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Common Running Injuries
Written by: James Gill BOst GOsC 6039. Registered Osteopath, Founder & Clinic Director
Medically Reviewed: Yannick Gracia, M.Ost GOsC 10475. Registered Lead Osteopath
Casual jogger? Park runner? Marathon buster?
Whatever your level, getting out under your own steam is incredibly rewarding. Running is currently enjoying a surge in popularity, with as many as 10.5 million of us Brits getting the kilometres under our belt – and applications for the London Marathon at an all-time high.
Running doesn’t just offer the social buzz of meeting a mate or raising money for charity – it’s also packed with health benefits: lowering blood pressure, strengthening bones, improving memory and boosting mood. But, as with any sport, there’s always the risk of aches, pains and injuries. If these aren’t properly managed, they can quickly lead to time off training.
With all ongoing injuries, your first port of call should be a qualified healthcare professional. At our clinics, we’ve pulled together the most common running complaints, plus how we treat and prevent them using Osteopathy, Chiropractic, Physiotherapy and advanced Shockwave Therapy (radial and focused).
Achilles tendon pain (tendinopathy)
- Makes up around 10% of all running related injuries.
- The achilles is one of the strongest tendons in the body. It transmits all of the force generated in your legs in the toe off phase of running, which can be up to three times your bodyweight.
Symptoms
- Pain around the back of the heel.
- Creaking’ sensation when walking.
- Morning stiffness in the ankle
Causes
- All the tendons in your body are made up of fibres called collagen. These are structured like ropes, with a regular pattern linking the fibres together and making them very strong.
- However with repeated strain on these fibres without adequate recovery time, the ‘ropes’ can become overstrained making them tangled and weak, leading to microdamage and prolonged sensitivity.
Treatments & Prevention:
- Ice Therapy.
- Reduce training load to tolerable levels.
- Eccentric calf strengthening exercises.
- Chiropractors, Osteopaths and Physiotherapists - improving ankle mobility, easing stiffness, correcting biomechanics, and building calf strength.
- Shockwave Therapy – Radial or Focused Shockwave Therapy may be recommended for persistent Achilles pain. Focused shockwave penetrates deeper into the tendon, stimulating cellular repair for stubborn cases.
Factors leading to tendon damage:
- Repetitive overuse: Increasing your training load or not allowing adequate recovery time between runs can lead to progressive degeneration within the tendon as it doesn’t get adequate time for healing.
- Decreased flexibility of the ankle and joints in the foot.
- Tight or weak gastrocnemius/soleus (Calf) muscles.
- Lack of varied training.
Treatments and prevention
- Ice: Apply to the area for 10 minutes, let the area reheat naturally, then repeat four times.
- Reduce training, only exercise as much as your body can tolerate without pain. This may mean stopping running and walking instead.
- Eccentric training. Research suggests eccentric exercise (placing load on tendons and muscles when they are lengthening) is the most effective method to re-align the disorganised collagen fibre ‘ropes’ and make them stronger.
- Osteopathy, Chiropractic or MSK Physiotherapy can help increase the mobility in your ankle and speed up the healing process.
Runners Knee (Patello-femoral syndrome)
- Contributes to about 20% of running related pain.
- Irritation to the cartilage and structures underneath the kneecap (patella).
Symptoms
- Pain around the kneecap, either deep underneath or either side of the kneecap.
- Stiffness to bend the leg
- Dull pain at rest which can be sharp during running.
Causes
- Repetitive Overuse: not allowing adequate rest between training.
- Imbalance in the muscles of the thigh, altering the movement of the kneecap.
- Ligament injuries.
- Hip muscle weakness.
- Restricted ankle movement.
Treatments and prevention
- Relative rest. Decrease your running, only go as far as you can without pain.
- Ice: Apply to the area for 10 minutes, let the area reheat naturally, then repeat four times.
- Gentle loading of your hip muscles, using cross training like cycling and bodyweight exercises like side steps and squats.
- Osteopathy, Chiropractic or MSK Physiotherapy can help ease stiffness in the knee and encourage mobility in the hip, knee and ankle.
Plantar Fasciitis
- Irritation to the thick band of fibrous tissue which runs from the toes to the heel bone.
- A very common running injury (10%) and also affects non-runners.
Symptoms
- ‘Bruised’ feeling on the underneath of the foot, tender to touch.
- Worse when weight-bearing, even when walking.
- Sore first few steps in the morning.
- When running, may be sore on the first few steps before fading, then returning when at rest afterwards.
Causes
- The plantar fascia is made up of fibres called collagen. These are structured like ropes, with a regular pattern linking the fibres together and making them very strong. However with repeated overstrain on these fibres, the ‘ropes’ can become overstrained making them tangled and weak, leading to microdamage and prolonged sensitivity.
Factors leading to plantar fascia micro damage:
- Overtraining, not allowing adequate rest between runs creates prolonged micro trauma to the fibres tissue that makes up the plantar fascia.
- Decreased ankle range of movement.
- Achilles tendon problems.
Treatments and prevention
- Wearing supportive footwear, this can ease the sensitivity in the fascia, so avoid flat shoes and high heels.
- Stretches focusing on the calf and plantar fascia.
- Massage and Osteopathy, Chiropractic or MSK Physiotherapy
- Ice: Place a water bottle half filled in the freezer, then roll your foot on top of it to help stretch and ease pain in the foot.
