Running injuries are caused by one or a combination of these five main causes…
Patellofemoral pain syndrome (PFPS)
Sometimes called “runners knee,” this is used to describe pain around the patella (kneecap) and in front of the knee. This is common in people who participate in sports that require running or jumping and the most common injury among all runners. Symptoms of PFPS include dull aching pain in the front of the knee which can be aggravated with walking up or down stairs, kneeling, squatting or sitting for periods of time. Women tend to experience PFPS at a higher rate than men but it is the highest recorded injury in both sexes.
Causes of PFPS include:
Running or jumping sports put repetitive stress on your knee and can cause irritation under your patella.
Muscle imbalance or weakness
When the muscles surrounding your hip and knee are weak, they often do not keep your patella properly aligned which can cause irritation to the knee.
Trauma to the patella, such as dislocation or fracture, has been known to cause PFPS due to malalignment
How you can prevent PFPS injuries:
- Maintain strength of all muscles surrounding your knee and hips.
- Ensure good technique and alignment while performing exercises.
- Lose excess weight.
- Stretch – make sure the muscles surrounding the knee are at their proper length.
- Increase intensity of exercise/activity gradually.
- Ensure you have proper fitting shoes.
Achilles tendinopathy is an injury caused by overuse. The Achilles tendon connects your calf muscles to your heel. Tendinopathy can develop with repetitive and/or intense activities, especially with activities that you aren’t used to doing on a regular basis. This has frequently been called achilles tendinitis but as our understanding of the injury process has progressed inflammation is rarely present and therefore the term tendinopathy is more accurate.
People who are at risk for Achilles tendinopathy include:
- “Weekend warriors” or individuals who only participate in sports or high levels of activity on the weekends
- Runners who suddenly increase their running distance, train in worn out shoes, or run on hilly terrain
- People who have flat feet
You may have Achilles tendinopathy if you have these symptoms:
- Pain in the back of the lower leg or heel
- Pain that increases with increased activity levels
- Stiffness in the ankle after long rest periods
Medial Tibial Stress Syndrome (MTSS)
Medial Tibial Stress Syndrome (MTSS), also known as shin splints, is an overuse or repetitive stress injury present along the shinbone involving musculature and bone structures in the area. MTSS may begin with an inflammatory reaction in the outer region of the bone and also in the soft tissue connecting the tibialis muscles to the bone and if left untreated may progress to a stress reaction or fracture of the tibia. The most common complaint is a diffuse pain along the shinbone associated with increased activity. In the early course of the injury process pain may be worse when beginning exercise and subside during training and completion of activity – as it progresses though, pain may be provoked with less activity and/or be present at rest.
People who are at risk for MTSS include:
- Females seem to be more predisposed to MTSS with a 1.5-3.5 times greater risk of progression to stress fractures.
- Training errors represent the greatest risk factor as athletes try to do “too much, too fast”.
- Running on hard or uneven surfaces is also a common risk factor.
- MTSS is most often found in runners as well as some other ballistic sports (football, basketball, soccer, and track events) and those athletes with previous lower extremity injuries and who run more than 20 miles a week are particularly predisposed.
The plantar fascia is a thick tissue that runs along the bottom of your foot and spans from your heel to the ball of your foot. This tissue helps to absorb shock as you walk and run as well as store energy and propel you forward. Frequently called plantar fasciitis, in the last decade or so this term has been found to be inaccurate as the suffix, -itis, indicates inflammation which is rarely present in this condition. As you are running, the plantar fascia has to stretch which helps give support and stability to the foot. However, when the plantar fascia becomes irritated from too much pressure, it often results in small tears or microtrauma. This can become very painful when having to bear weight during standing, walking, and running.
Plantar Fasciopathy typically occurs in these 3 groups of people:
Those with altered foot mechanics:
People who have flat feet, high arches, or an abnormal walking pattern are at a higher risk of developing plantar fasciopathy because changes in how weight is distributed through the foot can cause abnormal stress on the plantar fascia leading to inflammation and tissue degeneration. This can include people who frequently wear high heeled shoes and/or have tight muscles through their calves.
Those who are overweight or obese:
A higher BMI is one of a few factors that significantly predict injuries in runners. The heavier you are, the more pressure your feet have to endure as you stand and move around. The extra weight puts more stress on the plantar fascia and can lead to inflammation and tissue degeneration.
Those who spend a lot of time on their feet:
Some job requires you to spend a lot of time on your feet and stand on hard surfaces which can put extra stress on the plantar fascia if the muscles in your feet aren’t strong enough to take extra stress off of the plantar fascia.
Symptoms of plantar fasciopathy to look out for include:
- Pain at the bottom of the foot, typically close to the heel, without traumatic injury
- Pain upon standing and first few steps in the morning or after a long rest period
- After standing, walking, or running for a long period of time pain gets worse
Iliotibial Band (ITB) Syndrome
Iliotibial Band (ITB) Syndrome is a common knee injury that presents with pain and/or tenderness along the lateral aspect of the knee. It is primarily seen as an overuse injury caused by repetitive stress. Studies describe an “impingement zone” that occurs around 30 degrees of knee flexion that causes irritation of soft tissue structures on the outside of the knee with repetitive movements such as running or cycling. Like almost all other running injuries the primary trigger seems to be a significant increase in training loads.
Risk factors for ITB syndrome include:
- Sudden increases in training volume or intensity
- ITB pain is significantly more common in male runners
- You are more likely to develop ITB pain with downhill running or walking
- Running in worn out or improper fitting shoes
- A narrow foot strike pattern will transmit more forces through the ITB