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Running-related Injuries: Pitfalls and Perils

Running Injuries, Physical Therapy
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Added on September 19, 2016


By Bob Capri, PT, MPT,OCS, STC
Director of Rehabilitation, IvyRehab Voorhees, NJ

Fall season is among us. Children have recently returned to school, football season is here, and many are enjoying the milder weather. The fall season also marks an exciting time for runners who are getting ready to race in their neighborhood 5k, half-marathon or full marathons. As mileage mounts, physical therapists are usually seeing more running related injuries. So how can you stay healthy and achieve your goals?

Running-related injuries are not new or rare. It has been reported that as many as 79% of runners will have a running-related injury during a year period. Problems like: shin splints, Achilles tendonitis, plantar fasciitis, and knee pain are the most prevalent. Fortunately many can be avoided and managed with some common sense and proper considerations. Physical therapists, who understand running mechanics and lower extremity injuries can be invaluable in these cases.

One easy way to look at running-related injuries or any overuse injury pattern is to account for all known variables both intrinsic and extrinsic.

Intrinsic factors:

·Age:(Can't change.) The aging musculoskeletal system may need more repair time and may have other morbidities that need to be aware of. Younger athletes need to be mindful of rapid skeletal growth, associated soft tissue tightness and stress-related responses with overtraining.

·Sex:Women and men do lend themselves to some injury pattern peculiarities especially in the hip and knee.

·Race:(Can't change.) Interesting research is mounting on race and also genetic influences in collagen tissue synthesis and injuries such as tendinopathies and ruptures.

·Genetics:(Can't change.)

·Experience level:Novice —> advanced?

·Weight:(Can change.) More weight = more load.

·Other:Structural/anatomic issues, strength, range or motion flexibility and psychological aspects are the biggest factors here. Proper Lower extremity strength, core stability and lower extremity flexibility are easy additions to your training regimen. A trained professional can pick up on problems in this area in minutes.

Extrinsic factors:

·Training errors:Training errors are the biggest and most avoidable cause for running-related injuries. In short, too much biomechanical stress over too little time. Tissues need to recover and repair. Respecting your body's limits is a particular concern. Knowing when to advance, regress or hold steady in training can be coached. Many training models have attempted to thwart the overzealous human tendency by limiting weekly mileage to no greater than 10% and building in regression in weekly miles every 4th week or so. Where are you running? Treadmills vs outdoors, trails, streets, hills or beaches? All have some pros and cons.

·Sneaker selection:Sneaker selection is always a lengthy discussion. The sneaker should feel comfortable and offer sufficient control and cushioning for your foot type. People with low arches or flexible/pronated-foot types typically do better in stiffer-soled sneakers with some rear to midfoot motion control and cushioning. Most good running sneakers have this technology built in. (The amount of cushioning, control or stability are usually the variables that can be different depending on foot type)

·Other considerations:What other types of training is occurring or not occurring: plyometrics, interval training, hills, swimming, cycling, yoga, strength training? In the presence of injury all variables need discussion.

Don't be sidelined by injury or let your goals pass. Call one of our physical therapists for a running analysis and a complete evaluation including amending your training regimen to minimize your risk. Some of our clinics also have state of the art technology to continue training in a zero-gravity environment!


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