Running Injuries

Eighty percent of runners end up with an injury at some point. If you find yourself with some aches and pains,vuse this information to gain a better understanding of why you’re hurting.

**seek professional help if you feel that you are dealing with an injury**


Common Injuries Experienced By Runners

Below you will see a list of the most commonly seen running injuries and the common symptoms of each as divided by location of pain.

Having thigh pain? It could be:

      1. Quad Strain: Pain along front of thigh, possible bruising/swelling, pain with walking/running/stairs, localized tenderness

      2. Hamstring Strain: Pain along back of thigh, possible bruising/swelling, pain with standing/walking/bending over, localized tenderness 

      3. Adductor Strain: Pain along the inner portion of the thigh, possible bruising/swelling, pain with walking/running/stairs, localized tenderness

Having knee pain? It could be:

      1. Patellofemoral Pain Syndrome: Generalized pain around or above the knee, gradual worsening overtime, pain with squats/stairs/running/jumping

      2. Patellar Tendinopathy: Generalized pain below the knee cap, swelling/stiffness, pain with going down stairs worse than going up stairs

      3. IT Band Syndrome: Pain along the outside of the thigh, pinpoint tenderness at the outside knee, pain running or walking downhill/stairs, can especially hurt in the middle of a run when starting up after stopping (ie. running after waiting at a stop light)

      4. Pes Anserine Bursitis: Pain/tenderness around inner knee, swelling around inner knee, pain with walking/standing/stairs/running/jumping

      5. Ligament Sprain: Pain/tenderness at ligament location, knee joint laxity, popping/clicking/catching sensations, feelings of instability/giving way

      6. Meniscal Injury: Pain/tenderness at knee joint, knee joint laxity, popping/clicking/catching sensations, feelings of instability/giving way, pain with weight bearing activity

Having buttock and/or back pain? It could be:

      1. Gluteus Medius/Maximus/Minimus Strain: Pain in the buttock region or at the side of the hip, tenderness at side of hip or in buttock region, pain with sitting/running

      2. Sacroiliac Joint Dysfunction: Pain in low back/buttock region, inability to sit for long periods; pain with single leg activities like running/walking/stairs, getting up from a seated position, or standing

      3. Piriformis Syndrome: Pain in buttock region, sharp/shooting pain that can radiate into the thigh, pinpoint tenderness in buttock region, pain with sitting for long periods of time/running/walking

      4. Pelvis or Sacrum Stress Fracture: Pain in buttock/back/pelvic region, tenderness over pelvic bone or sacral bone, pain with sitting/walking/running/jumping/standing/sitting

      5. Lumbar Muscle Strain: Pain across low back, tenderness over low back muscles, pain bending forward with worsening of pain as you come back up, pain with twisting and side bending, pain referral into buttock

      6. Psoas Muscle Strain: Pain in low back/upper buttock/front hip, tenderness in deep abdomen/front pelvis/upper thigh, pain with running 

Having leg pain? It could be:

      1. Shin Splints: Pain in the front or inner portion of the lower leg, tenderness along “shin” bone, pain with walking/running (especially down hill)

      2. Stress Fracture: Deep aching pain that gets worse over time, pain increased with activity and can decrease with rest, pain continues at the end of the day/into the night, localized tenderness

      3. Achilles Tendinopathy: Pain at the back of the ankle/heel, stiffness/swelling/tenderness in area are common, pain with standing/walking/running/jumping

      4. Gastrocnemius/Soleus/Posterior Tibialis Strain: Pain and tenderness in the calf.  Pain increased with pushing off your foot or standing on your toes

Having foot pain? It could be:

      1. Plantar Fasciitis: Pain on the heel that can spread over the arch of the foot, tenderness at the inner portion of the heel, pain is worse first thing in the morning and eases with activity 

      2. Stress Fracture: Deep aching pain that gets worse over time, pain increased with activity and can decrease with rest, pain continues at the end of the day/into the night, localized tenderness

      3. Ankle sprain: Pain around the ankle; outside ankle more common than inner ankle, swelling/tenderness/bruising around ankle, pain with weight bearing activities, decreased range of motion

      4. Posterior Tibialis Tendinopathy: Pain and tenderness on the lower part of the inner shin, behind the inner ankle bone, and/or the arch of the foot.  Pain increased with weight bearing—standing, walking, running, squatting, jumping

so How Do You Treat These Injuries?

As you may have already noticed with the above list of common running injuries, it is clearly evident that different injuries and diagnoses will have similar presentations. While presentations may be similar, the cause(s) of the injury can be very different, though. For example, that buttock pain you are experiencing could be a muscle strain, sciatica, sacroiliac joint sprain, lumbar sprain, lumbar strain, stress fracture in the hip/pelvis/sacrum, and even a low back disc issue.  Addressing each of these may require completely different strategies to determine the root cause of the injury and different corrective interventions with varied timelines for recovery.

Common reasons that an injury will occur include:  training volume, training intensity, training terrain, abnormal running biomechanics, shoe wear, general weakness, and general mobility.  Due to the fact that running injuries can be multifactorial in their root cause, it is imperative that you seek the expertise of a skilled specialist who can determine the root cause of the injury.

In all of the above injury scenarios the process for ameliorating the symptoms follow a common formula: 

  1. Identify the injured structures that are causing your symptoms, and address the inflammation.

  2. Identify the underlying dysfunction or issue that is causing stress to the injured structure. This can be muscle inflexibility, muscle weakness, poor soft tissue mobility poor muscle recruitment patterning, poor neuromuscular coordination, poor joint mobility, poor running mechanics, poor training.

  3. Correct the dysfunction/issue.

  4. Get quality sleep and nutrition.

  5. Give your body time to heal while finding alternative modalities to continue training your energy system without exacerbating your symptoms.

Over time and with the appropriate corrections and anti-inflammatory interventions your body can heal itself.  Sometimes we forget that our body is always trying to repair and heal itself, and all we need to do is give it the time and appropriate interventions to foster the process.  Too many times we want the quick and easy answer to heal our injury.  I hate to break it to you, but our bodies don’t always work that way when trying to heal itself.  We believe that people have been conditioned to subscribe to short-cut interventions—changing shoes, getting arch supports, using the latest injury doodad, self-medicating—that is many times a waste of time and resources when you don’t know the root issue of your pain. 

The most common mistakes that people make when self-treating an injury include:

  • Over-utilization of non-steroidal anti-inflammatory medications (Advil®, Ibuprofen®)

  • Excessive stretching

  • Hastily buying new shoes/orthotics/braces/support clothing without even knowing what you’re trying to correct.

So before you buy that $8 bottle of Advil®, $50 compression sock, $45 shoe insert, $150 running shoe, $10 foam roller, $20 kinesiotape, and $20 knee brace to “heal” your injury consider spending your hard earned money on finding the root cause of your pain from a qualified professional who understands the science and art of differential diagnosis of running injuries, lower extremity biomechanics, running form, the role of the core in running mechanics, the principles of strength training, and proper rehab interventions who can then determine the root cause of your injury and develop a plan to fix it.