4 Running Injuries and How to Prevent Them

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It is the beginning of the track and road race season.  You are excited and energized to start your training.  You have a lofty goal for this season and there is nothing that is going to stop you from achieving this goal...and then it happens.  You, like many runners before you, are hit with an injury that brings your training to a halt.

Physical and mental preparation is very important when it comes to setting new personal bests and achieving the goals you set at the beginning of this year.  But, just as important to all of this hard work is getting to the starting line healthy.  Too many times the runners who are winning races aren't always the best, but are the ones that could make it through a season without injury.

Here are four of the most common injuries, what causes these injuries, as well as some strategies to overcome these injuries or hopefully prevent them from happening in the first place.

1.  Hamstring Strain

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 Of these four running related injuries, hamstring strains by far have the highest rate of recurrence, with as many as one-third of injured runners suffering re-injury within the first few weeks following return to sport (1).

The hamstrings consist of four muscles and runners almost exclusively injury the outer hamstring muscle, the long head of the Biceps Femoris.

There are a few different theories as to why hamstrings commonly re-injure.  One being that a muscle with previous injury heals with less flexibility.  Although often cited as a potential cause, there is little evidence to support this theory (1).  With a large amount of recent research on the topic, strength has been shown to play the most important role in preventing injury.

An exercise regimen including agility and trunk stabilization exercises produces significantly better short and long-term outcomes when compared to conventional rehabilitation.  70% of the athletes treated with conventional stretches and exercises were re-injured, compared to only 7.7% of the athletes completing the progressive agility and trunk stabilization program (1).

 

Strengthening exercises

Bridge and Plank series

  • This series of exercises is designed to load the hamstring and the core.

 

 

 

Single-leg windmill

  • This exercise is designed to challenge both balance and core strength.  It is also great for loading the hamstrings.  This is a great exercise to progress to once you have mastered marching and glute bridges. 

 

 

2. Iliotibial Band (IT Band) Compression Syndrome

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 Runners with this injury often describe a burning pain along the outside of the knee.  Contrary to popular belief this pain is not caused by the band snapping back and forth over a bony prominence on the outside of the knee.  The pain is actually coming from compression of the IT Band into the outer side of the femur when the knee is in 30 degrees of flexion.

            The cause of this compression is due to tension in the Tensor Fascia Latae (TFL) and Gluteus Maximus muscles as well as weakness in the lateral hip musculature.  Weakness in the hip will result in dropping of the opposite hip and twisting of the involved knee amplifying compression of the band.

            To help elevate and or prevent IT band compression our strategy is to decrease the tension in the TFL and Gluteus Maximus muscles as well as strengthen the muscles that are controlling the pelvis.

Preventing IT Band Compression Syndrome

4 way isometric hip holds

  • These exercises are designed to improve lateral hip strength. It is very important for runners to have appropriate hip strength so they can control the pelvis during single leg stance in the gait cycle.

 

 

 

IT Band stretch

  • This stretch is designed to help stretch the muscle that attaches to the IT band, the glute, and the oblique muscles along the trunk. This is a great stretch for anyone dealing with lateral knee pain related to IT band tightness.

 

3. Patellofemoral Pain Syndrome (pain behind the kneecap)

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Patellofemoral pain syndrome affects 25% of the population.  A classic sign of this condition is that your kneecap aches when you sit for long periods, and the pain goes away when you straighten your leg (1). 

Research by Powers et al. discovered that the pain is due to internal rotation of the Femur causing the distal femur to shift into the Patella.  Hip weakness has been shown to be the most likely cause for this increase of internal rotation of the Femur.                                                                       

Preventing Patellofemoral Pain Syndrome

Increase cadence (how many steps per minute you are taking)

  • Manipulating cadence is an excellent way to improve running mechanics and is also a great place to start to improve form when dealing with an injury. In this video, my cadence starts at 162 SPM and then I change my cadence to 172 SPM.

 

 

 

Squat progression

  • This is a squat progression designed to gradually introduce load to someone who has never squatted before or someone who has been dealing with some lower extremity pain. The squat is an excellent exercise but it is often too complicated of a movement for most people to handle.

 

 

4. Medial Tibial Stress Syndrome (aka Shin Splints)

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Shin splints are very common among runners especially at the beginning of the track or cross-country season.  The term “shin splints” refers to pain along the inner edge of the tibia or “shin bone.”

Shin splints commonly occur when unconditioned athletes build their mileage too quickly.  The increase in stress on the lower legs causes an overuse of the muscles surrounding the tibia.  This overuse can cause pain and inflammation.

 

Preventing Shin Splints

Gradually builD mileage during the beginning of the season.

  • Often times athletes come into a season unconditioned and are not ready for the demand that is placed on them once track or cross-country start.  This quick increase in mileage can lead to overuse of the musculature in the lower extremities.

Increase cadence to decrease the stress on the lower extremities.

  • Check out the video above on running cadence.

 

Strengthen muscles in the feet to help absorb the forces produced while running.

  • These exercises are designed to improve foot strength for those dealing with a past or present lower extremity injury as well as those who are trying to improve tendon tolerance. In this video I am using a device called a ToePro (https://www.humanlocomotion.org/produ...). It is a great product for isolating foot strength.

 

 

References

1. Michaud, T. (2013). Injury-free running: how to build strength, improve form, and treat/prevent injuries. Newton, MA: Newton Biomechanics.

 

These tips and exercises might not work for everyone in every situation.  If you have any questions or concerns please call the clinic to talk to one of our docs.