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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

Switch-Physiotherapist-in-Sydney-that-helps-alleviate-pain-from-my-knee-after-running

Running injury physiotherapist in Sydney

In the Sydney suburbs of Maroubra, Penshurst & Concord, Switch Physiotherapy’s clinics provide physical therapy treatment to runners suffering from running injuries. The vast majority of people In Australia suffer from some sort of sports injury, especially running injuries, because we live an active, outdoor lifestyle and many people participate in outdoor activities.

A running injury can be caused by different factors including;

  • Simply running too much too soon

  • Running with poor technique

  • Running when your body isn’t quite ready for it.
 

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:

  • Your running biomechanics – using movement analysis we can look at your running technique
  • The type of footwear you are using
  • Assess your training load – what is good, too much, too little
  • Examine your joint range, muscle length and overall flexibility
  • Test your muscle strength: core control, foot arch control, hip, knee and lower limb control.
 

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.

Running injury classifications

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) 

Does getting a scan help identify a running injury?

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.

What are the most common running injuries a physio treats?

Shin Splints 

  • Pain in front of shin 
  • Pain on touch of tibia bone 

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 

  • Pain in back of ankle 
  • Achilles tendon sore to touch 

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)

  • Weakness in the muscle 
  • Pain on contraction 
  • Sudden onset – feel a “pull/catch or twinge” 

Pain from this doesn’t ease with rest and normally needs treatment by a physical therapist.

 

Other injuries can be;

  • Runners knee (ITB friction syndrome) – pain outside of knee 
  • Patella Femoral Pain – pain under knee cap
  • Runners hip – clicking hip 
  • Plantar Fasciitis – pain under heel 
  • Meniscus pain – pain in the joint line of the knee 
  • Shin splints 
  • Pain in the ankle and foot: plantar fasciopathy, tib post tendinopathy, Achilles tendinopathy, peroneal tendinopathy
  • Pain in the knee: patellofemoral pain syndrome, patella tendinopathy, quads tendinopathy, ITB syndrome
  •  Pain in the hip/back: hamstring tendinopathy/tear, gluteal tendinopathy, trochanteric bursitis, adductor strain/tendinopathy, hip flexor strain/tendinopathy, lumbar overload

 

The main causes of these types of running injuries include; 

  • Poor functional or structural alignment.
  • Poor running technique.
  • Incorrect footwear.
  • Overstriding or under striding 
  • Not sticking to the 10% rule. Too much too soon.
  • Poor stability through the entire running chain.
  • Running at too high a volume too soon; progressing things too quickly E.g. running 10km after not running for months
  • running with poor technique and overloading structures. E.g. running with excessive ‘heel strike’ which can overload the knee 
  • muscle weakness and poor control of specific muscle groups. E.g. poor gluteal strength 
  • not enough rest between runs

How often should you run & how can you avoid an injury?

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.

11 tips for preparing & recovering from running

Like anything the more preparation the better the outcome and running is no different. 

  1. Sleep: Clients who sleep for 8 hours or more can decrease risk of injury by 80% and also recover quicker if they get injured. 

  2. Diet & hydration: you need the right mix of food and liquids in your diet to keep your body fuelled to give it energy for your running but to also recover. 

  3. (Active) Rest: Active recovery refers to going for a light form of physical activity when you’re not running to promote blood flow and help with recovery. So a light walk or stretching or something else that is low intensity.

  4. Warm up: Getting your body ready by doing 10 minutes of light activity (paced walk, light jog) and some form of stretching put you in a limber state & ready to run. It can help prevent injury and improve performance because it helps your respiratory and cardiac systems

  5. Cool downs: If you gently decrease the intensity of activity it will help the body reset and feel fresher after your run but also assist in the removal of any lactic acid which can help with recovery. 

  6. Maintaining healthy body weight: You can manage the load placed on your body’s joints, muscles and tendons. 

  7. Physical treatment: have “niggles” treated before they become more sever injuries

  8. Change your footwear: running in your favourite shoes you have had for a few years may be keeping your wallet happy but causing damage to your body.

  9. Apply the 10% rule: progressing running volume in a progressive and safe manner; following the ‘10% rule’ – only progressing the total amount ran by 10% each week 

  10. Strength and control training: do this for key muscle groups involved in running; e.g. glutes, quads, calves etc

  11. Running with adequate technique: your body movement patterns can be adjusted to run correctly to reduce or avoid injuries.

How can Switch physio clinics provide treatment for running injuries?

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;

  • Where is the pain?
  • When does the pain come on? Before, during and/or after running? 
  • How far do you usually run? 
  • What terrain do you usually run on? Concrete? Grass? Sand? Trail?
  • How long has this been going on for? 
  • What footwear do you use to run in? 
  • Any other niggles or previous injuries? 
  • How long have you been running for/when did you start ? how have you progressed your running regime ? 
  • What intensity do you run at ? 
  • Do you do any other physical activity ? If so what ? 
 

