Running has often been promoted as a universal form of exercise for aerobic fitness and enjoys a large following since the running craze started three decades or so ago.
Despite its many health benefits (including reducing cardiovascular disease, reducing risk of developing diabetes and helping to maintain health bone mass, over zealous running can sometimes lead to negative health impact, the foremost of which is running injuries.
Common running injuries are often overuse injuries. They occur when we subject the body to excessive cyclical loading which overwhelms the ability of the body to adapt to training stress. Instead of improving in performance, the body tires. If the body is allowed to rest at that point, the body adapts and recovers. If however, the body is subjected to further stress, injury ensues.
Common running injuries
Some of the running injuries than I see often in my clinic include
- Runner’s knees
- Jumper’s knees
- Iliotibial band friction syndrome
- Plantar fasciitis
- Shin splint
Runner’s knees is one of the most common overuse injuries in running. Presenting as a vague pain over the front of the knee, the pain is worsened by activities such as running and stairs climbing. Besides an excessive increase in training loads, other factors have been implicated as including quadriceps weakness, over pronation, abnormalities of the running gait and inadequate flexibility.
Jumper’s knees also present as pain over the front of the knee, although the pain tends to be more localized. The pain occurs as a result of degeneration of the patellar tendon. Sports that require repeated jumping (e.g. basketball), lunging (e.g. squash), as well as running can cause this problem. In more severe cases, recovery can be prolonged and may require progressive strengthening, stretches and bracing to aid recovery. Chronic cases may require treatment with Extracorporeal Shockwave Therapy (ESWT) or surgery.
Iliotibial band syndrome
Iliotibial band syndrome occurs as the iliotibial band rubs against the side of the knee during running. This causes inflammation and results in a sharp pain on the side of the knee. Tightness of the iliotibial band has been implicated as a contributory factor. The inflammation can be treated with icing as well as oral medication. Some cases need injections of cortisone to control the inflammation. One of the common reasons is poor running technique which can be corrected by looking for running faults with video gait analysis.
The plantar fascia is a tough fibrous band that attached to the bottom of the heel and is one of the structures that help to maintain the medial arch of the foot on standing. When injured, this can result in pain at the bottom of the heel, often worse in the morning on first getting out of bed or after prolonged walking. Treatment includes physiotherapy, orthotics, cortisone injections, ESWT and surgery
Shin splint occurs as pain over the front of the shin. The pain gradually sets in and is worsened by running. The pain occurs as a result of inflammation of the attachment of the deep muscles of the calf to the shin bone. In some instances the pain can also result from a stress injury of the shinbone. It is thus important to distinguish between these two conditions, which may require investigations such as X-rays.
Most of the running injuries that I see in the clinic can be prevented with appropriate attention to running shoes, adequate conditioning and a individualized training. If injury should occur, early treatment often makes a difference in how soon you can recover.
Dr Jason Chia is a Consultant and Head of Sports Medicine And Surgery Clinic, Tan Tock Seng Hospital. First published in Hanah Press