Running is a vital aspect of many athletes’ training and livelihood. But running can also take a heavy toll on one’s body. Runners are used to having minor body aches and pains from time to time, but a running injury is an entirely different story.
Below are six of the most common overuse injuries in runners and how to deal with them.
1. IT Band Syndrome
The iliotibial band, or what’s commonly referred to as the IT band, is a long piece of connective tissue running from the outer hip to the knee that helps keep the knee joints stable. When you run, your IT band shifts between the front and back of your knee, rubbing over the bony prominence near your knee. This repetitive friction can lead to pain as the band becomes irritated.
ITBS (iliotibial band syndrome) is typically characterized by a sharp pain on the outside of the knee while running. It is often caused by factors such as poor running form, incorrect shoe type, and sudden increase in mileage or intensity, among others.
Upon experiencing the first signs of ITBS, reduce your running mileage and intensity, and transition to a softer running surface to avoid putting more strain on the outside of your knees. Also, excessive pronation can cause ITBS, so check your running shoes and replace them if they are starting to wear on the outside.
Applying ice over the affected area, taking non-steroidal anti-inflammatory drugs, and deep-tissue massages should also help alleviate the pain and address underlying ITB issues.
2. Plantar Fasciitis
Plantar fasciitis is a common foot injury among athletes, which occurs when the fascia (the thick ligament that connects the front of your foot to your heel) degenerates or becomes irritated. This ligament acts as the shock absorber when you walk or run, and takes on a lot of wear and tear.
Runners who increase their running volume too quickly are more prone to developing this condition. Those who have plantar fasciitis experience pain anywhere along the underside of the foot, usually at the bottom of the heel where the plantar fascia originates.
Rest, ice, and anti-inflammatory drugs are first-line treatments for plantar fasciitis. You can also try rolling the heel of your foot on a tennis ball or wear a Strassburg sock while sleeping, so your foot heals in a stretched position. If these techniques don’t work, however, consult your doctor or see an orthopedic specialist.
Depending on the severity of your injury, you may be required to undergo physical therapy to improve the strength and flexibility of your plantar fascia and prevent recurring injury.
3. Runner’s Knee
Runner’s knee, also called patellofemoral syndrome, is one of the most common overuse injuries experienced by runners. It is characterized by pain in the front of the knee or around the kneecap that gradually gets worse as you run.
There are several possible reasons for “runner’s knee,” but the majority of the cases are attributed to muscle or structural imbalances, which cause the kneecap to misalign with the thigh bone while running.
Athletes who are experiencing symptoms of runner’s knee are advised to reduce their running mileage and intensity and avoid hills. Ice and non-steroidal anti-inflammatory drugs (NSAIDs) can also be used to control the pain.
After proper diagnosis, the injury can be corrected by addressing the root problems that caused it. Treatment for “runner’s knee” typically involves physical therapy sessions focused on strength and flexibility.
4. Shin Splints
Medically known as medial tibial stress syndrome, “shin splints” is an umbrella term used to describe a number of conditions that affect the shin bone. Those with shin splint injury typically feel a dull ache radiating along the length of their shin bone that progresses to a persistent pain as they continue running.
Shin splints often happen when you increase your running volume too soon and is very common among new runners. If not treated correctly, they can develop into stress fractures and could keep you from running for months.
Most shin splints aren’t serious and tend to go away after enough rest. You can also apply ice on the area and take nonsteroidal anti-inflammatory medicines to lessen the pain and swelling.
Many shin splint injuries are caused by flat foot or overpronation of the ankle. In such cases, wearing shoes with proper arch support should help treat or prevent shin splints in runners who tend to overpronate or have flat feet.
5. Stress Fracture
Running strengthens the body, but increasing the intensity and duration of your runs can cause damage to your bones.
The bones in your body constantly go through a “remodeling” process, where old bone tissues are replaced with new ones. Abruptly increasing your running pace and time makes your body lose old bone tissues faster than it can replace them. When this happens, repetitive stress and impact from running can lead to the formation of hairline cracks in your bones or stress fractures.
Stress fractures generally exhibit a sharp, localized pain that may be felt even when you’re at rest. In runners, stress fractures often occur in the shin, foot, thigh, hip, and pelvis.
Out of all overuse running injuries, stress fractures are the most concerning and require more care than the others. If you suspect a stress fracture in any area of your body, see a doctor right away and get an X-ray for a more accurate diagnosis.
Most uncomplicated stress fractures take 6 to 8 weeks to heal. You may have to use crutches, casts, or walking boots to decrease weight-bearing on the affected body part and allow the injury to heal. If the fracture is quite severe or in a high-risk area, surgery may be required.
6. Achilles Tendinitis
The Achilles tendon is a band of tissue located at the back of your heel, connecting your calf muscles to your lower legs. This tendon works to plantar flex the ankle while running, but it can also get worn out and injured from repetitive plantar flexion. Achilles tendinitis usually presents a dull pain in the lower leg, just above the heel. You may also notice swelling along your Achilles tendon.
Runners develop Achilles tendinitis due to a number of reasons, including wearing incorrect footwear, overtraining, or suddenly increasing mileage. Regardless of the cause, Achilles tendinitis must be addressed immediately. Left untreated, the tendon can rupture and you’ll need surgery to repair it.
As with most running overuse injuries, reducing your running mileage and intensity will allow your injury to heal faster, while ice and nonsteroidal anti-inflammatory medicines will help manage the pain.
If the pain persists, consult with a physio or sports doctor. You may be asked to undergo physical therapy sessions aimed at improving the strength and flexibility of your calf muscles and Achilles tendon to accelerate your recovery.
Preventing Running Overuse Injuries
Like many athletes, runners have to deal with an injury at some point. However, you can minimize your risk of injuries if you:
- Warm-up before training
- Work on your running technique
- Wear the right shoes/training gear
- Include strength and flexibility exercises in your training program
- Slowly increase your running volume
- Take time for rest and recovery
If you do experience any pain or discomfort when running, don’t leave things to chance. Consult with your doctor as soon as possible and address the problem before it keeps you from hitting the tracks.
A running injury will not only disrupt your training but your daily life, in general. While many of them can be treated with rest and ice, others may require surgery or bone fracture treatment – and make you miss the competition you’ve been training hard for!
About Dr. Kaelin
Dr. Charles R. Kaelin received his medical degree from the University of Louisville, Kentucky, and completed his orthopaedic training at Orlando Regional Center in Orlando, Florida. Dr. Kaelin also received training in Sports Medicine at Alabama Sports Medicine with Dr. Lemak, specializing in sports medicine and workmans compensation injuries. He has been a fellow of the American Academy of Orthopaedic Surgeons (AAOS) since 1990. He is a charter member of the International Cartilage Research Society, Founding member of the AAOS Education Enhancement Fund (AAOS) and past editorial board member for the American College of Sports Medicine Health and Fitness Journal.
1. van der Worp, Maarten P et al. “Injuries in runners; a systematic review on risk factors and sex differences.” PloS one vol. 10,2 e0114937. 23 Feb. 2015, doi:10.1371/journal.pone.0114937