Running injuries are some of the most common ones that we treat in our clinics. We explain what causes them and how to get them treated
A running injury can be caused by different factors including;
There are both pains and joys associated with running. Running is a wonderful exercise for getting fit, reducing weight in the body, as well as helping to clear your mind. In addition to working out your body, there may be risk of an injury that can result in a sudden halt in your performance. Having a better understanding of how to store and reuse energy has allowed humans to increase their ability to run and cover significant distances as they have evolved over time. As you run on your feet, did you know that your achilles tendon can store up to 30% of the energy generated by your calf muscles and that it can snap back to help you lift your heel off the ground as you run?
You can gradually increase the distance you run by gradually increasing the time and the workload of the exercise, and gradually the load on your muscles, tendons, and bones increases as well. Increasing the workload too quickly can, however, lead to breakdown of these structures, resulting in an injury.
Some people cannot run due to a lack of mobility, range of motion or strength, but this can usually be changed relatively quickly with the help of trained physiotherapists at Switch, who aid in creating a running injury recovery program and provide education to prevent further injuries. Running injury strength training, a return to running program after a hamstring injury, or even retraining for lower limb injuries are all possible with Switch physiotherapy.
Physios are trained to look at several areas to determine what may have led to your injury, including:
In the event that our physiotherapist is able to identify the factors that led to your running injury, then they will work with you to help you get back to running as soon as possible. Depending on the severity of your injury, you may need to rest for some time for it to heal, during which time cross-training can be an effective way of maintaining your fitness. There is no better person than your physiotherapist to advise you on a running injury since he or she has a special interest in this field.
When we treat running injuries we normally group them into these classifications;
Non-traumatic injuries are usually a sign of a ‘chronic problem’. So you may think, “oh my pain started out of the blue for no reason”… although we disagree, there is always a reason. Humans don’t just wake up with an achilles tendon injury or a feeling of hamstring tightness randomly. The body is out of equilibrium somehow.
“Acute injuries” are typically a chronic problem and you have to find out what the underlying cause is and a physiotherapist can help with this, for example an acute hamstring tear is a chronic lack of eccentric/lengthening of hamstring strength and muscle flexibility)
The common comment we hear when our physiotherapist starts a treatment session for a running injury is that ‘My GP sent me for a scan but the report was all clear”
Keep in mind that a scan is basically a static photo of you sitting or laying under a machine. So it won’t detect movement problems like when you are running or lifting weights. So you may be able to see individual bone problems but you can’t really see soft tissue issues. That is why having a deeper analysis with a physical therapist is a wise decision.
Shin Splints
This will progressively gets worse and the pain might ease with rest although gets much worse with exercise (particularly during and after) and can be a sign of too much running (overload) or the need to have a podiatry review to make sure you are wearing the correct shoes or even a running assessment to make sure you have the right technique or movement pattern.
Achilles Tendinopathy
The pain is similar to shin splints where it will progressively gets worse and ease off with rest. A physical therapist can help with physiotherapy treatment to increase ankle range + mobility and also recommend strength work.
Patella (knee tendinopathy) Muscle Tear (Hamstring or Calf)
Pain from this doesn’t ease with rest and normally needs treatment by a physical therapist.
Other injuries can be;
The main causes of these types of running injuries include;
There is no strict rule or time period for anyone to follow, if you love running then do it as much as you like. Although it is important to understand and listen to your body – bones, tendons and ligaments to know how well they respond to lots of running activity.
A seasoned runner may be able to run consecutive days with minimal rest, but someone starting out may need 24 to 48 hours to recover. If you feel like your muscles are still achy from the last run then it may be a good idea to take an extra amount of time off to let your body recover sufficiently. This may be a sign of the body’s tissues not absorbing that load quick enough or well enough.
Sometimes you can feel a “niggle” before a running injury occurs, these are warning signs that the body is not coping and if you don’t listen to this warning you may injure yourself. So maybe after a long 10km run you feel some tightness and a little catching pain in the back of your achilles. This may be the sign of an achilles tendinopathy injury forming.
Potentially that “niggle” as the tip of the iceberg where you feel 10% of the problem, whilst 90% of it is about to surface if your body isn’t given the rest it needs. It is important to consider getting physical therapy or seeing a podiatrist so that your recovery process is shorter and less painful. Some serious injuries may take 3-6 months to repair.
Like anything the more preparation the better the outcome and running is no different.
Our dedicated health professional team (Physios, Podiatrist and massage therapist) can help you prevent injuries, prevent pain, improve quality of life and achieve your goals. Sports podiatrist, Sean, who can help recommend the perfect running shoe for you as well as performing a biomechanical running/walking assessment to help fix any little movement problems.
When a client visits our clinics to get running injury treatment we typically ask these questions;
There are a number of running injury treatment services available at Switch physio clinics;
Our physiotherapy practioners have provided physical therapy to hundreds of clients at our clinics in Sydney for various running injury scenarios.
Tami, 22 years old
Starting running for lifestyle improvement & work / life balance
The situation
Tami decided to take up running as an escape from the pressures of a full time job. Running was a way to clear the mind and get some fresh air. Unfortunately Tami suffered from Shin Splints and was experiencing great pain in both legs.
