the toes

Plantar FasciitisPlantar Fasciitis

CausesCauses– Weak foot muscles Weak foot muscles – Tight Achilles tendon Tight Achilles tendon – Flat or high arches Flat or high arches – Poor shoe support Poor shoe support – Sudden increase in activity level Sudden increase in activity level – Sudden increase in weight Sudden increase in weight

Plantar FasciitisPlantar Fasciitis

Signs and SymptomsSigns and Symptoms– Heel pain that is worse in the morning Heel pain that is worse in the morning

with the first few steps with the first few steps – Since it is difficult to rest the foot, this Since it is difficult to rest the foot, this

problem gradually worsens problem gradually worsens – Pain may start interfering with activities Pain may start interfering with activities

of daily living of daily living

Plantar FasciitisPlantar FasciitisTreatmentTreatment– Temporary decrease in training Temporary decrease in training – Gentle Stretching of calf muscles Gentle Stretching of calf muscles – Check shoes for flexion stability Check shoes for flexion stability – Perform 20 seconds of "toe curls" to strengthen Perform 20 seconds of "toe curls" to strengthen

your foot muscles. your foot muscles. – Ice 15 minutes, 10 minute break x 2 each day Ice 15 minutes, 10 minute break x 2 each day – Consider rolling your foot over frozen water Consider rolling your foot over frozen water

bottle bottle – Do not go barefoot in your house or at any Do not go barefoot in your house or at any

other time for 6 weeks. other time for 6 weeks. – Try over the counter orthotics Try over the counter orthotics

Plantar FasciitisPlantar FasciitisPreventionPrevention

– Wear orthotics to Wear orthotics to prevent excess prevent excess pronation and pronation and prevent lengthening prevent lengthening of the plantar fascia of the plantar fascia and continued and continued tearing of the fascia tearing of the fascia

– Stretch regularlyStretch regularly

SummarySummary

Most mild conditions will resolve with Most mild conditions will resolve with conservative treatment as outlined conservative treatment as outlined aboveabove

For conditions that persist or are For conditions that persist or are refractory to conservative treatment, refractory to conservative treatment, evaluation and treatment by a evaluation and treatment by a professional may be warrantedprofessional may be warranted

Questions?Questions?

Common Running Injuries …And When to Seek Medical Treatment!

Documents

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shin slide

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symptoms pain

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