Should I Start Running? Common Injuries and How to Prevent Them

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Originally Posted On: https://sloanestreetsurgery.co.uk/articles/should-i-start-running-common-injuries-and-how-to-prevent-them/

Inspired watching the London Marathon? Seen your neighbours take part in your local park run? Keen to lose some weight? Or already a runner but wanting to know the best way to stay injury free? Then read on…

Running isn’t for everyone and many runners never thought they’d be able to run a mile let alone enjoy it! With the right guidance it can bring huge benefits to your quality of life both mentally and physically and before you know it you’re signing up to the local 5k race or entering the London Marathon Ballot!

You just need to grab your trainers and off you go, be it in silence, listening to a podcast or one of the numerous running playlists available. With the increased heart rate getting those endorphins going whilst you’re out in the fresh air, you won’t look back.

If you’re starting for the first time, progress will be slow and as we mention later the key is starting gradually, but you’ll soon increase your mileage, feel the benefits and reap the rewards!

• Weight loss/heart health: Most people want an exercise which will help them lose or maintain a healthy weight and running is a fantastic way to do that, but that’s not the only benefit. It is a cardiovascular exercise so it strengthens the heart and improves your circulation, reducing your overall risk of heart disease. If you suffer with high blood pressure and struggle keeping your weight down then running could be for you.
• Muscle and bone health: As we get older our bones become thinner (osteoporosis) and muscle becomes weaker. Running increases muscle tone and strengthens the bones which is crucial to helping maintain a good quality of life and increase longevity.
• Immunity: Running helps boost your immune system and like all exercise can improve sleep quality and duration which also helps immunity.
• Reduces chronic diseases: Long-term it helps prevent diseases such as diabetes, hypertension and obesity.
• Joint health: When done properly with correct footwear and not always on hard surfaces it can improve the health of your joints, protecting against arthritis.
• Respiratory health: It increases your lung capacity.

• Stress reliever: Daily, we encounter numerous stresses in life and taking this time out to focus on ourselves to lift that heart rate and get the endorphins going can be a huge stress reliever.
• Improve concentration and focus: It can help you clear your head and increase your concentration and focus.
• Help with anxiety and depression: It’s known to reduce depression and anxiety levels in addition to boosting your self-esteem. Cardiovascular exercise can be crucial for many who suffer with mental health conditions.
• Help create a sense of community: Running is a great way to meet your local community with numerous running clubs available to join in addition to Saturday morning park runs across the country. Running with others and having events to look forward to can really help keep you motivated especially when winter approaches.

The most significant risk factor for an injury is having had a previous one, so the key is to focus on prevention from the start. Other risk factors include:

• Non-supportive/old footwear
• Not warming up or stretching after exercise
• Muscle weakness/imbalance
• Improper technique
• Not enough recovery time.

All of these can lead to the running injuries listed below. If you focus on addressing these then you’re less likely to have an injury.

We frequently hear the phrase “I haven’t been for a run for years but I’m sure I can just do that 10k”.

Runners can get fractures, sprains and strains of ligaments and tendons however most of the injuries are from overuse, not allowing yourself enough recovery time and running too far too quickly.

Injuries tend to affect the knee, foot, ankle, hamstring and the tibia (shin bone) and below are the most common ones:

1) Iliotibial band syndrome

Do you have a sharp pain on the outside of your hip or knee during or after running, or even at rest which is generally worse going downhill?

We have a tendon running along the outside of our leg from the hip bone to the knee. If this tendon becomes tight it starts to get irritated rubbing against the bone into which it inserts either at the knee or hip, becoming swollen, causing pain. Having too tight or too weak hip muscles in addition to over-training can cause this injury.

It will improve with rest but also anti-inflammatory medications such as ibuprofen (unless there is a medical reason not to take it), foam rolling to massage the tendon and physiotherapy if necessary. Most patients will recover within 2 months with this treatment program.

2) Patellofemoral Pain syndrome (PFPS also known as Runner’s Knee)

Do you have a dull, achy pain around the front of your knee or behind your kneecap (Patella)?

A third of runners’ knee pain is caused by this injury.

Is your knee pain generally made worse by climbing stairs, sitting with knees bent for a long time, squatting or running? If so, you might have PFPS. The actual cause isn’t well understood however a few things make you more at risk of acquiring it such as misalignment of the kneecap, repetitive movement of the knees such as jumping or bending your knees for work, weak or tight muscles around the knees or increasing your activity too quickly.

Treatment, like with most sporting injuries, starts with “RICE”: Rest, Icing the area for 20 minutes every 4 hours, Compressing the area with a bandage or wrap of some sort to help reduce the swelling and Elevate the knee above your heart. A physio can help show you exercises to strengthen the muscles around the knee, possibly give you a knee brace and make sure you have a good posture. Anti-inflammatories will also help with the swelling.

You can make a full recovery in a few months depending on the cause.

3) Plantar Fasciitis

Do you have persistent pain in your heel or bottom of your foot, that’s worse on resting the foot?

This is the most common cause of heel pain in runners.

There is a thick band of tissue (fascia) akin to a rubber band which runs from your heel to your toes known as the plantar fascia. It is responsible for the arch under your foot. When this fascia is stretched, often from tight calf muscles or stressed from overuse it becomes inflamed causing heel pain. The pain tends to be worse in the morning or after inactivity.

Running can irritate the plantar fascia, especially if you have no arch in the foot or have a very high arch, exercise on a hard surface and don’t warm up or cool down.

