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All About Running Injuries

Are you a runner who needs help getting back up to speed? Running injuries are seen in everyone from the recreational runner to the most advanced ironman athletes. As a provider for all athletics at the University of Memphis, one of the most challenging sports to tackle is track and field. It is a well acknowledged fact that track and field is the quintessential environment for keeping a sports doctor’s skills sharpened, as conditions seen in this sport span the entire length of the injury spectrum. From shoulder impingement and labrum tears all the way down to shin splints and stress fractures of the foot, track and field is an every day challenge.

 

 

Very often, running injuries are a result of a wear-and-tear like breakdown in the body. Over time, these micro-traumas accumulate until reaching a point where the body can no longer adapt and heal fast enough. This is when pain is finally experienced. Common causes of this running trauma include improper running surface, poor running shoes, inadequate training or preparation, joint immobility or fixation, and muscular imbalances or compensations. Importance must be placed in these factors in order to properly address these injuries.
Running produces added and abnormal stress to many joints in the body including; the feet, knees, hips, and back. It has been found through numerous studies and surveys that approximately 72% of people involved in running will incur some sort of injury throughout their career. To emphasize how important proper joint biomechanics are, Mid-South Spine and Sports Performance would like to educate you on some of the most common injuries in running athletes, their association to improper biomechanics, and the best line of treatment for these injuries. Each of these following six injuries are also some of the most common running injuries that we have had great success with at Mid-South Spine and Sports Performance.

 

1.  Stress Fractures:

Stress fractures are a common cause of pain in running and typically occur in the foot and lower leg. In fact, it is estimated that stress fractures are responsible for up to as much as 15% of pain in runners.  Stress fractures typically begin from either over-use or imbalances in muscles or both. In an over-use instance, added intensity or distance without proper acclimation can lead to muscles that are unable to handle the added stress causing the bony structures in the involved joints to absorb most of these forces.  On the other hand, a muscle may be overworking and cause excess stress on the same bony tissues with the same result. This could be due to an imbalance in particular muscles during the athlete’s stride or a malposition in the foot or ankle leading to changes in joint mechanics causing added stress the bone. These changes in biomechanics could also be due to a chronic or acute compensation in the body, which causes the nervous system to produce alterations in muscle contraction. Proper treatment must result in either case as both the athlete’s volume and intensity need to be reduced. Proper evaluation and treatment of the causes must be addressed as well in order to ensure the athlete is able to handle these stresses once they are back to full participation.

 

 

 

2.  Achilles Tendonitis:

To understand achilles tendonitis, it is first important to understand what the achilles tendon is.  The achilles tendon is one of the strongest structures in the body, connecting the calf musculature to the calcaneus or heel of the foot. Through this design, a person is able to lift and move the foot during activities such as running. Tendonitis is a term that means inflammation, but inflammation really only identifies a symptom. What we are concerned about is the cause of that inflammation. If the calf muscles are weakened or not functioning properly, activities such as jogging and running can cause stresses that normally spread across the muscle to localize in the tendon resulting in overuse, pain, and swelling.  When this occurs, people typically experience pain near the heel, swelling around the ankle, and limited flexibility of the joint.  Typically, the pain is worse at the beginning of exercise and lessens throughout the workout. Achilles tendinitis has many of the same causes as stress fractures. This is why proper evaluation is needed to identify not only the correct diagnosis and cause, but to also identify predispositions to other injuries which have similar risk factors.

 

 

3.  Shin Splints:

If you are experiencing pain throughout your lower leg, specifically the shin region, and have just begun an intense workout following a long period of rest, there’s a good chance your suffering from shin splints. Shin splints typically begin at any age and are most commonly associated with individuals who overdo it during their initial training phase. Shin splints are better explained as over-use stress in the muscles of the lower leg. Typically, shin splints are first noticed as a dull/achy sensation throughout the front of the lower leg.  Overtime, swelling and tenderness below the knee and into the shin will occur. Large increases in exercise volume or intensity, poor shoes, and flat feet can contribute to its development, as can imbalance in the neuromusculoskeletal system. If not properly treated, shin splints can quickly develop into stress fractures, which is why proper treatment is required. This could range from biomechanical assessment of the foot, ankle, or surrounding muscles that control these joints to supporting the foot with Foot Levelers orthotics, to incorporating proper training and peaking methods in running. Dr. Detweiler’s “track record” with running athletes will ensure you are moving down the right path to return to activity.

 

Foot Levelers can help relieve pain as well as prevent future injury.

