The Five Most Common Running Injuries
Here at Flex, we love working with runners. As of late, running has been gaining in popularity as many look to become fitter and to join the running community. However, like any other sport, running can be linked to a number of injuries. This blog will explore five of the most common running-based injuries, shedding light on their causes and symptoms. Whether you are a seasoned marathon runner or a beginner, understanding these common ailments can help you to stay injury-free and on track with your running goals.
Runner’s Knee (patello-femoral pain syndrome)
Patello-femoral pain syndrome (PFPS) is one of the most common injuries seen in runners, accounting for 13-30% of running injuries (Esculier et al, 2020). It is defined as pain around or behind the patella-femoral joint – the joint between your patella (kneecap) and femur (thigh bone) (Esculier et al, 2020). Several factors can contribute to PFPS, such as:
- Abnormal anatomy of the patello-femoral joint (e.g. patella alta, trochlear dysplasia)
- A reduction in quadriceps muscle strength
- Biomechanical deficits such as poor hip and knee strength/control
- Suboptimal running kinematics (i.e. an altered running gait)
Iliotibial Band (ITB) Syndrome
The iliotibial band (ITB) is a thick band of fascia that runs along the outside of the thigh, starting at the iliac crest (top of your hip) and inserting into the lateral tibial plateau (lateral knee). Hip muscles such as the tensor fascia latae (TFL) and gluteus maximus muscles attach into the ITB. The ITB can assist with both straightening and bending of the knee, depending on the angle of which the knee is at.
ITB syndrome describes pain in the lateral aspect of the knee during flexion and extension (bending and straightening) of the knee, and pain can also radiate up to the lateral thigh and down to the lateral calf. Risk factors for ITB syndrome include:
- Biomechanical deficits (such as hip abductor weakness, overpronation of the foot and internal tibial torsion)
- Training load and surfaces (e.g. hill training, running on tilted surfaces, increase in training volume) (Hadeed, 2023)
Shin Splints (medial tibial stress syndrome)
Medial tibial stress syndrome (MTSS) is a common overuse injury usually seen in people participating in recurrent impact exercises, such as running. MTSS is classified as pain along the distal ⅔ of the medial tibial border (lower ⅔ of the inside of the shin bone) that improves with relative rest. The main contributing factors to MTSS include:
- A significant increase in load such as:
- Training volume
- Training intensity
- Training frequency
- Intrinsic factors such as:
- Reduction in medial foot arch height
- Foot overpronation
- Reduced calf strength
- Reduced ankle range of motion (McClure, 2023)
Achilles Tendinopathy
The Achilles tendon is the strongest and largest tendon in the human body. It connects the superficial calf muscles (gastrocnemius, soleus and plantaris) to the heel bone (calcaneus bone). Achilles tendinopathy (AT) is classified as pain, inflammation, and stiffness of the Achilles tendon (Maffulli et al, 2020). It is divided into two categories depending on the location of the pain, swelling, and inflammation: insertional tendinopathy and mid-portion tendinopathy. The following factors can contribute to the onset of AT symptoms:
- Mechanical overload
- Increase in training effort (e.g. uphill running)
- Reduction in calf strength
AT is also likely to reoccur if it is not rehabilitated and treated appropriately, leading to chronic inflammation (degeneration) of the tendon (Maffulli et al, 2020).
Plantar-fasciopathy
The plantar fascia is a thick, fibrous aponeurosis that originates from the calcaneus (heel bone) to the metatarsal heads (ball of your foot). Plantar-fasciopathy (PF) is commonly referred to as plantar fasciitis and accounts for 10% of running injuries (Monteagudo et al, 2018). PF is characterised by pain and structural changes of the plantar fascia at the calcaneal insertion point. Most individuals will experience progressive pain in the medial and inferior heel over time, with pain often being worse in the morning due to prolonged inactivity.
Key contributors to PF include:
- Age
- Increased body weight
- Altered anatomy and biomechanical dysfunction (such as a high arch/flat arch)
- Poor ankle control during dynamic activities
- Increased tightness in the calf muscles
Preventing and managing running injuries often requires the expertise of a Physiotherapist. At Flex, our highly skilled Physiotherapists can help you to address your biomechanical factors, provide a tailored rehabilitation and strengthening program, and provide effective manual therapy. For runners with recurring injuries, a comprehensive running analysis can help to identify underlying issues and promote optimal running performance.
Through an in-depth, individualised assessment and a tailored management plan, our team can help you feel your best and prevent future injuries. To book your Running Analysis, click here or reach out to our friendly admin team on (03) 9670 7041.
Written by Physiotherapist, Faith So
References
Esculier, J.-F., Maggs, K., Maggs, E., & Dubois, B. (2020). A contemporary approach to patellofemoral pain in runners. Journal of Athletic Training, 55(12), pp. 1206–1214, DOI: 10.4085/1062-6050-0535.19
Hadeed, A. (2023). Iliotibial band friction syndrome. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK542185/
Maffulli, N., Longo, U. G., Kadakia, A., & Spiezia, F. (2020). Achilles tendinopathy. Foot and Ankle Surgery, 26(3), pp. 240–249, DOI: 10.1016/j.fas.2019.03.009
McClure, C. J. (2023). Medial tibial stress syndrome. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK538479/
Monteagudo, M., de Albornoz, P. M., Gutierrez, B., Tabuenca, J., & Álvarez, I. (2018). Plantar fasciopathy: A current concepts review. EFORT Open Reviews, 3(8), pp. 485–493, DOI: 10.1302/2058-5241.3.170080
