Whether or not you’re a big-time runner, landing yourself on the injured list is never fun. But when you’re training for a big race, it’s almost inevitable: increased mileage means more stress on the body, which can often translate to some unwanted ailments. The most common running injuries can be avoided with a few smart decisions before and after you hit the road.
Don’t worry, sister. We’ve got you covered. We checked in with Tyler Nightingale, DPT, a physical therapist at Bespoke Treatments in New York City, to get the lowdown on the most common running injuries and what you can do to treat them so you can be in tip-top shape come time to toe the starting line.
1. Runner’s Knee
What is it: Another name for patellofemoral pain syndrome, runner’s knee typically presents itself as pain in the kneecap. Essentially an irritation of the cartilage on the underside of the patella, it’s caused when your knee isn’t moving properly on the correct track. “It tends to occur when you have biomechanic factors that overload the knee during repetitive movements like running,” says Nightingale.
When you feel it: Going down stairs, sitting with a lot of knee bend or after a long run
Who’s most at risk: People with poor eccentric (or, the lowering phase) control of foot pronation, hip adduction and internal rotation, all of which will allow your knee to turn inwards with each weighted step
Running modifications: Try to reduce your mileage and downhills while pain is most severe, suggests Nightingale. “If pain presents in the first 5 minutes and does not decrease, that’s a big sign that you should stop running.”
Rehabilitation tips: The best thing you can do is to address your overall foot and hip strength (Nightingale suggests exercises including a heel raise with ball at ankles and a stability lunge into march) and consider upping your stride frequency. A cadence increase to 178 to 182 can decrease joint loading around 30 percent per step, according to University of Wisconsin research.
2. Achilles Tendinopathy
What is it: More commonly referred to as Achilles tendinitis, this is an irritation of the tendon due to an overloading of the tissue. In the early stages it presents as inflammation and swelling, but long term can result in weakening of the tendon structures, commonly referred to as a tendinopathy. It occurs frequently with runners, mostly due to rapid increases in mileage and poor running mechanics.
When you feel it: Going down stairs or walking uphill
Who’s most at risk: Those new to running or people with poor calf strength
Running modifications: “If pain is moderate to severe, stop running,” says Nightingale. “While it may be possible to run through mild tendinitis, you risk worsening it without adequate rest and rehabilitation.”
Rehabilitation tips: Stretching can help to reduce symptoms: Nightingale suggests exercises including eccentric heel drops and calf stretches.
3. Iliotibial (IT) Band Syndrome
One of the most common running injuries that occurs on the outside of your knee, IT band syndrome occurs due to irritation of fat pads on the side of your femur (leg bone) near the knee. This tends to happen to runners who increase their mileage too rapidly in the presence of poor single leg stability and an inability to elongate necessary hip muscles with each stride. This increases tension through the IT band, and it eventually leads to inflammation and pain.
When you feel it: Walking downhill, 10 minutes into a run, reducing with a walking break
Who’s most at risk: People with poor eccentric control of foot pronation, hip adduction and internal rotation, all of which will allow your knee to turn inwards with each step
Running modifications: Hate to break it to you, friends, but typically you cannot run with IT band syndrome. Just like that boss you wish you could escape, its nagging presence is persistent until near full recovery.
Rehabilitation tips: Work on hip mobility, foot and hip stability and running mechanics. Nightingale suggests a 90-90 hip stretch and a foot pronation supination warm-up, and just like with runner’s knee, consider upping your stride frequency.
4. Plantar Fasciitis
Plantar fasciitis presents as pain on the bottom of the foot near the heel bone or through the main arch. It starts as an inflammatory issue, but over time becomes similar to an achilles tendinopathy. Typically runners experience it after rapid increases in mileage or with poor foot and hip strength. This nagging pain tends to be a reactive injury related to changes in running mechanics. “Consider whether you’ve been running through an old hip or back injury as it may be related,” says Nightingale.
When you feel it: Usually with your first steps out of bed in the morning or after long periods without movement
Who’s most at risk: People with poor foot mechanics and inadequate control of end range foot pronation or supination
Running modifications: First things first, reduce your mileage. Then, consider building in cross training—like cycling—while you allow healing to take place. Nightingale says that you can run through the pain, but it tends to prolong your recovery.
Rehabilitation tips: Do warm-up stretches and strengthening exercises targeted at bettering foot mechanics, hip mobility, and core stability. Nightingale suggests this foot pronation supination warm-up, and a plantar flexion loaded heel raise.
5. Stress Fracture
Stress fractures occur as a result of cumulative stress to a particular bone. In runners, the shin bone, heel bone or metatarsals (toes, friends) are most commonly affected. Unlike other soft tissue injuries, stress fractures can be serious and almost always require time off from impact activity. In some cases, they may even require a period of immobilization or a stiff walking shoe.
When you feel it: With activity but also at rest, usually a dull ache or throbbing sensation.
Who’s most at risk: Those with nutritional deficiencies other hormonal and metabolic issues and decreased bone density.
Running modifications: If you have a confirmed stress fracture you can expect to need two to three months off from running to allow your bone to heal
Rehabilitation tips: “After a period of rest, rebuild your activity tolerance letting pain be your guide,” suggests Nightingale.
If you take one thing away from Nightingale’s expert advice, know that the most common running injuries are often preventable.
Try this cool down stretch specifically designed for runners:
Now that we’ve got the tough stuff out of the way, here are some major LOLs runners have had while on the road and this is your inspiration station for all things running right now.
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