INJURY AWARENESS

As you get further into your training, it's not uncommon for little aches and pains to start popping up.    You've put so much work in your training that we want you to pay attention to these pains and not just walk/run through them.   Failure to follow RICE  (Rest, Ice, Compression and Elevation) could sideline you on September 28th. The five most common endurance training injuries are summarized below.   Be aware of your body and aware of these injuries.  We share the details for identification purposes but recommend you seek proper medical advice. 

1.  Shin Splints:  Inflammation of the muscle attachments and membranes to the tibia (shin bone) on the inside of the front of the lower leg. 

  Symptoms:  

  • Pain or tenderness along the inside of the shin, usually half way down the shin.  
  • Pain and tenderness may extend to the knee.  
  • Pain is most severe at the start of a workout but may disappear as the muscles loosen up.
  • If the pain continues during weight bearing activities such as walking or stair climbing, see a medical professional to rule out a stress fracture.

Causes:  

  • Inflexible and/or tight calf muscles and achilles tendons place more stress on to the muscle attachments.
  • Over pronation (feet rotate too far inward on impact).
  • Excessive running on hard surfaces, such as concrete pavements.
  • Incorrect or worn shoes.
  • Over training.
  • Rapid increase in training load or intensity.  Beginner runners are more susceptible to this problem for a variety of reasons, but most commonly due to the fact that the leg muscles have not been stressed in such a way before they started running.

2.  Iliotibial Band Syndrome:  Pain and inflammation on the outside of the knee, where the iliotibial band (a muscle on the outside of the thigh) becomes tendinous, and results in a friction syndrome by rubbing against the femur (thigh bone) as it runs alongside the knee joint. 

  Symptoms: 

  • Initially, a dull ache 1-2 miles into a run, with pain remaining for the duration of the run.
  • The pain disappears soon after stopping running, later, severe sharp pain which prevents running.   
  • Pain is worse on running downhills, or on hard surfaces.
  • Pain may be present when walking up or downstairs. 
  • Local tenderness and inflammation. 

  Causes:  

  • Anything that causes the leg to bend inwards, stretching the ITB against the femur.  
  • Over-pronation (feet rotate too far inward on impact). 
  • Tightness of the ITB muscle from lack of stretching of the ITB.  
  • Incorrect or worn shoes. 
  • Excessive hill running (especially downhills) and running on hard surfaces.
  • Over training.

3.  Achilles Tendonitis:  Inflammation of the Achilles tendon.  The Achilles is the large tendon connecting the two major calf muscles, gastrocnemius and soleus, to the back of the heel bone. Under too much stress, the tendon tightened and is forced to work too hard. This causes it to become inflamed (that is tendinitis), and, over time, can produce a covering of scar tissue, which is less flexible than the tendon. If the inflamed Achilles continues to be stressed, it can tear or rupture.

  Symptoms:   

  • Dull or sharp pain anywhere along the back of the tendon, but usually close to the heel. 
  • Limited ankle flexibility.
  • Redness or heat over the painful area. 
  • A nodule (a lumpy build-up of scar tissue) that can be felt on the tendon. 
  • A cracking sound (scar tissue rubbing against tendon) with ankle movement.

Causes:  

  • Tight or fatigued calf muscles, which transfer the burden of running to the Achilles.
  • Poor stretching.
  • Rapidly increasing distance, over-training, excessive hill running or speed work, all of which stress the Achilles more than other types of running.  
  • Inflexible running shoes, which, in some cases, may force the Achilles to twist.  
  • Those who over-pronate (feet rotate too far inward on impact) are most susceptible to Achilles tendinitis. 

4.  Runner's Knee:  A softening or wearing away and cracking of the cartilage under the kneecap, resulting in pain and inflammation. The cartilage becomes like sandpaper because the kneecap is not riding smoothly over the knee.

Symptoms:  

  • Pain beneath or on the sides of the kneecap crepitus (grinding noise), as the rough cartilage rubs against cartilage when the knee is flexed.  
  • Pain is most severe after hill running.  
  • Swelling of the knee.

Causes:  

  • Over-pronation (feet rotate too far inward on impact) - can cause the kneecap to twist sideways.  
  • Fatigued or weak quadriceps muscle. The quadriceps muscle assists in the proper tracking of the kneecap. Weakness, especially of the inside part of the quadriceps, can prevent the kneecap from tracking smoothly. 
  • Muscle imbalance between weak quadriceps and tight hamstring and iliotibial band (ITB).  
  • Hill running (especially down hills) and running on hard surfaces.  
  • Incorrect or worn shoes.  
  • Over training.

5.  Plantar Fascitis:  An inflammation of the plantar fascia, a thick fibrous band of tissue in the bottom of the foot which runs from the heel to the base of the toes. When placed under too much stress, the plantar fascia stretches too far and tears, resulting in inflammation of the fascia and the surrounding tissues. The tears are soon covered with scar tissue, which is less flexible than the fascia and only aggravates the problem.

Symptoms:   

  • Pain at the base of the heel.  
  • Pain is most severe in the mornings when getting out of bed and at the beginning of a run.  
  • The pain may fade as you walk or change running stride, in an attempt to alleviate the pain.  (This provides only temporary relief.) 

Causes:  

  • Stress, tension and pulling on the plantar fascia.  
  • Inflexible calf muscles and tight Achilles tendons place more stress onto the plantar fascia. 
  • Over-pronation (feet rotate too far inward on impact).  
  • High arches and rigid feet.   
  • Incorrect or worn shoes.  
  • Over-training.