Common Running Pains & Injuries

Aches and Pains of Running

Even with the best preparation, aches and pains are an inevitable result of a new jogging regimen. If the pain subsides with slow easy exercise, you may continue, but if it gets worse, stop the activity and rest. If it persists, see your podiatrist.

The most common pain associated with jogging is known as runner’s knee, a catch-all for jogging-related knee pain. One of the most common causes of runner’s knee is excessive pronation, or rolling in and down, of the foot. This syndrome is now often called the patello-femoral pain syndrome.

Orthoses (arch supports — shoe inserts) prescribed by your podiatrist are the best way to alleviate the problem. Occasionally, rubber pads in the arch of the shoe will help.

Shin splints, which painfully appear at the front and inside of the leg, are caused by running on hard surfaces, overstriding, muscle imbalance, or overuse. Treatment includes changing running technique or insertion of an orthotic device in the shoe.

Common Running Injuries

Plantar fasciitis (arch pain) — Arch pain is often caused by frequent stress on the plantar aspect, or bottom of the foot. When the plantar fascia, a supportive, fibrous band of tissue running from the heel to the ball of the foot, becomes injured, pain on the bottom of the foot results. Forefoot and rearfoot instability, with excessive pronation, may result in plantar fasciitis. Overtraining may contribute. Shoes with good midfoot stability may help prevent plantar fasciitis. If pain persists visit your sports podiatrist.

Heel spurs — Heel spur syndrome, related to plantar fasciitis, occurs after calcium deposits build up on the underside of the heel bone. Heel spurs form gradually over many months. Both plantar fasciitis and heel spurs can be avoided by a proper warm-up that includes stretching the band of tissue on the bottom of the foot. The soft tissue injury is usually the cause of the pain and not the spur itself.

Sesamoiditis — Sometimes referred to as the ball bearings of the foot, the sesamoids are a set of accessory bones found beneath the large first metatarsal bone. Incredible forces are exerted on the sesamoid bones during aerobics, and inflammation and fractures can occur. Proper shoe selection and custom orthotic devices can be useful in treating sesamoiditis.

Shin splints — Aside from ankle sprains, shin splints are perhaps the most common injury to the lower body, as the muscles attached to the shin bone bring the foot up and down. The pain is usually an inflammation of the shin muscle and tendon due to stress factors. Treat shin pain with cold compresses immediately after the workout to reduce inflammation. Proper stretching before the workout should prevent the onset of shin splints. Strengthening of muscles also helps reduce shin splints.

Achilles tendon and calf pain — The frequent rising on the toes of an aerobics routine often creates pain and tightness in the large muscles in the back of the legs, which can create pain and tightness in the calf and inflammation of the achilles tendon. Again, stretching the calf muscles gently and gradually before and after the workout will ordinarily help alleviate the pain and stiffness.

Stress fractures — Stress fractures often occur from overtraining. Make sure you gradually increase your running distance and intensity and have an adequate dietary intake of calcium.

Before beginning an exercise regimen, proper stretching is essential. If muscles are properly warmed up, the strain on muscles, tendons, and joints is reduced.

The foot is an engineering marvel consisting of 26 bones, 33 joints, 112 ligaments, and a network of tendons, nerves, and blood vessels all working together to establish the graceful synergy involved in running. Running requires balance, support and propulsion which all depend on the foot. Therefore, it is important to make sure your feet and shoes are in good working order before undertaking a serious running regimen.

A good start for someone just starting a training regimen is to examine your feet for anything that may seem irregular to you, such as lumps and bumps, skin irritations or discoloration. A podiatrist can perform a thorough evaluation and recommend any treatment if necessary along with shoe buying recommendations. Of course if you have any underlying medical conditions or have not been seen by a doctor in less than a year, a thorough check up is recommended before starting any training program.

Forget The Pain, Running Injuries Can Be Depressing!!

Earlier this year I treated a patient who ran the Houston Marathon and jumped right into training for the upcoming triathlon season the following week, against my advice, while nursing a painful case of posterior tibial tendon tendonitits. Unfortunately this approach eventually sidelined him and forced him to scrap the entire triathlon season in order to undergo surgery and recover from his injury. This eventually led to a major case of depression which far outlasted his recovery from injury and almost kept him out indefinitely.

