Common Running Injuries

In my last article I reviewed some of the recent research that may indicate that typical aerobic exercise such as distance running may be more problematic than just your common office visit injuries many doctors see in their offices. As a recap, the evidence seems to show a relationship that generic "aerobics" may actually cause a reduction in the lungs residual capacity. Which may eventually lead to serious cardiac conditions?

However, I also realize that convincing a die hard running enthusiast to change their chosen activity is about as likely to happen as me winning the lottery three times in a row. So, this article will focus on those individuals who may experience the unfortunate but all too common injuries associated with running.

Running injuries are commonly attributed to faulty biomechanics and errors in training methods. Faulty training techniques such as rapid build up in training mileage, running on worn-out shoes, or ignoring our body's message and continuing to run through pain.

Although these important aspects of a running program should be addressed, runners should also consider the cumulative effects that thousands of repetitive motions have on their bodies. Even with good biomechanics and excellent training, runners are always exposed to a considerable amount of cumulative trauma.

Injuries to soft tissue (ligaments, muscles, blood vessels, fascia and nerves) result in inflammation and swelling of the tissue. The body responds to this inflammation by laying down scar tissue (cross fibers on the tissue) in an attempt to stabilize the affected area. This scar tissue restricts motion, reduces circulation, inhibits nerve function, and causes ongoing friction and pressure, and usually results in the production of more cross fibers and adhesions.

Effective treatment of soft tissue injuries requires an alteration in tissue structure by breaking up cross-fiber adhesions and restoring normal function to the soft tissue. This process substantially decreases healing time, treats the root cause of the injury and improves running performance.

In my practice, working with a broad range of soft tissue injuries, I have discovered that Active Release Technique (ART) combined with Cold Laser Therapy to be the most effective method for breaking the restrictions formed during running.

I will now describe some of the various soft tissue injuries that I frequently encounter.

Achilles Tendonitis

Achilles Tendonitis is an inflammation of the Achilles tendon. Initial symptoms are a dull, aching pain in the tendon after running.

Improper treatment of Achilles Tendonitis can lead to major problems. Cross friction massage often irritates this area, extending the period of recovery rather than reducing.

Problems often arise in the treatment of this syndrome when a therapist uses heavy direct pressure and tension over the Achilles tendon.

When standing, the Achilles tendon is constantly under pressure resulting in limited blood circulation to the tissue. Inflammation of the Achilles tendon is often caused by the tissue just in front of it. After treatment, Cold Laser therapy along with stretching, strengthening, and balance work continue to be key components in correcting the problem.

Plantar Fasciitis

The plantar fascia is a band of fibers which runs from the heel bone to the base of the toes. Plantar Fasciitis occurs when these tissues are irritated and inflamed. Bone spurs often form on the heel if this condition is not correctly treated.

Biomechanical or training flaws such as over-pronation, flat feet, a tight Achilles tendon, a high arched foot, or a sudden increase in training mileage often cause Plantar Fasciitis.

Conventional therapy (without surgery) usually requires six weeks to three months. With ART, we have seen resolution of this problem in 90% of cases with just one to three treatments.

Runners Knee / Iliotibial Band Syndrome

Runner's knee is the term given to diffuse pain around the knee, under the knee cap, often with stiffness under the knee joint. It is often related to too rapid increase in mileage, tight hamstrings, and imbalances between the hamstring and quadriceps. Other physical structures that are often involved include: The knee capsule, Meniscus, Collateral ligaments and Patellar tendon.

Even the posterior knee is often involved especially a muscle called the Popliteus. This muscle is involved with rotary stability of the knee.

The Psoas muscle is also often involved with knee problems.

The Psoas muscle is a primary hip flexor. When the Psoas muscle becomes shortened, fibrotic and weakened, the quadriceps has to exert more force to make the hip flex. This is a major (and often undiagnosed) cause of unresolved knee pain.

Shin Splints

Shin splints are commonly caused by muscle imbalances, pronation, insufficient shock absorption (worn out shoes) and toe running.

Anterior shin splints are often caused by a muscle called the Tibialis Anterior. Fibers from the Tibialis Anterior tear away from the periosteal (outer surface of the bone) attachment surface. As these fibers heal, they often become fibrotic, making it difficult for the muscle to lengthen normally.

This makes the probability of future shin splints likely.

The same holds true for posterior shin splints where the Tibialis Posterior is often involved.

Running Tips:

Warm up Cool down - Always warm up and cool down. Start out walking or very slow running; give your core a chance to warm up. This will help prevent injuries.

After the run remember to cool down this will also help prevent numerous injuries.

Extreme Pain No Gain - Never try to run through extreme pain. If your body is giving you a signal to stop because of an injury, listen to it.

Train As You Race - Your training should mimic your race. You can only expect to do as well on your race as you did during your training. The closer the training conditions are compared to the race course the better off you'll be.

No Last Minute Dietary Changes - On race day never, I mean never eat or drink anything new.

The 10% Rule - Increase your weekly mileage by no more than 10 percent per week, any more than this and you set your self up for injuries.

Big Meals and Running Don't Mix - Do not run after you eat, it's best to wait 2 hours.

Recovery Takes Time - For every mile you race, allow yourself one day post race before returning to hard training. On the other hand don't stop all activity, keep moving but don't over do it.

Keep Talking - You should be able to talk to the person beside you when you are running. If you can't you are pushing too hard. (Of course this harps on the point I made in the last article.)

Carbo Loading Works - It is a good idea to increase your carbohydrates a few days before a race. This is especially true for long distance races.

Protect Yourself - Always run facing traffic, never run in unlit areas.

Restore your Fuel - Take a combination of protein, simple carbohydrates and electrolytes within 30 - 60 minutes after your runs, the best way to do this is a shake. You will see a big difference in your recovery times.

Cross Train - Cross training will prevent injuries, increase performance and give your muscles a rest while still keeping you active.

Old Running Shoes are Dead Shoes - Running shoes have a life expectancy of about 400 to 500 miles, after that you are setting your self up for injuries.

It's OK To Take a Day Off - At any age you need one day off for every hard day of training.

Increasing your VO2 Max - An effective pace for VO2 max is about 20 seconds faster per mile than your 5-K pace.

Also, re-read my last article regarding the Supra-Anaerobic training method. This will also increase your VO2 Max.

Efficiency Counts - The more effective you're running biomechanics the less energy you will expend. Concentrate on your running form: Stay upright with your head, shoulders and hips are lined up over the feet. Your chest should be forward and up. Try not to land too heavy on the heels or too far on the toes.

Your arm action will vary from athlete to athlete, but they should swing naturally from the shoulders, relax. Do not allow your arms to cross the midline of your body. In stead of lengthening your stride develop a faster turnover, stride length will come.

Develop a Strong Core - The core of your body is where you derive your power; having a strong core will greatly improve your running. Training long hours does not guarantee that you have strong core stability.

In fact, spending too much time working within one plane of motion often creates core imbalances.

Add these imbalances to stresses caused by poor posture during running, and you have an equation for the development of a weak core. Try adding a free weight routine which incorporates unilateral lifts to your program. If you need specific help on this I can recommend referrals to some very qualified personal trainers.

Remember To Stretch - Our bodies are designed to work in balance- every time a group of muscles contracts to perform an action, an opposing group of muscles (antagonist) must relax and lengthen.

These muscles can only contract as forcefully as their antagonist can relax. For example, the quadriceps muscle can contract more quickly if the hamstring muscle group is able to easily lengthen and relax.

Without the lengthening of the antagonist, we lose our power, balance, and endurance; we become susceptible to injury, and waste our energy.