Treatment from Switch Physiotherapy included;
Outcome:
Tami returned to running after 2 weeks with no pain and was able to learn running principles that should improve running performance and minimise a re-occurrence of the injury.
Joshua, 23 years old
Grade 2 hamstring tear from Oz-Tag
The situation
Joshua enjoyed playing Oz-Tag and during a sprint he experienced a Grade 2 tear in his right hamstring. This was re-confirmed with an ultrasound.
Treatment from Switch Physiotherapy included;
Outcomes;
Josh is now able to run and sprint pain free, and he is ready to return to training (once restrictions end)
An important starting point for any running injury is to get a proper assessment. Once the cause of your injury has been determined, physiotherapy treatment may involve:
– Hands on techniques eg. Soft tissue release, dry needling, active releases
– Exercise prescription eg. stretching, mobility exercises, strengthening/stability exercises
– Improving your running technique, biomechanics and body alignment
– Managing your training load
All running injuries vary. They can vary in terms of nature, severity and the person experiencing them. We try to take a systematic approach but often it is tailored to the individual.
First step: De-load if needed, this may mean taking sometime away from running or simply running a little bit less
Next: settling down the pain and inflammation
Then: correcting the impairments such as strength or technique which caused the pain to happen in the first place
After: Slowly introduce running back at a manageable load. While monitoring any pain or niggles closely with your physio.
If you have an injury, you should see a physio straight away, as a lingering injury is much harder to rehab than a minor injury that happened only recently. Injuries can cause compensations, which will alter how you run, which can cause other injuries.
Beyond injuries however, physio should be looked at like maintenance for a car, you want to make sure your car is running in good condition, so a check up regularly will keep you at it’s best.
A physio can assess your running technique, and pick up if there are any compensations that are happening, so you can run at your best for longer! We can also give you maintenance exercises to keep you running with good form!
Running speed is dictated by 2 things, your running technique, and your lactic acid threshold. In English, the body has 3 main energy systems, your ATP-PC system (fast bursts of energy), your lactic acid system (moderate energy), and your aerobic system (long continuous energy).
Your lactic acid system is mostly involved in running, and the waste product from that system (lactic acid) is responsible for the feeling of heaviness in your legs. When your run above your usual speed for too long, your legs get really heavy because lactic acid builds up in the muscles, which can cause injury, and post-exercise soreness. You need to build that threshold, to make sure you can run at the speed you want to for longer!
The way to do that is to do intervals. These are shorter bursts of running (400m-1km) at a speed that is just above your usual pace but is interspersed with rest, to allow the lactic acid to disperse. This will train your body to get used to producing less lactic acid, to allow you to run harder for longer, without injury!
Knee injuries when running usually come from poor technique. This can be summed up by poor striking technique when hitting the ground, or from poor technique with push off. What we look at here at Switch, is the alignment of your knee in both of these positions.
Ideally, your knee should be in line with your foot and your knee, which are your 2 power creators in your leg. Your knee should just be a hinge between these 2 points, and deviation from this usually means the knee will be overloaded and therefore painful.
Corrective exercises and soft tissue release are great ways to fix these alignment issues, and are done here in clinic.
Some of the most common running injuries are generally from overuse. These can include: patellofemoral pain syndrome (runner’s knee), iliotibial band (ITB) friction syndrome, plantar fasciitis, meniscal injuries, tibial stress syndrome (shin splints) and tendinopathies (patella/achilles/tib post).
It is important that we have adequate rest time following a run, to allow adequate muscle recovery. Generally, it is important to have a rest day in between training. For example running on a Monday, Wednesday and Saturday over the course of a week rather than 3 days in a row.
If you are training most days, mixing up distances/intensity can add variety and help manage your load.
The most common cause of running injuries is overuse. Put simply, it generally comes down to doing too much too soon.
No, it won’t directly cause an injury. However, if it impacts your form/technique this may contribute to some injuries. You want to find a good comfortable pace, where you can push through the ground and be as efficient as possible!
It won’t completely prevent an injury. However, if you are trying to run faster times/longer distances, this will increase the load on your muscles + joints – so slowing down may help to ease this pressure. Decreasing your stride length and increasing your cadence when running has been proven to take load off of your joints. It will also help you to land with your foot underneath your body – helping to keep you more upright and will help improve your efficiency.
The most important thing is listening to your body and not doing too much too soon. A great rule of thumb for this and managing your training load is the 10% rule. For example, if you run 10kms one week, the following week you would run 11kms, followed by 12km etc… Managing the intensity that you are training at, along with running on a flatter/softer surface will be easier on your joints.
It is also important to have adequate rest time + rest days following a run, to allow adequate muscle recovery. For example running on a Monday, Wednesday and Saturday over the course of a week rather than 3 days in a row. A warm up + cool down before/after training is also important.
You can also help in other ways such as looking at your running technique and footwear. A physiotherapist or podiatrist will provide a thorough assessment and help target any biomechanical, strength or technique deficiencies.
Founder of Switch Physiotherapy. We have physio clinics located in Penshurst, Concord & Maroubra that focus on getting people out of pain and moving again.
