If you’re a runner, the joy of running really is unlike anything else. But, the repetition of movements involved means training volume can quickly become hard on the body. We’ve all heard the stories or maybe even experienced some of them personally—the niggles that drag out over months or years or, the full-blown injuries that keep a runner’s shoes tucked away in the cupboard for weeks or months at a time.
Whether you’re running for the sheer pleasure, or training for a race, you’re bound to face a few aches and pains along the way. Injury prevention isn’t about the absence of pain… it’s about having the right response when pain does comes along. Knowing how to manage your training volume and when to seek treatment will help you the kinds of running injuries that could pull you off the pavement for an extended period of time.
Runners knee is a bit of a generic term for pain around the patella or kneecap. The condition got this name because runners are most commonly afflicted with this pain. It is often described as a dull, aching pain but the term runner’s knee is really used to describe any one of several conditions that cause pain around the patella. These conditions include anterior knee pain syndrome, patellofemoral pain syndrome, and chondromalacia patella, to name a few.
Runner’s knee is more common in women than in men, particularly middle age women – we think this might relate to differences in pelvic anatomy between men and women. This sort of pain is fairly prone to becoming persistent so seek treatment and advice early if you experience twinges of knee pain when you begin your run, but then seem fine throughout, only to flare up post-run or when you are sitting for long periods of time.
Achilles tendinitis is an ‘overuse injury’ of the Achilles tendon, which is the band of tissue that connects the calf muscles at the back of the lower leg to your heel bone. ‘Over use’ is a relative term that must always consider use, relative to condition of the area so ‘over-use’ doesn’t always imply a need to do less. In fact, doing more might be part of the solution.
Overload related irritation of the Achilles tendon often presents with pain in the calf and heel of the foot. If you’ve got a dull pain in your heel during and after a run, but simple home remedies like gentle stretching and ice aren’t resolving it, get a professional to take a look at the injury. We can help you manage the acute issue and work out better load management and training progression strategies.
Your hamstrings make up the majority of the muscles at the back of the thighs, but it is important to remember that they’re not the only thing back there.
Hamstring pain and injury can be caused by lack of flexibility or strength, or much like the Achilles, it can often be a matter of too much too soon. Hamstring strains are common and they can take a long time to heal. Re-injury is common also, particularly if the return to running is rushed or if you haven’t had treatment or rehabilitation when required for the initial injury.
If you struggle with aching or tightness in the back of your legs when you run, try to ease it with a slower pace or a shorter stride before building back up. If you hear a pop or a snap, or there’s a visible bruise, there is clearly a tissue injury and you should probably have it seen to by your osteo.
Although hamstring issues can be recurrent, if you take all the usual steps but continue to struggle, or your pain or cramping extends below the knee, you could have a nerve irritation. The sciatic nerve runs through the back of the thigh with the hamstrings and it’s another common cause of thigh pain. If you’re not sure what’s going on, again you should probably have it seen to by your osteo. We’ll be able to work out what is going on and get you on track to recovery.
This is another common injury that involves micro tears and inflammation in the support ligaments of the foot. This often results in pain that might feel like a dull ache or bruise along your arch or heel. Seek treatment if you’re having sharp foot pain when you first get out of bed, walking around after sitting for a bit or at the very start of a run. It may disappear after that, but again this is an area that can be prone to persistent pain so you’ll want to get on top of it as soon as possible.
Much like the hamstrings in the thigh – the plantar fascia is not the only thing in the foot so if it’s failing to resolve, it’s definitely worth considering the nerves in the area. What starts out as a plantar fascia injury, common continues as a chronic nerve sensitivity.
Iliotibial Band (ITB) Syndrome
Your IT band connects your hip to knee and shin, it’s a really thick and strong band of fascia that probably gets blamed for a heap more problems than it actually creates. Nonetheless, when the ITB gets irritated, runners (and often cyclists) experience pain around the outside of the knee. There’s a lot of overlap with Runner’s knee so the two are often confused.
ITB or lateral knee pain, that isn’t traumatic, is more often than not a load management issue, so again – work with a therapist or trainer who can help you maximise your efficiency and manage your training volume and progression.
This usually presents as an achy pain down your shins that comes on with activity and when persistent, can also be referred to as “medial tibial stress syndrome”. This sort of issue can range from being quite minor and short lived to quite severe, when not managed well. The initial injury is often a mild soft tissue inflammation but when recurrent this inflammatory process can effect the neighbouring bone, resulting in bony stress. When unmanaged, this bony stress can progress to a stress fracture so, see your osteopath before it gets to that.
With shin splints you can typically walk and even jump without pain, but there’s a tightness and ache that develops around your shin when you run and it’s usually more pronounced when there’s any incline. A dull ache may then persist after your training and it may be tender to touch and/or walk. If the pain persists into the night, you’re likely to be in bone stress territory and you should definitely get it seen to.
Often considered the most serious of all the typical running injuries, unrelenting bony stress can sometimes accumulate and degrade bone to produce a structural fracture. The repetitive impact of running means loading volume accumulates easily and sometimes this leads to shin, heal and foot fractures. Stress fractures are different to acute fractures that happens in a single traumatic event, stress fractures accumulate gradually over time, which means they can be prevented. Like any progressive injury, it’s important to listen to your pain and respond early—an osteopath can help make sure you’re on track to prevent or recover from stress fractures caused by running.
If you’re a runner with pain, or would like to be a runner but pain is stopping you – book an appointment with one of our osteopaths. If you’re not sure we can help you, we’ll happily do a 15 minute assessment free of charge so we can be sure we’re not wasting your time or money.
Want to improve your running form and minimise your risk of injury?
Most running injuries relate to load and capacity mismatches… too hard, too fast, too soon. But many sporting injuries also relate to poor running mechanics, and it can be difficult to determine exactly what is going wrong without the correct tools. Diagnosing an injury can largely happen on a treatment table but working out why it happened requires more careful observation and this is where video technology becomes invaluable. Slow motion video capture allows for an accurate analysis of your running gait and, when paired with targeted interventions and load management advice, can help you avoid many injuries caused by running.
Our analysis involves watching you walk and run on a treadmill – we’ll even record it so that we can play it back for you later, frame by frame. So, you’ll be able to see exactly where gains can be made. We’ll look at the way you move to identify any inefficient movement patterns which are usually caused by poor muscular flexibility and stiff joints but can also be caused by structural problems like torn ligaments, arthritic joints or anatomical abnormalities.
If we find anything in your running mechanics, we’ll examine you further to accurately diagnose and/or rule out any structural variation or pathology. Then we’ll get down to the business of improving your running gait. To improve your gait we can use hands on treatment, targeted exercises, advice on running shoes to suit your individual running style and even advice on orthotics that might limit the impact of any altered running mechanics.