There are a number of running injury treatment services available at Switch physio clinics;

  • hip flexor running injury treatment
  • calf injury running treatment
  • return to run program after injury
  • running injury recovery program
  • running injury treatment
  • running program after injury
  • treadmill running injuries
  • achilles tendon running injury treatment
  • itb running injury treatment
  • knee injury running treatment
  • return to running after injury program
  • return to running program after hamstring injury
  • running injury physio sydney
  • running injury stress fracture
  • running progression after injury
  • strength training for running injury prevention
  • walk to run program after injury
  • calf muscle injury running treatment

How did we treat running injuries in Sydney for our patients?

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;

  • Shockwave treatment
  • Alignment correction through manual therapy
  • Running technique strength training
  • Managing a return to running return through a step by step framework.

 

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;

  • Manual therapy to reduce the muscle tension that comes with a muscle tear as well as improving flexibility which is usually lost after a muscle tear. I
  • Treatment also consisted of a mobility program to help with flexibility deficits.
  • A personalised strengthening/loading program to correct muscle imbalances.
  • Work on strength of surrounding muscles such as glutes and calves.
 

Outcomes;

  • Once pain was no longer an issue and Joshua had adequate strength, control and flexibility, we started a running program which starts off at running at 50% maximum capacity building up to 100% sprints. 
  • After getting through this, we then began an agility program consisting of movements involved in Oz-Tag and soccer (sports he wanted to get back into).
  • Josh is now able to run and sprint pain free, and he is ready to return to training (once restrictions end)

Common questions about headache treatment

Switch provides running innjury treatment in Sydney in our three clinics that have experienced physiotherapists located in;

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

There are a few things to do to reduce injury as a runner. The first is have a dynamic warm up, it only has to be about 5 minutes or so – this could include stretching or light jumping to warm up the muscles. The other key component is to think about taking short, quick and light steps. This will reduce your overrstride when running and minimise the forces going through the joints such as knees or ankles.
If you’re just getting started with running a good number of runs is 3 runs per week (A minimum of 2 runs to start seeing improvement and a maximum of 4 runs to allow the body recovery time). If you are running 3 times per week it is good to structure it with 1 longer run with 2 smaller runs and a days rest (or other exercise) in between each. If you’re into a good groove with running or have been doing it for a little while, and you want to increase how often you run the best way to do it is to increase the number of the kms you run in a week by 10%.
A few things you can do to minimise risk of injury when training for a marathon include: following the 10% rule (mentioned above), adequate recovery in between sessions (having a day in between runs) , cross training to involve leg strength such as weights, good nutrition and sleep as well as coming in to a physio to review your running technique and see if any tweaks are required (such as fixing overrstride or how your pelvis is tilting)
It can be easy to be overwhelmed and get bogged down with trying to find good running form. Its essential you stay natural and do what feels right for you but some cues to use and think about while you are running is to “run tall”, “run light” and have good knee drive forward. Good running form also includes quick steps of approximately 170-180 steps per minute.

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.

I think the more important question is the best way to heal a running injury. You must take the time even after the person is out of pain to address the reason why the injury occurred in the first place. This may be muscle weakness or changing running technique or changing their type of footwear. While this might take a little bit of extra time – it pays off in the long run (no pun intended) because you won’t have a reoccurrence.
All running injuries vary. They can vary in terms of nature, severity and the person experiencing them. Therefore the recovery time and return to running also varies.
Runners should come in to see a physio almost immediately after they feel an injury. If you are getting little niggles or pains when running, the best way to know if it’s something you should pay attention to or if it could develop into a larger injury is if has a consist pattern. If you start getting the same little niggle, before, during or after a run, pop in to see a physio as soon as possible. The sooner you see a physio, the sooner we can nip it in the bud and potentially get you back on your feet quicker.

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!

A return to running shouldn’t be done without the guidance of a physiotherapist, as returning to running with poor form can lead to more injuries than when you started. A general guide is to start off with walking your chosen distance, and build up that over the first week or so. In order to improve with running, aiming for at least 2x/week is a good goal. Once you’ve ironed out the imbalances between both sides (in terms of strength, stability and spring), work on adding some short running spurts into your walk for about 100m at a time. This should be done on flat ground, and shouldn’t break 60-70% of a sprint. You can slowly increase the distance of how far you’re running, to increase the ratio of running to walking. As you get to the point of just running, you can add in some extra pace to your regular jogging pace, and continue to progress the distance from there!
2 most important factors for staying injury free when running are running technique, and overall volume. Running technique is endless to analyse, but a general guide is that you should be using both feet evenly, as to not overload one side. In terms of overall volume, this is a common problem in runners that are looking to increase their capacity for when they run longer distances/faster speeds. The general rule is to ensure you don’t increase your running mileage by more than about 10% per week. For example, if you’re running 4kms 3x/week, that’s 12kms total per week. If you then you increase your distance to 5kms 3x/week, then that’s increasing your total volume to 15kms per week. That’s a 25% increase, which is a big jump. Granted this isn’t a hard and fast rule, but is something to keep in mind to keep your body in good shape!

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.

This is actually a really tough question to answer, as there’s so many factors that go into hamstring injuries! Can do a longer post talking about this, but would take some time!

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.

JAMES BECERRA

JAMES BECERRA

Founder of Switch Physiotherapy. We have physio clinics located in Penshurst, Concord & Maroubra that focus on getting people out of pain and moving again.

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