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Common Running Injuries

Whether you’ve been clocking up the miles in preparation for the Bristol half marathon ( well done if you have ever completed the distance ) or simply pounding the pathways of Durdham Downs for the sheer fun of it, your weekly mileage may be beginning to take its toll on the body.

Aches and pains caused by a heavy running schedule are extremely common and at Queen Charlotte Street Osteopaths we work with amateur and professional athletes of all ages and abilities to help them overcome injury and to keep them doing the sports they love.

Our approach looks first at the specific tissue injury to optimize healing using appropriate soft tissue massage, ultrasound and dynamic stretching and mobilisation techniques.

But we don’t just want to just patch you up!

Finding out why the injury occurred is vital to prevent it happening again. That’s why we’ll always include treatment and rehab advice to target the factors that have led you to be in pain in the first place – whether it’s addressing foot mechanics, knee function, muscular imbalances in the legs and hips or inflexibility through the pelvic and lower back regions, we’ll make sure you leave us in the best shape possible.

It often helps to know as much as you can about these injuries, to ensure that you’re doing everything you can to help yourself. Similarly, if you’re keen to avoid these common running injuries it’s a good idea to be familiar with the signs and symptoms (and at the bottom of this article we’ve included our top tips on how to stay injury free!).

So below is a brief synopsis of the more common running injuries that you need to be on the lookout for……..starting from the feet and working our way up!

Plantar Fasciitis

Plantar fasciitis is a painful condition of the base of the foot and refers to the inflammation of the band of thick fibrous tissue (the plantar fascia) that runs from the heel bone to the ball of the foot. Pain is usually felt on the inside of the heel but can also be spread along the inside arch of the foot.

The plantar fascia contributes to maintaining the inside arch of the foot and is also one of the major transmitters of weight across the foot as you run. In runners, it is thought that the repetitive running action causes the damage to this fibrous band of tissue.

The pain of plantar fasciitis is typically at its worst early in the morning after sleep. At that time, the arch tissue is tight and simple movements stretch the contracted tissue. As you begin to loosen the foot, the pain usually subsides, but often returns with weight-bearing activities such as running.

Achilles Tendonitis

Achilles tendonitis is an inflammation of the large tendon in the back of the ankle and is a common injury that tends to occur in recreational runners who have stepped up their training intensity. Achilles tendonitis can also lead to small tears within the tendon, which make it susceptible to rupture.
The 2 muscles of the calf (gastocnemius and soleus to be precise) generate much of the forward propulsion (or spring!) required for running and they act on the ankle and foot via the Achilles tendon, which, as a consequence, is placed under a great deal of stress during those long runs!
The main symptoms of Achilles tendonitis are pain and swelling over the back of the heel (the point where the tendon inserts onto the heel bone). The tendon itself can also feel tender or bruised. The pain is usually at its worst following periods of inactivity (e.g. walking first thing in the morning) when the Achilles tendon has had a chance to tighten up.

Shin splints

Commonly seen in runners who rapidly increase the intensity of their workouts, ‘shin splints’ is a generic term for pain over the front of the shin bone (or the tibia bone if we’re going to get technical!).

The pain from ‘shin splints’ can be due to either problems of the muscles, the bone, or the attachment of the muscle to the bone. However, most people use the term ‘shin splints’ when referring to the irritation caused by the overuse of the tendons attaching the lower leg muscles to the shin bone. This leads to a diffuse ache on the inside of the shin bone that usually subsides once you’re up and running but comes back with a vengeance the following morning! Swelling and localized tenderness complete the symptom picture.

Iliotibial band syndrome (ITBS) – AKA ‘runners knee’

The iliotibial band is a thick band of fibrous tissue that runs from the hip to the knee and – in tandem with the large muscles of the thigh and buttock area – plays an important role in the stability of both these joints.

ITBS occurs as a result of friction between the iliotibial band and the bony prominence of the thigh bone at the level of the knee joint, leading to pain and tenderness on the outside of the knee with movement. The pain is aggravated by running (especially downhill) and eases with rest.

Hip bursitis

Hip bursitis is a common problem for runners and causes pain over the outside of the upper thigh. A bursa is a fluid-filled sac within the body that allows smooth motion between two uneven surfaces.

For example, in the hip, a bursa rests between the bony prominence over the outside of the hip (the greater trochanter) and the firm tendon that passes over this bone. When the bursal sac becomes inflamed (bursitis), each time the tendon has to move over the bone (i.e. with every step taken!), pain results.

TOP TIPS for avoiding injury:

1) Don’t over-train!
Sounds obvious, but most injuries are caused this way. Increase your distances and/or training intensity gradually. Always build in rest days to your training schedule.
2) Treat your feet with the respect they deserve. 
Always wear properly fitted running shoes (specialist stores can provide advice to ensure you are using running shoes suited to your feet) and replace them if they become worn out. Good Bristol running shops are MOTI and Easy Runner.
3) Avoid concrete if you can.
Try to find grass or dirt trails to run on – concrete is extremely harsh on joints, which have to absorb the shock passing through your legs as you run.
4) Stretch those muscles.
A regular stretching routine, especially after a run, can go a long way toward injury prevention.
5) Keep yourself hydrated.

Being properly hydrated before, during and after your run is vital for optimising performance but also has a key role to play in injury prevention by enabling your muscles (and other body tissues) to function properly.

And Finally –

6) Wear red.

Athletes dressed in red are statistically more likely to win events than athletes wearing another colour! (or so says Nature magazine)

If you find you have any of the symptoms described come and see us and GET THEM TREATED EARLY !

Happy running! –Tim Chapman, Osteopath

Bristol Osteopaths