Common Running
Injuries
Patellofemoral pain
Knee injuries are most common for runners
Patellofemoral pain
Maltracking of the patella (knee cap) at the knee
Pain behind patella at foot strike mostly (pain also
with stairs and after sitting for a while)
Treatment
Taping may help
May be related to foot pronation
May be related to weak hips
Strengthen quads in midrange
Patellofemoral pain
Hip strengthening
Squats (NOT FULL)
Single leg squats (NOT FULL)
Backward walking with elastic bands
Controlled landings
IT Band Syndrome
Pain on outside of leg or at knee
Usually due to tightness
May also be due to weakness of the hip
Overpronation
Treatment
Lamppost Stretch
Seated stretch
STRENGTHEN HIP
Posterior Tibialis Tendonitis
• Pain behind medial malleolus
(inside of ankle)
• Due to excessive pronation
• Rest and ice initially
• Prevention
– Strengthen posterior tib
» Single leg standing
– Strengthen hip abductors and ERs
Tarsal Tunnel Syndrome
• Symptoms
– Pain behind medial
malleolus
– Referred pain on medial
and lateral plantar
surface of foot
– Numbness and tingling
– Possible weakness of
foot muscles
– SERIOUS CONDITION
Achilles Tendonitis
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Pain in distal 1/3 of posterior calf
May be due to weakness of calf
Stretch HAMSTRINGS
Stretch CALF
Prevention
– Strengthen calf and hamstrings
– May use heel lift during initial flare
up
Tibial Stress Fracture
• Usually in distal 1/3 of tibia
• Point tenderness over tibia
– Not diffuse
– Not over muscle belly
• Seen more in women than men
• Due to excessive repeated stress
– Usually vertical
Tibial Stress Fracture
• Treatment
– REST!!!
– Decrease mileage
– Isometrics
– Orthoses
• Depends on foot type
– Shoes
• Depends on foot type and motion
Sprains
• Most common injury at the ankle
• Lateral (outside)
– 90 to 95% of sprains
– Anterior talofibular ligament
– Calcaneofibular
– Posterior talofibular
– Bifurcate ligament
Sprains
• Grading
– Grade I
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Minimal functional loss
Mild swelling
Microtearing
Tender
Mild pain
Able to run in 1-2 days
– Grade II
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Moderate functional loss (difficulty walking)
Swelling
Diffuse tenderness
Able to WALK in 7 days
– Grade III
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Severe functional loss (crutches)
Severe swelling
Bruising
Unable to walk NORMALLY in 10-14 days.
Sprains
• High Ankle Sprain
(distal tib/fib sprain)
– Swelling more proximal
– Usually accompanies other
sprains
– Tender with rotation of foot
– More severe sprain
– Painful from midstance to
pushoff
– May need bracing to prevent
DF
Fractures
• Fifth metatarsal
– Stress fracture
• Supinators
• Unload
• Cast-nwb 3-4 weeks
– Avulsion fracture
• Base fracture
• Peroneus brevis
• Taping
– Jones fracture
• Proximal 1/3
• Rod
– Dancer’s fracture
• Spiral fracture at neck
• Inversion
5th MT Fractures
• Prevention
– Shoes
– Calf stretching
– Balance training
– Orthotics
Plantar Fasciitis
• Symptoms
– Pain in the morning
• Medial calcaneal tubercle
– Pain after inactivty
– Pain is reduced with activity
INITIALLY
– Pain usually lasts 8-10
MONTHS!
Plantar Fasciitis
• Factors
– Tight Achilles
– Leg length discrepancy
– Poor footwear on hard floors (think about your feet
when you are NOT running)
– Pes Planus (flat feet)
• Stretch plantar fascia at end range
– Pes Cavus (high arched feet)
• Tight and can’t stretch
– Heel spur??
Plantar Fasciitis
• Treatment
– Rest
• Use a heel lift ONLY in acute stage then wean off.
– Stretching IF NEEDED
• Plantar fascia
• Achilles
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Heat
Deep friction massage
Ice massage
Taping
Foot orthoses
Shoes
Sinus Tarsi Syndrome
• Signs and Symptoms
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Pronation
Past lateral ankle sprain
Gradual onset
Usually on one side only
Radiating pain on top/outside of foot
Pain with inversion & PF PROM
Peroneal muscle weakness
Rearfoot instability
Sinus Tarsi Syndrome
• Treatment
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Get rid of inflammation
Electrical stim works well
Cortisone shot
Foot Orthotic Devices
• Control pronation
– Over the counter
– Custom molded
Others
• Cuboid Syndrome
– Lateral instability
– Taping
• Spring Ligament Sprain
– Different from plantar fasciitis
– Pain in back of arch
– Taping, orthoses or motion control shoe
• Lis Franc Sprain (midfoot pain)
– Taping, orthoses or motion control shoe
• Fat Pad syndrome
– Rest
– Cushioning shoes or orthoses
Final Thoughts
• Strong core and hips! Cross Train
• Nutrition
• Large majority of injuries are due to
improper training
– Too much
– Too quick
– Too fast
THANK YOU!
I plan to be running as long as I can and have
no plans to stop. -Frank Shorter