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Running Injuries - Prevention and Treatment

More than 40 million Americans run regularly, perhaps because it is such an easy sport to take up. Running not only results in good health but, unfortunately, often results in injuries. The vast majority of injuries are as a result of repetitive stress rather than a single traumatic event. A large percent of the injuries are attributed to an increase in running speed, duration, or to negotiating more challenging terrain too quickly. The overwhelming majority of running injuries can be successfully managed through nonoperative care which allows the majority of runners to continue to enjoy running. Below are some tips for injury prevention and about the management and treatment of common injuries.

Who is Most at Risk for Injury?

  • Beginner runners
  • People that run more than 40 miles per week
  • Those that suddenly increase speed or distance
  • People with low bone density

General Recommendations

  • Start running at a slow pace and short distance, increase training slowly
  • Rest 1-2 days per week or do different exercises those days (cross-training)
  • Perform strengthening exercises 2-3 days per week to maximize muscular support
  • Change sneakers every 350-500 miles
  • Run on soft, even surfaces whenever possible

Common Injuries

1. Stress Fractures

  • Defined as bone fracture as a result of overuse
  • Can progress to fully displaced fractures if not treated
  • Treatment usually involves adequate rest and, on rare occasions, surgery
  • Patients with stress fractures should get a bone density to determine if they have osteoporosis

2. Runner's Knee

  • Formally known as patellofemoral syndrome
  • Pain emanates from the joint formed by the kneecap (patella) and lower end of the thigh bone (femur)
  • Overuse and shifting of the patella from the groove from in which it sits on the lower femur can cause pain and inflammation
  • Consult a physician to discover the source of pain
  • Treatment may include manual therapy, stretching, strengthening, orthotics, or taping.
  • Rest, ice, and anti-inflammatory pills or cream may be helpful

3. Achilles Tendonitis

  • Involves microtears of the structure that attaches the calf to the top of the heel bone (calcaneus)
  • Symptoms include tenderness and swelling at the lower portion of the heel cord, which causes pain particularly on push off
  • The tendon has poor blood supply so healing is often slow and incomplete
  • Treatments include reduction in running, wearing heel lifts, physical therapy with therapeutic ultrasound and stretching, wearing supportive footwear, and injection of PRP.

4. Shin Splints

  • Also known as medial tibial stress syndrome
  • Thought to be a mircrotear in the posterior tibialis muscle at the upper and inner lower leg bone (tibia)
  • Onset is usually with overuse and is a result of inadequate arch support in runners
  • Pain is in front & inner leg when foot hits the ground
  • Treatments include a reduction in physical stress through modifying the running regimen and assuring that there is adequate arch support.
  • Physical therapy and injections may also be helpful


Rehabilitation Institute

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