Saturday, May 15, 2010

Common Injuries to Watch Out For As a Runner

As a runner, our worst fear is to be sidelined by aches and pains and have to take a break from running. God forbid our overall running fitness be affected or we don’t get our usual endorphin fix, but in reality running injuries can happen to both the novice and elite runner. Here are a few common injuries to watch out for that may help before a single symptom strikes.

Area of Pain: Shins. You think it could be: Shin Splints. It could very well be: Stress Fractures

Only a doctor can tell you for sure. Usually you need an x-ray (though many stress fractures won't show up until they start healing), bone scan, or MRI to tell for sure whether it's shin splints or a stress fracture of the tibia.

In general the differences between shin splints and stress fractures are that shin splints will hurt over a larger area. With a stress fracture, you usually can find one small spot (often you can cover it with one finger) that hurts a lot if you press on it. The spot will be located right on the bone.

Shin splints are often worse when you first start exercising, but do get better as you warm up, only to usually come back at the end. Where stress fractures will hurt more and more the longer you exercise, often to the point where it makes you have to stop.

Also, shin splints usually stop hurting once you stop exercising. A stress fracture will often hurt even after you stop exercising, including while walking and might even keep you up at night.

Lastly, stress fractures will often hurt if you walk up or down stairs. A quick test is if you can hop up and down on one foot on the affected leg ten times without causing severe pain, you probably don't have a stress fracture, but rather shin splints. If you had a stress fracture, it would be almost impossible to hop up and down like that without causing a lot of pain.

Treatment: Rest, Ice, Compress, Elevate (R.I.C.E), proper footwear, try pool running or the stationary bike, limit excessive training and follow a consistent stretching routine. Seek a personal trainer for ideas and extra support.

Area of Pain: Knee. You think it may be: “Runners Knee”.It could very well be: Illiotibial Band Syndrome

In general, the kneecap (also known as the patella) can move up and down slightly because the foot evenly distributes the impact of your body weight when running. Runners’ knee is where the kneecap is pulled inward because the foot rolls in when it touches the surface. When this happens, the quadricep muscle pulls the kneecap outward which causes rubbing on the thighbone. So these two opposing forces cause the friction which causes the pain and inflammation in the knee. No Fun! Now, Illiotibial Band is the connective tissue that runs from your hip to your knee. A tight IT band can cause friction on the outside of the knee and create inflammation to this connective tissue which keeps it from gliding properly and in effect causes the pain in the knee. A runner can be more prone to Illiotibial Band Syndrome if mileage has increased to quickly, the gait of the runner is off due to overpronation or runners who are bow-legged.

Treatment: Stretching (Foam Roller), Icing (R.I.C.E.), Cross-Training, Rest and/or work with a Physical Therapist.

Area of Pain: Pain in the lower calf, near your heel. You think it may be: Ankle Strain. It could very well be: Achilles Tendonitis

The Achilles tendon is the large tendon at the back of the ankle. It connects the large calf muscles (Gastrocnemius and Soleus) to the heel bone (calcaneus) and provides the power in the push off phase of the gait cycle (walking and running). Achilles tendonitis is a running injury that typically occurs from abnormal foot stroke in push off and too-tight calf muscles. A runner that pronates when running to the side and at an improper angle, can cause the area to become stressed and inflamed. An orthotic would work well to correct the biomechanics of the foot stroke at push off.

Treatment: R.I.C.E., wear a heel pad to lift the weight off the achilles tendon, wear proper running shoes and /or seek medical help for rehabilitation and treatment.

Below are general tips on how to avoid injuries:
Avoid Overtraining.
Cross-Train: Stationary Bike, Pool Running; or something low or non-impact. Wear proper shoes.
Integrate a stretching routine.
Seek out a personal trainer for specific stretching and training needs.

Lastly, to speed healing use R.I.C.E.:
Rest the injury. As much as possible, try to avoid putting weight on the injured area.
Ice to reduce pain and swelling. Do it for 20-30 minutes every 3-4 hours everyday, or until the pain is gone.
Compression. Use an elastic bandage, straps, or sleeves to give you’re the area extra support.
Elevate (if you can) the injured area on a pillow when you're sitting or lying down.

Take anti-inflammatory painkillers. Nonsteroidal anti-inflammatory drugs ( NSAIDs), like Advil, Aleve, or Motrin, will help with pain and swelling. However, these drugs can have side effects, like an increased risk of bleeding and ulcers so check with your physician first.

Keep in mind that running injuries are often hard to diagnose, so at the first sign of pain take a break from running for a few days and cross-train instead. Most runners misdiagnose, so if pain persists after you head back out again seek medical help to get to the root of the problem.

Written by Crystal Kennedy
Wellness Director / Personal Fitness Trainer, Seattle Athletic Club Northgate

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