If you are a frequent runner, or just starting out, then you have probably experienced (or going to at some stage) a few different aches and pains whilst you have been out pounding the pavement and tracks.

Over the next series of 5 posts we will look at 5 common running injuries that we see in the clinic at Leading Physiotherapy and outline some useful ideas to help alleviate these issues.

1. RUNNER’S KNEE (PATELLOFEMORAL JOINT SYNDROME)

Patellofemoral Joint Syndrome (PFJS) is a common injury to the knee which can be caused by abnormal biomechanics of the hip, knee and foot, poor muscle activation patterns, as well as general overuse.

It is often described as vague pain which is poorly localised and felt mainly around or behind the kneecap with running, stair climbing and down hills.

HOW IS IT TREATED?

Initially, the main aim of treatment is to decrease the inflammation around the knee and take the load off. This doesn’t mean to completely stop moving, it just means that you need to reduce the amount of activity to a level which does not aggravate the pain for hours afterwards or into the next day.

The use of ice, taping techniques and anti inflammatory medications can also assist in reducing inflammation and pain initially.

The next step is to correct the biomechanics through stretching the tight structures, particularly the muscles on the outside of the thigh and strengthening the weak muscles, commonly the hip abductors (gluteus medius) and the muscles just above the knee (vastus medialis obliquus or VMO).

2. ITB FRICTION SYNDROME

ITB friction syndrome is a common condition that affects the outside of the knee and often causes pain, swelling, burning/friction sensations or compressive feelings when running.

It occurs when the Iliotibial Band (ITB), which runs along the outside of the thigh from the hip to the knee, and structures around it, become irritated.

Poor biomechanics of the hip, knee and foot are commonly at fault which increase the tension of the ITB and causes an increased amount of friction between it and the structures beneath.

HOW IS IT TREATED?

Pain management, reduction of inflammation and load reduction are 3 key areas to address immediately.

These can be achieved by icing the affected area, anti inflammatory medications and reducing the amount of running.

Your physiotherapist can then use a range of treatments including:

• Massage

• Dry needling

• Foam rolling

• Stretching

• Exercises that strengthen muscles to correct your biomechanics.

By releasing and stretching the gluteal, hip flexor and thigh muscles with prolonged stretching and foam rolling, the tension of the ITB can be reduced and allow you to run with a lot more freedom and less pain.

3. ACHILLES TENDINOSIS

Achilles Tendinosis is a condition that affects the tendon which joins your calf muscles to your heel bone.

The pain is felt either right down on the bone where the tendon joins, or about 3-5cm above it in the body of the tendon.

Pain and stiffness are the 2 main symptoms and it is very common to experience these first thing in the morning when you get out of bed and take your first steps.

Quite often achilles tendonitis become an issues when a runner either increases their milage, changes the intensity or type of workout, runs up more hills or changes footwear.

HOW IS IT TREATED?

Initial treatment may consist of the addition of a heel lift into your footwear to reduce the tension on the achilles tendon.

Ice, anti inflammatories and moderated activity may also assist.

Your physiotherapist can then prescribe a range of treatments such as:

• Dry needling

• Massage

• Taping

• Stretching

• Eccentric strengthening exercises to lengthen the calves and reduce the tension of the achilles tendon.

Be aware that continuing to push through the pain and ignore the symptoms can lead to more chronic issues such as degenerative tendinopathy which take considerably more time to recover from.

 4. SHIN SPLINTS

Shin splints are a painful condition which affect the lower part of your shin typically on the inside edge of the bone and are generally at their worst at the beginning of your run.

The Tibialis Posterior is the muscle which causes the pain and it is due to repeated stress and tension which causes inflammation.

Runners with shin splints often have recently increased their mileage and pace too quickly and not given ample time for their muscles to adapt.

People with poor leg biomechanics, i.e ‘the over-pronators’, stiff ankle joints and poor flexibility are also more susceptible to forming shin splints.

HOW IS IT TREATED?

Shin splints are certainly not a condition that should be neglected. They have the potential to, if left untreated, become a stress fracture of the tibia which can take months to recover from and undo all the hard work you just put in.

Load management and inflammation reduction are key and these can be achieved through:

• Ice*

• Anti inflammatories

• Stretching the calves

• Reducing time, frequency and pace of runs

• Seeing your physiotherapist.

Your physiotherapist will be able to assist in reducing the tension and strengthening targeted muscles to correct biomechanics with treatments and exercises.

* A useful method for icing shin splints is to fill a styrofoam cup with water and freeze it. Once frozen remove the first centimetre or so of the cup and then use this to massage the sore areas. Spend 10 minutes doing this every 2-3 hours.

5. PLANTAR FASCIITIS

Plantar Fasciitis is a common ailment that runners may experience and it is characterised by pain in the arch (plantar fascia) or inside of the heel, which can often linger around if left untreated.

It is caused by a combination of weak foot muscles, poor biomechanics of the above joints (ankle, knee, hip) and people often find that it is most painful first thing in the morning when getting out of bed.

Recently changing footwear or the amount, pace, type of running may also contribute to developing plantar fasciitis.

HOW IS IT TREATED?

Reducing the load on the foot, icing, anti inflammatories and physiotherapy are once again the starting point for treatment.

Once the pain is under control your physio will prescribe exercises that will help to strengthen the foot muscles, as well as correct any biomechanics of the ankle, knee or hip.

A graded return to running is beneficial as getting back into it too quickly will just flare things up again and set you back.  Taping methods may also be used to help provide support to the plantar fascia.

**A quick home exercise that may help is to use a hard ball (golf ball) and place it underneath the foot. Then, roll it around under the foot while applying firm pressure. Find all the sore spots!

If you experience any of the above issues we recommend that you seek the assistance of one of our physiotherapists, who will be able to use their expert knowledge and skills to treat and help you get back out and running.