Running is becoming one of the fastest growing exercise activities. Its no surprise that many people choose to pound the pavement over other activities, as it is one of the most effective ways to burn calories and is a great way to de-stress and zone out after a stressful day. However there is a downside to all this, many injuries also arise from this form of exercise.

Here are 3 of the more common injuries we treat at our practice and ways you can manage and hopefully prevent them from stalling your running career.

Plantar Fascitis (PF)

The plantar fascia is a band of tissue (like a ligament) that joins the heel bone to the front of the foot. The attachment of this band, on the heel bone, commonly gets inflamed from excessive and repetitive stretching of the band.

PF generally affects people in a similar way. Most people complain of a throbbing pain at their heel at night in bed, or a sharp pain when taking their first steps in the morning. Normally the pain gets better as the day progresses and the band of tissue starts to stretch more.

The more common causes of PF in runners are repetitive use (i.e. running!), poor choice of foot wear, increasing training time and distance, changes in running surface, poor running biomechanics, the ageing process and more often than not more than one of the above.

To address PF completely, you will need to address any of the factors mentioned above, apart from the ageing process (sorry can’t help you there!).  Here are some tips to help manage PF.

• If you are a regular runner, it is worthwhile getting shoes fitted expertly by a podiatrist; occasionally orthotics can be the answer.
• Training time and distance needs to be monitored and gradually increased over time to allow your body to adapt to these changes.
• Try to vary the running surfaces occasionally, so you are not always ‘pounding’ on a hard surface.
• Get you biomechanics checked by a professional, as this may require some expert knowledge in identifying tight and/or weak muscles affecting in your running technique.

Iliotibial Band (ITB) Syndrome

Commonly known as Runner’s or Cycler’s Knee as both activities require repetitive flexion and extension of the hip and knee joints.  The ITB is a thick band/tendon that runs from the outer side of your Ilium (hip bone) to the outer side of your tibia (shin bone) and hence its name the ilio-tibial band.  Where the ITB crosses over the knee, is a common site of repetitive friction and pain.

As both PF and ITB Syndrome are considered as repetitive use injuries, the causes of both these running injuries are similar too. Some of the common causes of ITB Syndrome are: overuse/over-training, increasing your training time and/or distance too quickly, poor hip and knee biomechanics caused by the tightening of the core muscles responsible for the running action, namely the gluteals, hamstrings, quads and hip flexors.

Some of the easiest ways that you can manage and prevent ITB Syndrome are:

• Stretch regularly before and after running. Focus on the gluteals, hamstring, quads and hip flexor muscles.
• Use a foam roller or a football to roll on the ITB. As the ITB is a thick band of tissue, stretching will help but rolling over the ITB will be more effective in lengthening the band.
• Strengthen any weak muscles in the lower limb. Generally a weakened muscle in the chain will cause tightening of other muscles. The tight areas are simply symptoms of weakened muscles along the biomechanical chain.

Low Back Pain

Low back pain can be caused by many different things and I would like to clarify that an existing condition i.e. disc bulge, made worse from running compared to low back pain after running where there has not been an existing condition are different and need to be treated differently.

In the first case, running should most probably be avoided, as the running would most likely be aggravating an existing condition and if the aggravating factor is not ceased, then we would most certainly expect the problem to get worse. Whereas in the latter, if you did not have an existing back problem, and gradually developed back pain that worsened every time you ran, this possibly indicates that there is a flaw in your biomechanics causing tissue fatigue and eventually pain. This scenario does not only apply to the low back region and occasionally we see this in the hamstrings and hip muscles during running.

In North Sydney 90% of our patients are office bound workers and are more likely to find that the sedentary work leads to tighter and stiffer bodies. After sitting most of the day, then running with stiff or immobile joints particularly the hips, leads to increased workload to other areas of the body, most commonly in the lower back or lumbar region.

My suggestion to help manage this specific type of low back pain is to dedicate time in your training program to focus on flexibility and increasing range of motion through the lower back and lower limbs, the areas that are normally not so active during the working week. Be disciplined with this, as flexibility is just as important as strength or power in athletic performance.

My only other suggestion would be to spend less time of inactivity during the day, which may seem like a no-brainer however this may not always be possible for most office workers. Ideally a lunch-time walk, an hourly stretch break and less time sitting at other times not at work would be the way to balance the week of inactivity. This advice applies for any office worker but more importantly for the running ones as this may prevent most problems caused by habitual inactivity.

Plantar Fascitis, ITB Syndrome and low back pain are conditions that can be self-managed but more importantly are preventable.  If your condition persists for more than 2 weeks with no improvement, we highly recommend visiting a health professional.