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How to treat a running injury

Running is a cardiovascular activity that offers many benefits. However, as with any sport, there is also a risk of injury. Knowing how to recognize the onset of an injury and choosing the right treatment, including medical imaging, is essential to continue running safely.

The effect of running on the body

Gravity is what causes the majority of running injuries. When we run, our entire body is propelled forward and into the air. Gravity then pulls our body back down to the ground. With each step, our muscles, tendons and stabilizers have the job of absorbing a force that is greater than our body weight.

Running injuries mainly affect the knees, legs and feet.[1]

Zone % of total running injuries
Knees 7 to 50
Feet 6 to 39
Upper legs 3 to 38
Lower legs 9 to 32
Lower back 5 to 19
Ankles 4 to 17
Hips, pelvis, groin 3 to 12

The first signs of a running injury

It is important for runners to pay close attention to their body while running and even between runs. A minor pain can become more severe and require a break from running if it is not treated promptly.

According to Richard J. Price, M.D., a sports medicine physician in Colorado, the severity and duration of a running injury depends largely on what you do as soon as the pain begins. He recommends reducing the length and frequency of your runs and starting a treatment, as well as establishing an injury prevention program that you can continue even after the pain has subsided. This includes strengthening exercises, stretching and massage with a foam roller.[2]

Runner’s knee

Patellofemoral syndrome, also known as “runner’s knee,” is the most common cause of knee pain in runners, accounting for 40% of cases. The pain is caused by irritation of the cartilage under the patella (better known as the “kneecap”). This syndrome is normally experienced during or after running, when descending hills and stairs, and after spending a long time in a seated position.

Achilles tendonitis

The Achilles tendon connects the two calf muscles at the back of the heel. This tendon can become irritated, leading to tendonitis. Achilles tendonitis accounts for 11% of running injuries.[3]

Plantar fasciitis

The plantar fascia is a ligament attached to the heel bone and extending to the base of the toes. It serves to support the arch of the foot. When the plantar fascia is stretched through repetitive movements, an inflammation causes pain in the heel. This is called plantar fasciitis.[4]

Tibial periostitis

Tibial periostitis, also known as “shin splints,” is an inflammation of the surface of the tibia bone where it attaches to the muscles. It is usually diagnosed by a physician based on the patient’s history and a physical examination. Medical imaging such as MRI can also confirm a diagnosis. Without proper rest, this injury can develop into a stress fracture of the tibia.

This injury is common among first-time runners and those returning to the sport after a long break. It also occurs when the shoes are not suitable for running and among runners whose arches are too wide or flat.[5]

Stress fracture

Stress fractures are caused by repeated stress on the bones. When you run, the bones in your feet, heels and shins sustain a great deal of pressure with each step. This is one of the most serious running injuries.[6]

A stress fracture is a serious injury. You should not run with an injury like this.

Read also: Stress fracture of the foot: A common injury for runners

Treatments for the most common running injuries

Conservative treatments

There are a number of so-called “conservative” treatments for running injuries, including physiotherapy, rest and anti-inflammatory drugs. According to Ternest Damien, expert running therapist at Kinatex Sports Physio , shockwave therapy is the newest tool for conservative treatment in physiotherapy. This non-invasive procedure is quite simple and according to the scientific literature, has a success rate of 75-90%.[7]

When conservative treatments are not successful, patients may opt for a more invasive approach, namely infiltrations and surgery.

Infiltration treatments

In patients with patellofemoral syndrome who do not respond to conservative treatments, a cortisone infiltration into the knee joint, either fluoroscopy- or ultrasound-guided, usually provides temporary relief from the pain. Cortisone acts as an anti-inflammatory and pain reliever. Other types of injections, such as viscosupplements or platelet-rich plasma (PRP), can often provide longer-term relief.

For problems such as Achilles tendonitis or plantar fasciitis, which do not respond to conservative treatments, your doctor may suggest a cortisone infiltration. This treatment has a high success rate in providing temporary pain relief, but does not cure the underlying problem in the tendon or fascia. However, the procedure can significantly reduce the pain.

