Running has become a popular element in many exercise regimens and is a key part of many sports and sport-related training programs. Running is known to have positive effects on a person’s overall physical fitness, including reducing the risk of chronic health problems like obesity and cardiovascular disease. However, running isn’t without risk.
Running, jogging, and sprinting subject the feet, ankles, legs, and hips to a considerable amount of stress. For example, the body is subject to a force three times that of its weight each time a runner’s foot strikes the ground. This force travels from the feet all the way into the spine.
According to some studies, around 35-45% of all runners suffer a running injury each year. Furthermore, the sport of running has a higher prevalence of injury than any other sport.
What Causes Running Injuries?
Runners are most vulnerable to an injury during certain phases of running:
1. The first four to six months of running.
2. Anytime the distance of running is increased.
3. Anytime the frequency of running is increased.
4. Anytime the speed of running is increased.
5. Anytime the surface, such as going from a flat to uphill surface, is changed.
6. When returning to running after an injury.
Beginner to seasoned, professional to everyday, and old to young runners can all suffer a running injury simply due to the repetitive and forceful nature of running. Of course, there's also the risk of tripping or falling during running, which can easily produce a fracture or contusion injury.
The following factors can make a runner more prone to injury:
* Those with a misalignment problem, such as pes planus, genu valgus, genu varum, commonly suffer running injuries.
* Over-training, such as increasing distance, frequency, or intensity too soon and too fast, is considered one of the most common causes of running-related injuries.
* Failing to properly stretch prior to starting a running activity or sport.
* Failing to wear the appropriate foot wear.
* Failing to properly hydrate the body before and after running.
* Running on uneven surfaces.
What Are Some Common Running Injuries?
The most common injuries related to running are colloquially known as the “Big Five".
1. Achilles Tendonitis
About 11% of all running injuries involve Achilles tendonitis . The Achilles tendon can be felt along the back of the ankle. This large tendon connects the soleus and gastrocnemius calf muscles to the calcaneus heel bone. Whether walking or running, this tendon is what provides the push-off power for the motion.
Tendonitis is a term used to describe inflammation of a tendon, whereas tendinosis is used to describe the cellular degenerative damage to a tendon. These are collectively referred to as tendinopathies.
Achilles tendinopathy can follow a direct trauma to the Achilles tendon, but is more often a repetitive or overuse injury. General signs and symptoms of an Achilles tendinopathy include:
* mild aching pain at the back of the lower leg / heel area, especially after running
* stiffness in the morning or after prolonged periods of inactivity
* swelling, redness, and tenderness
* diminished strength of the calf muscles
2. Runner’s Knee / Chondromalacia
The knee is the articulation point for the tibia and femur and the femur and the patella. Knee problems often occur in an area referred to as the patellofemoral complex, which consists of the patella, femur, patellar tendon, and quadriceps. Patellofemoral pain syndrome is a fairly newly coined term that describes what was once referred to as runner’s knee, chondromalacia of the patella, or anterior knee pain.
Patellofemoral pain syndrome describes pain in the front of the knee. It may be caused by a direct injury to the knee, patellar tracking disorder, tight quadriceps, or degenerative changes to the patellofemoral complex. The pain is most intense when sitting with bent knees, descending stairs, jumping, squatting, and running. The knee may buckle or catch and there may be a popping or grinding sensation during knee movement.
3. Iliotibial Band Syndrome (ITBS)
Iliotibial Band Syndrome is considered the most common cause of lateral knee pain in runners, with yearly incident rates as high as 12% among runners. The iliotibial band is a thick band of fascia that crosses the hip joint and eventually inserts on the patella, tibia, and biceps femoris tendon. This band acts as a knee stabilizer during running and flicks back and forth over the knee as it’s extended and flexed.
The repetitive extension and flexion of the knee during running causes the band to rub across the bony part on the outside of the knee (lateral femoral epicondyle) and become irritated, inflamed, and thickened. Symptoms of ITBS include:
* lateral knee pain and tenderness, especially during knee flexion and extension
* pain may radiate up the leg to the hip
* snapping or popping sensation as the band flicks across the knee
4. Plantar Fasciitis
Plantar Fasciitis is one of the most common causes of heel pain in runners. It occurs when the thick band of tissue, called the plantar fascia, along the bottom of the foot becomes irritated and inflamed. This band connects the heel bone to the toes and supports the arch of the foot. Its tough design allows it to absorb a high amount of shock and stress. However, when stressors become too great, the band can become irritated, overstretched, suffer microscopic tearing, and become inflamed.