Like the runners’ knee injury, treatment is mainly anti-inflammatory medications, rest, ice and massaging/stretching the area. In addition to this being referred for insoles (orthotics) to help support the arch in your foot might be helpful.

Recovery can take a few weeks to months.

4) Achilles Tendinopathy

Do you have pain, stiffness or swelling in your heel?

The tendon which runs from your lower leg to your heel is known as the Achilles and this can become inflamed with overuse from running. The repetitive stressing of this tendon can cause inflammation especially if you don’t allow time to rest following exercise.

Like with the plantar fasciitis, you’re more at risk with flat arches and tight calf muscles or sudden increase in activity levels.

Pain would be worse climbing stairs, after you exercise or even the next day.

It’s important not to ignore the pain as it can progress to a tendon rupture which would then require surgery.

Treatment is the usual; rest, ice, compression, elevation of the leg and anti-inflammatories. Calf stretches would be the additional treatment for it, and we have advice on this in clinic.

Physiotherapy would be the next step if no improvement with this treatment and in some cases shockwave therapy to reduce the pain.

5) Hamstring Strain

Do you feel pain/aching at the back of your thigh or even buttocks and maybe have some swelling?

Running can cause strain or even tears to the muscles and tendons behind your thigh (the hamstring muscles). Most often it is caused by a sudden movement that tears the muscle, this is especially true for sprinters and footballers as they are quickly changing speeds.

The hamstring can become inflamed (tendonitis) from overuse or over-stretch if you have tight hamstrings.

If it is just tendonitis then this can resolve with a few weeks of rest, RICE and anti-inflammatories. Then physio can help with restrengthening. A tear would tend to require surgery.

6) Shin splints (Medial tibial stress syndrome)

Do you have pain/an ache along the front of your shin bone maybe with some swelling?

If there is repetitive stress on your shin bone (tibia) and the surrounding muscles from running then inflammation can occur which results in pain. You’re more at risk If you run on uneven or hard surfaces or increase your exercise too quickly. It’s crucial here to make sure you have supportive shoes.

The shin splint can develop into a stress fracture (crack in the bone) if you don’t rest enough, don’t have adequate nutrition or if you suffer with osteoporosis.

Generally shin splits takes around 1 month to recover.

7) Ankle sprain

Sudden pain and swelling around the ankle joint?

It’s very easy to “go over” on your ankle whilst running, rolling or twisting it. Often this can stretch and sometimes tear the ligaments that support your ankle joint. Treatment is once again rest, ice, elevation and compression. This can take weeks to recover and you might need additional crutches or a brace.

8) Hip pain

Do you have pain in the groin or inside thigh which sometimes radiates down the leg?

If you have discomfort where the thigh meets your hip in the groin region or lower abdomen then you might have a hip muscle strain or tear.

This is often due to improper running form, muscle imbalances and overuse. The treatment is, yes you’ve guessed it, rest, ice and anti-inflammatories.

All of the injuries listed above are mostly from over-use, repetitive exercise so how do we help prevent these injuries? Focusing on the following factors is key when it comes to preventing injuries in running and sticking to these will most definitely help keep you fit and healthy!

• Adequate footwear is vital: Running shops such as “Runners Need” can help find the correct trainers for you and it’s advised you replace trainers after every 300miles of running. If you have a flat arch we can refer you to a podiatrist for insoles to help support your foot.
• Correct running technique: A great starting point is to make sure that you have the correct running “form”, making sure your weight is evenly distributed, you don’t have any obvious muscle weaknesses and your stride is right. Places such as The Running Room have in house physios with special running machines to help get you started.
• Gradual progression: 10% rule – not increasing your activity level and intensity by more than 10% per week, allowing your muscles to gradually strengthen and adapt.
• Pre and post running care: Gentle warming up before and 5-10 mins stretching after will help with flexibility in addition to prevent injuries.
• Surfaces: It’s hard in London but try to avoid hard, uneven surfaces.
• Cross train: Try to vary your exercise to include lower impact options such as swimming or cycling. This avoids repetitive stress whilst maintaining your fitness.
• Rest days: It’s important for your body to rest so do make sure you take days off.
• Don’t work through the pain: If you’re in pain reduce your exercise until it settles.
• Strength training: Building the muscles around your hips, knees and ankles is crucial. Activities such as Pilates, Barre and high intensity work outs for even 20 mins at a time can be hugely beneficial. We also have wonderful physios we can refer you to in order to help with strength training.
• Good nutrition: It goes without saying that your body requires the best fuel in order to help get the best outcome in addition to using it for muscle repair and bone health.

Running isn’t suitable for everyone and you might want to consult us before taking on a training plan. Those with previous injuries, severe arthritis in their knees or hips, those who’ve had recent heart problems or uncontrolled high blood pressure and high-risk pregnancies. There are many alternatives such as walking and swimming which would be better for these patients.

If this article has helped you decide that running is for you, if you are worried about an injury, or if you’re keen to improve your form, please get in touch with us by booking an appointment here or call 0207 245 9333. We have a number of expert physios and sports doctors who can help assist you further in your running journey! Most of all enjoy it!

Links:

PHYSIOTHERAPY — The Running Room – Physiotherapy and Podiatry

Couch to 5k – C25K Running Program

Adidas Runners

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Running Training Plans – Marathon, half marathon, 10k & 5k training plans (runnersworld.com)