By nature, athletes have an extremely high tolerance for pain and at times tend to view their injuries as a normal part of their training regimen often to the point of ignoring serious symptoms. Posterior tibial tendonitis is a common injury in runners usually resulting from chronic overpronation and overuse caused by the repetitive force and trauma asociated with overtraining. Symptoms usually begin as soreness along the inside of the ankle and/or arch when pushing off and can eventually lead to weakness and severe pain. Left untreated, it can progress to a tear which usually requires lengthy immobilization or surgical intervention causing a major delay in any training regimen. However, if the injury is caught early and treated aggressively, it can be done without any interruption or possibly a slight, brief alteration in the training schedule while avoiding a lengthy delay which can spoil any runner's plans.

In this particular case, my patient underwent approximately 8 weeks of physical therapy, anti inflammatories and forced rest. During this time he became discouraged, angry and unmotivated, even though I recommended cross training to maintain at least some level of fitness so that his return to running would not be so traumatic. He resisted the entire time and even admitted to feeling "worthless" at one point. Once he was pain free, he was still afraid to resume running for fear he would reinjure his foot and it would sideine him again.

About 3 months after stopping running completely to rehabilitate from his injury, he began cycling, swimming and using the elliptical machine gradually. More recently, he resumed running starting at a much reduced distance than where he left off, and he is starting to regain confidence and a sense of self worth.

He now realizes what caused his depression and I have no doubt that he will return stronger than ever. More importantly, I think the lesson he learned and one that all athletes should learn, particularly runners, is not to ignore any injury. No matter how small or insignificant you may think the injury is, it can become significant if it is not addressed early and aggressively. The resulting depression from the mental trauma of having something so meaningful and enjoyable taken away can lead to an even more prolonged layoff from which you may never fully recover, long after the injury has healed.

Walking for Cancer: How to Save Your Feet!

Throughout the summer and into the fall, many hit the city streets to walk for breast cancer, arthritis, and many other devastating medical conditions. If you have ever participated in a Breast Cancer walk, you know the emotional drive behind finishing the race for yourself, and loved ones. Nothing stands in the way of a herd of women and men in pink. Well, maybe foot pain. Many of these walks are 20+ miles a day and for most of us, we don’t normally put that kind of millage on our feet. Even if you are an avid runner, walking applies different kinds of forces on your feet compared to running so don’t be surprised if you have some aching feet. Is there anything to prevent the blisters, aches, and pains during and after the walk? Here are some helpful hints to prepare you for your walks against cancer!
Train, train, and more training!
You may think that walking doesn’t take too much training, but it does! Just as marathon runners prepare for the big race, walkers should train for their big walk. Some walks are 50+ miles long. When was the last time you put that kind of mileage on your body? The best way to prevent injury is to build up your body’s endurance and appropriate muscle support. Walk daily and slowly increase the distance daily and weekly.

Don’t Forget Your Shoes!
Most walkers wear the wrong size shoes which can cause blisters, loss of toenails, and aches and pains. Proper fit is one of the most important factors in finding the correct shoes for your walking adventure. Make sure you try both shoes on and walk around in them before you buy them. While standing (not sitting) you should have about a fingers width between your big toe and the end of the shoe. Make sure the shoe is wide enough. You should be able to freely wiggle your toes inside the shoe. Buy your shoes several months before the walk and train in them. Never wear brand new shoes on a long distance walk.

Grease Up!
Most walkers get painful blister! Luckily, there are ways to prevent these fluid filled monsters! Vaseline or products such as Body glide decrease the friction of your skin with your shoe and sock. Applying such products to “high risk” areas of your feet will decrease the chances of a blister. Apply the product regularly along your walk or when you feel a blister coming on. If you have a blister, seek help at a medical tent. They can pop the blister and provide padding to relieve the pain.

Don’t Ignore the Pain!
There is so much emotion and drive in these walks that people stop listening to what their body is telling them. If you are experiencing pain, there are medical professional at every pit stop to help you. Something as silly as a blister can be cared for and you won’t have to stop walking, but some pains may be serious. Drinking lots of fluids and paying attention to how often you urinate is very important. Dehydration is the most common complication on these walks! If you want to finish the walk it is best to address your aches and pains on the way so you don’t end up with a more serious problem!

Enjoy Yourself
No matter what you are walking for or who you are walking for, remember to embrace the experience. You are making a statement for you community and the ill across the nation. The walks are long and hard, but stay positive and focused on the real meaning and purpose of this community gathering. WALK ON!!!