 

4.  Runners Knee:

As the name implies, runners knee is most common to runners.  However, the term is more general than you would think and the condition can develop in anyone who overworks the knee joint.  The most common initial symptom of runners knee is a dull/achy sensation that develops around the knee. Typically, pain is most severe during activities that require stabilization or bending of the knee.  There are many causes that contribute to its development in runners, but direct trauma, overuse, improper function of the thigh musculature, and improper biomechanics of the knee joint are the most common.  There is a widely held misconception that chiropractors only deal with treating the spine. The spine becomes a primary focus by nature, because not only are there more joints in the spine than any other region in the body, but the spine has the biggest impact on biomechanical function. Proper treatment of conditions in the knee joint are heavily reliant on an understanding of both neurology and biomechanics in order to properly diagnose and treat this condition. Because of this, Reflexive Performance Reset offers the best solution to assessing and fixing compensations in the body. RPR is a methodology that deals with evaluating and resetting the motor patterns of the nervous system. RPR has been shown to significantly reduce return to play times and prevent future injury, and is a prime choice for any performance based athlete.

 

5.  Plantar Fasciitis:


Plantar fasciitis is one of the most common conditions of the foot for all patients, runners or not. In order to better understand this condition, it is important to review what the plantar fascia is.  The plantar fascia is one of the strongest structures in the body and is fastened from the heel to the pads of your feet. This structure adds stability to your foot and helps you maintain the proper arch. Because of this, people who commonly have been described as having “flat feet” are more predisposed to this condition, as a flattening of the feet further stretches and stresses the plantar fascia. Running produces an increased stress to the plantar fascia, and if it is subject to EXCESSIVE forces or stress, can produce the pain that is attributed to plantar fasciitis. Overuse injury is the most common causes of plantar fasciitis. This includes sudden increases in activity, such as increasing running volume over too short a period of time, wearing poor running shoes, running on particularly hard surfaces, and misalignments or biomechanical changes in the joints of the foot. The pain associated with plantar fasciitis is often described as sharp and intense and is often the worst during the first few steps after awakening in the morning. It’s important to understand that the sooner proper treatment is obtained, the better. Anti-inflammatories, cortisone shots, and braces have been found to be effective for short-term symptomatic relief.  However, long term success is highly dependent on proper analysis and treatment of the biomechanics and function of the lower extremity. This may include physiotherapy such as ice massages or stretching, chiropractic therapy such as adjustments of the foot and myofascial release of the plantar fascia itself.

 

6.  Ilio-Tibial Band Syndrome:

Ilio-tibial band syndrome or IT band syndrome for short, is a common condition that arises as a result from imbalances in the hip and knee during running. The IT band is a long connective tissue structure that extends from the hip to the knee. Therefore, pain and other related symptoms can present anywhere along its path. The IT band is extremely important for the stabilization of the knee joint, and abnormalities of this structure along other supporting structures of the knee have been known to contribute to knee injuries. The most common symptoms of ilio-tibial band syndrome are pain and inflammation along the outside of the leg.  These symptoms may be felt during and even after running, and usually affects more experience runners, as it is a result of a long accrual of forces at the IT band and knee.  Since this structure involves everything from the hip to the knee, a complete study and examination of the leg is necessary. An IT band injury can also be the result of overworking the IT band due to a compensation in a runner’s motor patterns that cause the glutes to shut down. This scenario is typically observed in runners with poor glute and low back stability. Proper care involves a full spectrum of services including kinesiotaping, adjustments of the spine, hips, and feet, active rehabilitation and Reflexive Performance Reset.

Clearly, many injures and their resulting symptoms are associated with underlying causes that require a proper evaluation and set of tools to. A sports chiropractor is uniquely positioned to provide a great mix of conservative and effective treatment options for common non-surgical conditions such as these. Since running places additional mechanical stress on the body’s structure, it is also important for an athlete to see a chiropractor before these conditions occur as part of a preventative-wellness approach. A rule of thumb in many sports such as running is its not a matter of if, but when you get hurt. But this neglects a proactive approach to healthcare in which attention to alterations in mechanics and structure can identify and help prevent these common wear and tear injuries.

 

If you believe you are developing any of the previously stated conditions contact Dr. Detweiler and Mid-South Spine and Sports Performance at (901)-573-2526 or drdetweiler@midsouthssp.net for a complete evaluation.  For more information how you can reduce your risks of injury, check out our website at www.drtyreldetweiler.com

 

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