Common Running Injuries

Injuries can be extremely frustrating for regular runners as it means time away from their sport, sometimes even for a few months.  

The most common injuries tending to occur in runners are Achilles tendinopathy, plantar fasciitis, medial tibial bone stress (shin splints), hamstring and gluteal tendinopathies and calf muscle tears. 

The management of each of these injuries is very different, but the common cause is generally an excessive tissue overload.  This can be due to a change in training intensity, terrain, distance or even different footwear. 

Having your injury and running history thoroughly assessed by a physiotherapist can be the key to getting back to running as soon as possible and helping prevent future problems. 

Achilles tendinopathy 

The Achilles tendon is the largest tendon in the body and undergoes huge loads in runners, especially during hill work and sprinting.  The Achilles tendon attaches the main two calf muscles (Gastrocnemius and Soleus) to the heel bone (Calcaneus).  The tendon injuries can occur in 3 main areas, the upper portion, mid portion and at the insertion into the calcaneus.  A physiotherapist will identify the area of overload and tissue stress which is important as the treatment varies based on the location. 

Plantar fasciitis 

The plantar fascia is a thick band of connective tissue on the sole of the foot running from the heel into the toes.  The plantar fascia plays a large role in shock absorption and propulsion during running, but can become overloaded when overworked. The fascial band is highly innervated with pain receptive nerves making it very sore when injured.  Typical symptoms include pain in the sole of the foot/heel first thing in the morning or when getting up from a chair after a reasonable period of sitting.  Unfortunately, despite having lots of pain receptors, the blood supply to the plantar fascia is poor so healing can be very slow and lead to injuries lasting a long time. However, recent developments in shockwave machines have significantly reduced the healing time in those suffering with Plantar fascia injuries enabling them to get back to sport much quicker. A physiotherapist trained in shockwave therapy can determine whether this is an appropriate treatment for your injury. 

Shin splints 

Shin splints or medial tibial stress syndrome (MTSS) is a common overuse running condition causing pain along the inside edge of the shin bone (Tibia).  Pain is usually only present during running but can progress to pain when walking or even at rest if the condition is not treated.  Correct identification and management of this injury is very important in preventing stress fractures which can lead to runners needing a few months off, so it is important to see a physiotherapist if you are experiencing pain in this area. 

Hamstring tendinopathies 

Hamstring tendon injuries typically occur at the insertion into the sitting bone (Ischial tuberosity) so a common symptom is pain when sitting on a hard surface.  Most of the time pain is minimal in the morning but come on when trying to bend forwards, squat down or run.  Like with all tendon injuries, correct diagnosis and treatment by a physiotherapist is key in helping patients to return to sport as soon as possible.  Tendons also have a low blood supply meaning injuries can persist for a while, therefore running management is key to long term recovery and re-injury prevention. 

Gluteal tendinopathy 

Just like the hamstring tendinopathy, gluteal tendon injuries can also can pain when sitting.  This pain is more from a sideways load of the gluteal muscle bulk on the tendons causing compression.  The gluteal tendon pain is often felt on the outside of the hip at the attachment of the upper end of the thigh bone (femur) and as with the other tendon injuries, the cause is typically overload.  Pain can be felt with running but is also notable at night when trying to lie on the painful side.  

Calf muscle tears 

The most common of the calf muscles to be torn when running is the gastrocnemius muscle which runs from the back of the knee into the heel bone via the Achilles tendon.  Most tears occur at the point where the muscle starts changing into the tendon, an area of weakness in this structure.  Depending on the amount of damage, return to running can be anything from 2 weeks to 2-3 months.  Managing the injury early is very important for long term recovery, so seeing a physiotherapist quickly to determine the level of damage is key. 

Conclusion 

Running can place a large demand on the body tissues, with bony stresses varying from 2-3 times body weight during impact and muscle forces going upwards of 22 times body weight in sprinting.  The body is perfectly able to adapt to the stresses we place on it during running, but injuries can occur if the load demand exceeds the tissue threshold.  Put simply, when there is an imbalance between the stress running places on the tissue and its ability to recover.  Exact causes of injuries can be hugely complicated and multifactorial, but early assessment and the correct treatment enables a safer and quicker return to running, with a reduced chance of reoccurrence.   

So, if you are someone who runs and are worried about an ongoing niggle or recent injury, get it assessed sooner rather than later by a qualified physiotherapist so you can keep on running in the future.