The mechanism of injury is commonly associated with the repetitive impact the foot must absorb during running; tightened calf muscles making it difficult for the foot to flex during running; and after suddenly increasing the load on the foot, such as from a rapid weight gain or episodes of over-training. Runners that have high arches are at an increased risk for plantar fasciitis. The symptoms of plantar fasciitis include:
* a sharp stabbing pain in the heel of the foot
* pain that's most intense first thing in the morning and after prolonged sitting or standing, but that usually subsides after a few steps are taken
* pain may also be intense after exercise or activity
5. Shin Splints
Shin splints, also called medial tibial stress syndrome (MTSS), is a condition that accounts for an estimated 10-15% of all running injuries. A shin splint is pain behind or just along the inside edge of tibia. The repetitive pounding and push off involved in running activities can cause the muscles to fatigue.
The fatigued muscles cause a greater amount of stress and force on the periosteum, fascia and other connective tissues, and the tibia. This overload of stress can cause these tissues to become inflamed and cause the tibia to suffer a stress fracture. Symptoms of shin splints include:
* tenderness, mild swelling, and pain along the inside edge or behind the shin
* pain may initially only be present at the start of running
* pain may eventually last throughout and after the running activity
6. Hamstring Strain
A pulled hamstring may also be called a torn hamstring or hamstring strain. It’s when one or more of the hamstring muscles are abruptly or forcefully stretched/pulled past their normal positioning. A hamstring strain is a common leg injury involving a tear in one or more of the hamstring muscles. A hamstring strain can range from mild to very severe involving a complete tear of the hamstring muscle.
Mild hamstring strains may feel more like a tightness or low grade ache in your hamstring. Severe hamstring strains can be extremely painful, making it impossible to walk or even stand. Symptoms of a hamstring strain include:
* poor flexibility
* significant imbalances in strength or flexibility between hamstring and quadriceps muscle groups
* hamstring fatigue or weakness
* overexertion of hamstring
* leg length differences may cause tighter and more apt to pull hamstrings
* participation in activities and sports that require quick starts-and-stops
7. Ankle Sprain
An ankle sprain is an injury to one or more ligaments in the ankle, usually on the outside of the ankle. An ankle sprain can range from mild to severe, depending on how badly the ligament is damaged and how many ligaments are injured. Ligaments are bands of tissue – like rubber bands – that connect one bone to another and bind the joints together. In the ankle joint, ligaments provide stability by limiting side-to-side movement.
In everyday life, this can happen quite easily when the ankle unnaturally rolls inward and the foot rolls outward (an inversion injury) or when the ankle rolls outward and the foot rolls inward (an eversion injury) past the normal range of motion.
With a mild sprain, the ankle may be tender, swollen, and stiff. But it usually feels stable, and you can walk with little pain. A more serious sprain might include bruising and tenderness around the ankle, and walking is painful. In a severe ankle sprain, the ankle is unstable and may feel "wobbly." You can't walk, because the ankle gives out and may be very painful. Signs and symptoms of an ankle sprain include:
* a popping or snap may be felt during the injury
* pain, throbbing, or tenderness
* swelling
* bruising
* cold or numb sensation in the foot
* a wobbly feeling when weight is placed on the ankle
* inability to walk or weight bear
* stiffness
* redness and/or warmth
8. Stress Fracture
A stress fracture is a small crack in a bone. Stress fractures often develop from overuse, such as from high-impact sports like running. Most stress fractures occur in the weight-bearing bones of the foot and lower leg. Repeated stress of the foot striking the ground can cause stress fractures.
When muscles are overtired, they are no longer able to lessen the shock of repeated impacts. When this happens, the muscles transfer the stress to the bones. This can create small cracks or fractures.
The most common areas of stress fractures are the second and third metatarsals of the foot. Stress fractures are also common in the heel (calcaneus), the outer bone of the lower leg (fibula), and the navicular, a bone on the top of the midfoot.
Symptoms of a stress fracture include:
* Limited mobility or inability to move the body part associated with the affected bone.
* A deformed, misshapen, or not in normal position body part associated with the affected bone
* An obvious bone protruding through the skin
* Localized swelling
* Localized bleeding
* Localized bruising
* Moderate to intense pain, all depending on how many nerve endings surrounding the bone become irritated or injured
* Numbness
* Tingling
* Muscles surrounding the fractured bone may spasm as they try to compensate to hold the affected bone fragments in place.
More Running Injuries
The above are just some of the common running injuries. Runners can also suffer other knee injuries, anterior compartment syndrome , heel pain, quadriceps strain , foot bursitis and tight hamstrings.