Shin Splints
- Commonly affects runners that are new to the sport.
- Affects more women than men.
- Known as ‘Medial Tibial Stress Syndrome’
Symptoms
- Pain around the inside of the lower leg.
- Sharp when running.
Causes
- It is the result of irritation to the insertion of calf muscles into the lower leg bone (the tibia) and relative loss of local bone density in the area. This can occur when the muscles and bones are not used to the area loading in this way and have not adapted to the extra strain required for running.
Treatments and prevention
- Shortening stride length. This can help to reduce the strain passing to the tibia.
- Strengthen calf muscles to help support the transference of load through the area.
- Reducing mileage, intensity and frequency of running to let the area recover fully.
Stress fractures
- A small fracture in a weight bearing bone, which is caused by repeated micro trauma to bone when not enough time is allowed to rest and repair between exercise.
- Commonly affects the tibia and the bones in the feet (metatarsals).
- More common in women.
Symptoms
- Deep ache which is localised to the affected bone area.
- Tender to touch, with lingering pain.
- Progressive pain when active that persists at rest and night.
Causes
- Bones strengthen like muscles and tendons do with exercise, but take a longer time to do so. If not enough time is allowed for resting between training, or due to lack of nutrition, stress fractures can form.
- Excessive stride length can place greater impact loading force on the bones in the leg.
Treatments and prevention
- Unlike other injuries, it is crucial to treat potential stress fractures with respect and seek advice from a healthcare professional. Any attempt to run through the injury could lead to further damage and longer time off running.
- Rest. Unfortunately the only solution is letting your bone heal.
- Cross training: non weight-bearing exercises such as swimming can help to maintain muscle strength, and progression to a static bike after a few weeks of recovery.
Patellar Tendinopathy
- One of the strongest tendons in your body, your patellar tendon (running from the kneecap to the top of the lower leg bone the tibia) increases the efficiency and power of your thigh muscles moving the knee.
- Relatively common in runners, affecting about 5%, with more men than women getting symptoms.
Symptoms
- Pain and stiffness below the kneecap.
- Aggravated by descending stairs or running down hill.
- Often improves at the start of exercise, returning at rest.
- Doesn’t normally affect above or to the side of the kneecap.
Causes
- All the tendons in your body are made up of fibres called collagen. These rope-like structures called collagen, that have a regular pattern linking the fibres together and making them very strong. However with repeated strain on these fibres, the ‘ropes’ can become overstrained making them tangled and weakened, leading to microdamage and recurrent sensitivity.
Factors leading to patellar tendinopathy:
- Restricted quadriceps and hamstring flexibility.
- Reduced quadriceps strength can place greater demand on the tendon in the leg strike phase of gait.
Treatments and prevention
- Ice: Apply to the area for 10 minutes, let the area reheat naturally, then repeat four times.
- Osteopathy, Chiropractic or MSK Physiotherapy: can help to relieve stiffness and mobilise the joint in the leg.
- Stretches: Focusing on the quadriceps and hamstrings.
- Eccentric training. As with achilles tendinopathy, loading the tendon to strengthen and realign the fibres has been shown to be the most effective means of managing patella tendinopathy. Decline squats are best at taking the calf off stretch and focus on loading the patellar tendon.
- Return to training as early as you feel able, but be guided by your sensitivity. Try and walk/run as far as you can until the pain is aggravated.
Hamstring Tendinopathy
- The hamstrings are a group of muscles attaching from the back of the knee into the top of your pelvis, just under the buttock and are involved in bending both the knee and the hip.
- They are most commonly injured where they attach into the pelvis, leaving you with literally a pain in the backside.
Symptoms
- Pain and stiffness around the back of the hip and buttock.
- Aggravated by walking, running and bending forwards.
- If a muscular tear, there can be swelling and bruising in the area.
Causes
- All the tendons in your body are made up of fibres called collagen. These are structured like ropes, with a regular pattern linking the fibres together and making them very strong.
- However with repeated strain on these fibres, the ‘ropes’ can become overstrained making them tangled and weak, leading to microdamage and prolonged sensitivity.
Factors leading to hamstring tendinopathy
- Decreased hip muscle flexibility: both in the hamstrings, quadriceps and glutei.
- Restricted low back range of movement: increasing the demands placed on the flexibility of the hamstrings.
- Overtraining, which doesn’t allow the muscle and tendon to recover from efforts sustained during training.
Treatments and prevention
- Eccentric training, as with patellar and achilles tendinopathy, is the most effective treatment to aid recovery of the tendon to straighten and strengthen the fibres.
- Gentle stretching
- Ice: Apply to the area for 10 minutes, let the area re-heat naturally, then repeat four times.
- Osteopathy, Chiropractic or MSK Physiotherapy: to help mobilise the joints in the hip and improve range of movement.
The Ultimate Guide to Osteopathy, Physiotherapy and Chiropractic
Would you like to know whats the difference Osteopathy, Physiotherapy and Chiropractic?
Chiropractic, Physiotherapy & Osteopathy guide
Know what the difference is? Read bodytonic clinic’s Guide for Osteopathy, Physiotherapy and Chiropractic
Physiotherapy
Offers rehabilitation to all major systems of the body, including neurological, respiratory and cardio-vascular
Osteopathy
Primarily treats the musculoskeletal system of the body
Chiropractic
Deals primarily with spinal manipulation
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