Among the treatments with potential to heal are tenotomy (also called tendon fenestration), which involves passing a needle multiple times through the tendon following local anesthesia. There is also the option of injecting platelet-rich plasma (PRP) into the tissue. This is a fluid extracted from blood taken from your arm. The concentrated platelets contain growth factors, among other things, and can help regenerate diseased tissue. These procedures are quick and minimally invasive, and could help you avoid surgery.[8],[9]

Read also: What are Musculoskeletal Disorders?

How to prevent running injuries

Yes, running injuries are common. However, simple changes to your training habits can minimize the risk of injury.[10]

Warm up

Do not start running as soon as you step outside. Begin with a five- to 10-minute warm-up to awaken your muscles and cardiovascular system. You can jog at low intensity or do some dynamic stretching of your arms and legs.

Build up gradually

Avoid increasing your time or distance drastically. Your body needs to adapt to increases in order to avoid injury. The 10% rule, popular with many runners, states that you should not increase your running by more than 10% each week.

Treat persistent injuries

If not treated promptly, running injuries can worsen and force you to take a long break. Speak to a physiotherapist to get the right treatment for your situation. In cases of chronic Achilles tendonitis or plantar fasciitis that cannot be treated with physiotherapy, treatment with tenotomy or ultrasound-guided PRP injections may help you heal.

Fine-tune your technique

If your injury is the result of a poor running technique, it will return after treatment. To fine-tune your technique, speak to a kinesiologist or physiotherapist.

Choose soft surfaces

The harder the surface you run on, the greater the impact on your joints. Running on grass, a rubber track, sand or gravel is better for your body than running on asphalt.

Add variety to your training

Adding a low impact sport, such as cycling or swimming, to your training can help you perform better when running. This way, you can improve your aerobic health while giving your joints a break.

An ounce of prevention

Running carries multiple risks of injury, some minor, some more serious. It is important for runners to know how to identify the early signs of a running injury and to consult the right health care professional to treat the injury.

Working on your technique with a professional can help you reduce the risk and prevent running-related injuries. A few simple tips could make a big difference, helping you achieve your goals safely and enjoyably.

For professional support, we’re here.

We provide services that can help your doctor diagnose disorders musculoskeletal disorders and determine the right treatment.

Do you have a medical prescription for one of these tests? Please book an appointment online or contact Biron Health Group’s customer service at 1-833-590-2712.

Sources10
  1. Maarten P. van der Worp et al. “Injuries in Runners: A Systematic Review on Risk Factors and Sex Differences,” PLOS ONE (2015): Vol. 10, # 2, e0114937, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4338213/ (accessed May 12, 2021).
  2. Ashley Mateo. “Quick Fixes for the 15 Most Common Running Injuries,” Runner’s World, (April 27, 2021), https://www.runnersworld.com/health-injuries/a35994829/running-injuries/ (accessed May 12, 2021).
  3. Mateo, op. cit.
  4. Uniprix. “La fasciite plantaire,” https://www.uniprix.com/fr/conseils/1/sante/la-fasciite-plantaire#:~:text=La%20fasciite%20plantaire%20est%20une,soutient%20la%20cambrure%20du%20pied (accessed May 12, 2021).
  5. Mateo, op. cit.
  6. Ibid.
  7. Kinatex. “Thérapie par ondes de choc radiales,” https://www.kinatex.com/services/physiotherapie/therapie-par-ondes-de-choc-radiales/ (accessed May 12, 2021).
  8. Akram Abdel Moneim Deghady et al. “Platelet-Rich Plasma in Treatment of Plantar Fasciitis: Randomized Double-Blinded Placebo Controlled Study,” Journal of Applied Clinical Pathology (2019): Vol 2, #1, p. 1, https://scitemed.com/article/2623/Platelet-Rich-Plasma-in-Treatment-of-Plantar-Fasciitis-Randomized-Double-Blinded-Placebo-Controlled-Study (accessed May 12, 2021).
  9. Dr. Bailey. “Runner’s Knee (Patellofemoral Pain Syndrome),” Perimeter North Medical Associates, https://pnfm.com/about-us/articles/runners-knee (accessed May 12, 2021).
  10. Daniel Yetman. “The 8 Most Common Running Injuries,” Healthline (July 31, 2020), https://www.healthline.com/health/running-injuries (accessed May 12, 2021).
Dr Roxanne Labranche
Radiologist and Kinatex