running injuries

Runners are a hardy bunch. They spend hour upon hour pounding the pavement, building their stamina and cardiovascular systems to take on grueling races that can range from 10 kilometers in triathlons to 42 kilometers in full marathons.

Most runners, either competitive or casual, will experience some kind of running injuries in their career. Be it their ankles, knees, hips or back… And most runners will attest to the brutal toll the sport can take on one’s body.

A recent study analysed epidemiological data, and found the most common musculoskeletal running injuries. These were;

  • medial tibial stress syndrome (shin splints)
  • Achilles tendinopathy
  • plantar fasciitis
  • patellofemoral pain syndrome

These niggling problems are a major cause of lost training time, and cause you unnecessary pain. The worst part is that they are usually treatable by physical therapists, and often preventable.


Medial Tibial Stress Syndrome

shin splints

Medial tibial stress syndrome or ‘shin splints’ is commonly described as aching or sharp burning pains that usually occur on the front of the shin. What happens in the shin muscles can develop small microtears, or even start to separate from the bone. If the athlete leaves this and pushes through, the shin splints can even create stress fractures in the tibia.

Shin splints often occur when increasing the volume or intensity of a running program. The lower limb muscles often aren’t developed enough to cope with the sudden increase in workload, and leads to the annoying pains you might be feeling. Commonly this is combined with irregular or hard running surfaces, poor footwear, tight muscles and poor flexibility.

What can you do to help?

Resting your body and gradually increasing the volume of running gives your lower limb musculature enough time to strengthen and adapt. Running on softer surfaces like grass, and ensuring your shoes haven’t seen too much mileage will also help.

Other modalities such as ice will help decrease the inflammation, and self-massage to reduce muscular tension in the area.

What can we do?

Targeted rehabilitation plans aimed at loosening the tight muscles causing the stress, as well as strengthening these muscles at the same time to help them cope with the increased workloads. Ensuring the joints in your feet and knees can move easily and without restrictions to reduce the impact that continuous stress will have on the muscles.


Achilles Tendinopathy

achilles tendinopathyAchilles tendinopathies describe overuse running injuries where pain develops just above the heel, at the point where the Achilles tendon attaches the calf muscles to the heel bone. Commonly over time the tendon becomes unable to withstand loading, and leads to complaints of sharp lancing heel pains or swelling and aching in the region.

Factors that may play major roles in developing this include unsupportive footwear, sharp increases in workout intensity, tight or weak calves, poor ankle flexibility or stiff ankle joints. Usually a combination of these factors will predispose individuals to creating this problem, and keep it coming back.


What can you do to help?

Resting and stretching help unload the tissue initially to give the tissues a chance to heal. Ice helps reduce the inflammation, and decrease some soreness and tenderness.

Maintaining your ankle and knee flexibility helps reduce the stress on the Achilles tendon, and gradually increasing your workout intensity.

What can we do?

A trial of conservative treatment is often presented as an alterative to more invasive options like corticosteroid injections. This may include soft tissue work, mobilisations, adjustments, shockwave therapy and targeted rehabilitation, and usually results in positive outcomes. Research has found that shockwave therapy may help in tendinopathies by inducing a controlled amount of stress to an area, and restart the healing process.


Plantar Fasciitis

Plantar FasciitisPlantar fasciitis is an inflammation of the tissues that span from the heels to the toes. It is an extremely common condition affecting the general population and high-volume runners. Plantar fasciitis can typically feel like a bruise, ache or burning pain on the bottom of the foot and heel.

The plantar fascia plays an integral role in the Windlass effect, which ensures the foot becomes a stable structure during walking. It is associated with numerous risk factors including limited ankle mobility, muscle dysfunctions, prolonged standing, obesity, altered foot biomechanics, high or low arches, and running.

What can you do?

Rest, ice and stretching appear again, and will play a major role in controlling and eliminating the current episode of pain. Self-massaging the bottom of the foot with a frozen water bottle will help ice and stretch at the same time. Ensuring your shoes haven’t been worn in to the ground also helps with supporting your arches and gives you an excuse to go for a shopping trip.

What can we do?

Normalising the biomechanics of the foot and lower limb will help the efficiency of the Windlass effect, and reduce the amount of strain and stress on the area. This can be achieved by loosening abnormally tight structures, strengthening weakened musculature and addressing the problems that come with excessively high or low arches.

Like Achilles tendinopathies, research has shown that high-energy shockwave therapy is a viable and effective treatment. This helps control inflammation, scar tissue and adhesions in the fascia.


Patellofemoral Pain Syndrome

Patellofemoral pain syndromePatellofemoral pain syndrome or ‘PFPS’ for short is an umbrella term describing most anterior knee pains, either at the front or underneath the knee cap. It is an extremely common musculoskeletal condition, especially amongst younger populations. However for such a common condition, the causes of PFPS are numerous including tight hamstrings, gastrocnemius or iliotibial bands (ITB), overpronation in ankle joints, or even poor patellar tracking.

What can you do?

Again icing the area reduces inflammation, pain and soreness. Self massage and stretching to target problems muscles like your hamstrings, calves and ITB can reduce the tension on pain-sensitive structures. Often altering your running pattern by shortening your stride length, or changing the surfaces you are running can help.

What can we do?

As so many things can cause PFPS, finding out which few are the key components to your angry knee is vital. Then developing a strategic management plan designed to strengthen the knee and improve your biomechanics. Research has found that a combined approach of strengthening, stretching and taping together has significantly better outcomes than modalities in isolation.

Despite these injuries, running has extraordinary health benefits and is associated with a decreased risk of cardiovascular diseases, like heart attacks or high blood pressure. Just make sure you take care of your body to prevent these bothersome musculoskeletal injuries, and enjoy your time out there! Running is a time-proven method to keeping healthy, fit and active!


Please call your Chiropractor at AHS on 9948 2826 or visit our clinic at 9/470 Sydney Rd in Balgowlah servicing the surrounding suburbs of Allambie, Balgowlah Heights, Seaforth, Fairlight and Manly on the Northern Beaches.


Chang, K., Chen, S., Chen, W., Tu, Y., Chien, K. 2012, ‘Comparative Effectiveness of Focused Shock Wave Therapy of Different Intensity Levels and Radial Shock Wave Therapy for Treating Plantar Fasciitis: A Systematic Review and Network Meta-Analysis’, Archives of Physical Medicine and Rehabilitation, vol.93, no.7, pp.1259-1268

de vera Barredo, R., Menna, D., Farris, J.W. 2007, ‘An evaluation of research evidence for selected physical therapy interventions for plantar fasciitis’, Journal of Physical Therapy Science, vol.19, no.1, pp.41-56

Lopes, A.D., Junior, L.C.H., Yeung, S.S. & Costa, L.O.P. 2012, ‘What are the Main Running-Related Musculoskeletal Injuries? A Systematic Review’, Sports Medicine, vol.42, no.10, pp.891-905

Mason, M., Keays, S.L. & Newcombe, P.A. 2011, ‘The effect of Taping, Quadriceps Strengthening and Stretching Prescribed Separately or Combined on Patellofemoral Pain’, Physiotherapy Research International, vol.16, no.2, pp.109.119