In this second installment on running injuries, we are going to look at the common problems below the knee that we encounter and advise upon in the clinic.
Going the extra mile – part 2: The most common running injuries, their causes, symptoms and how to help yourself.
Shin splints
Location of the pain
Along the inside of the shin.
Symptoms
Recurring pain in the middle and inner aspect of the tibia (shin bone). Often described as an aching or a sensation of increasing pressure that intensifies until the pain forces the person to cease activity.
The detail
In summary, it is the inflammation of the connective tissues joining the muscle to the inside of the tibia. It is caused by overuse or too sudden increased activity levels. Running on surfaces that are hard and/or an upwards gradient probably can also contribute.
Self-management
- Use ice to decrease localised inflammation.
- As hard as it will be for you really keen runners, it may be necessary to stop running for a prolonged period. You can of course maintain cardiovascular fitness by diversifying into non-weight-bearing exercise, such as cycling or swimming.
- Consider foot and gait analysis to see if there is an underlying predisposing factor such as dropped medial arches of the foot and resultant tibial torsion.
Achilles tendonitis
Location of the pain
In the Achilles tendon itself, but also felt in the back of the heel where the tendon attaches.
Symptoms
An ache in the Achilles tendon that is often made worse with activity. Continuing to run through the discomfort can make the micro-tears associated with tendonitis worse and result in a longer recuperation period. The injury may also cause redness or swelling around the tendon and a sensation of tightness within the lower calf. Where there is a palpable lump within the tendon or an audible snapping sound, this may be due to a build-up of scar tissue due to a longer period of successive micro trauma.
The detail
The Achilles tendon is what connects your calf musculature to your heel. It is the biggest tendon in your body, and it needs to be, as it has to deal with large forces when walking, let alone running or jumping. The problem will often begin as a mild ache in the area after sporting activity. Prompt action can reduce the length of time needed to rehabilitate the area. Many factors are thought to predispose someone to Achilles tendonitis, including an increase in the intensity of activity, poor running technique, inappropriate footwear.
Self-management
- Ice the area, especially after activity.
- A small heel lift may be helpful in reducing discomfort in the tendon itself – the lift slightly shortens the calf musculature and so reduces pull and stretch on the Achilles.
Plantar fasciitis
Location of the pain
Underside of the foot.
Symptoms
Tenderness, stiffness or even a sensation of bruising in the sole of the foot. It often begins around the base of the heel. Stiffness in particular may be more evident upon weight-bearing for the first steps of the day or after a period of inactivity. Discomfort is also more likely when barefoot or wearing unsupportive footwear.
The detail
The plantar fascia is an extremely strong band of connective tissue that supports your foot arches. Its main purpose is to absorb much of the impact of heel strike and help to reform the foot arches after toe-off. With micro-tears in the fascia we get discomfort. Some people appear to be more prone to this and it is likely that there are several predisposing factors such as increased weight, inappropriate footwear, lack of stretching and increased activity.
Self-management
- It is possible to continue running through the discomfort for a prolonged period, but doing so will cause an exponential increase in healing time.
- While applying a moderate amount of pressure, roll the sole of the foot over a rolling pin for around five minutes a time, up to five times a day. This can also be done with a frozen water bottle if you wish to combine the benefits of icing with the facial stretch.
- Stop wearing any non-supportive footwear such as flip flops, sandals, etc.
- Liberal foam rolling of the calves and stretching of the calf muscles can be of benefit when suffering from plantar fasciitis.
Ankle ligament sprain
Location of the pain
On the side of the ankle.
Symptoms
Swelling, bruising, instability, pain and difficulty weight-bearing fully on the affected side, depending on the severity of the sprain. Often it may just be mildly uncomfortable with residual stiffness. However, when severe, all the above symptoms will present themselves in the days following the injury. It is also worth noting that pain, swelling and inability to weight-bear can be a sign of a fracture, so if you are worried you should visit A&E as soon as possible.
The detail
Inversion strains (when you roll on to the outside of your foot) are fairly common. Most people have experienced this to some extent, perhaps after losing their footing in a pothole, or during sporting activity where they have had to change direction quickly. Severity can range from a mild tear to a complete rupture.
Self-management
- Rest
- Ice the area regularly – for up to 10 minutes at a time.
- Compression bandages can help with the initial swelling.
- Elevate the ankle from time to time to aid with the reduction of swelling.
- Once the initial discomfort and swelling have reduced, proprioceptive exercises that help your body control the movement of your ankle can be undertaken in order to decrease the likelihood of further sprains.
Hopefully these two blogs on common running injuries have helped to give you an insight into how to self-manage. Of course, it is always a good idea to get the problem looked over by a musculoskeletal expert, such as an osteopath.
