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If You Run, You’re a Runner ...

“If you run, you are a runner. It doesn’t matter how fast or how far. It doesn’t matter if today is your first day or if you’ve been running for twenty years. There is no test to pass, no license to earn, no membership card to get. You just run.” ~ John Bingham


Continuing with our theme of overuse injuries, let's jump into a common activity that puts individuals at risk for injury...Running.


Running continues to be a popular US activity. In 2019 it was documented that 17.6 million US runners registered for road races nationwide (Runner USA). Although many formal races have been cancelled in 2020 secondary to COVID-19, many have continued to choose running as their exercise of choice due to convenience. Participation in “virtual running races” has helped runners stay engaged while still socially distancing. 


Running has been documented to have many benefits including cardiovascular health, improved general health, weight control, stress management and more. As running continues to be a prevalent means for exercise, stress relief and a dose of healthy competition, prevention of running injuries is a top priority. The incidence of running injuries ranges from 20-70% (Nielsen et al.), while 80% of running related injuries are due to overuse (Masselli et al.). In order for runners to stay healthy and avoid missing training sessions, here is some advice so you know when you may be at risk for an overuse injury and when to seek help!


Anyone who has hit the pavement or track for a middle to long distance run is not a stranger to muscle soreness. But where is the line between muscle soreness and pain from an injury? If you experience the following with running, you should seek guidance from your physical therapist. 

  • Any pain that lasts more than 2-3 hours after a run

  • Complaint of sharp or burning pain while running

  • Pain that increases with running and/or exceeds a 3 on a 10 point pain scale

  • Pain experienced in the same area every time you run

  • Any pain that wakes you at night


If you experience any of the above symptoms you may be at risk for developing a more severe injury. Some of these common injuries are listed below. 


Hip pain

  • Gluteal tendinopathy: pain located on the outside of the hip to outer thigh, worsens with running


Knee pain

  • IT Band Syndrome: pain and tenderness to the connective tissue that attach on the outside of the hip and outside of the knee. Most commonly a diffuse pain noted outside of the knee that worsens with running. 

  • Patellofemoral Pain Syndrome: pain in front of the knee and around the “knee cap” or patella. 

  • Patellar tendinopathy: pain in front of the knee, typically just below the “knee cap” or patella, worsens with running


Foot and Ankle pain

  • Achilles tendinopathy/calf injury: pain and stiffness with potential swelling to lower leg where calf muscle meets the heel, worsens with running

  • Plantar Fasciitis: pain in heel or bottom of foot, typically noted on the first few steps after sitting or inactivity, may worsen after running. 


Stress fracture

  • 2nd metatarsal stress fracture: small crack or deep bruise to base of 2nd toe, worsens with running

  • Tibial stress syndrome: sometimes known as “shin splints”, pain in the lower front of leg or “shins”, worsens with running, can develop into stress fracture if progresses


Want to avoid dealing with the above ailments? Here are a few tips for staying healthy while running...


A general rule of thumb for runners is to not exceed more than a 10% increase in training distance from week to week. Listen to your body! When you feel pain, do NOT ignore it. Ignoring pain will increase your risk of developing an overuse injury that could bring your training to an abrupt halt. Taking running breaks throughout the week to mix in cross training is advised. Cycling or elliptical training are options to minimize impact to joints and tissues while still focusing on cardiovascular endurance. 


Incorporating strength training for core and hips muscles is an important part of training for runners as well. This promotes a stable base and can improve running mechanics, especially as you increase mileage. 


Not only is strength important, but coordination of movement and proper mechanics is essential to prevent injury. Running with soft landing on your feet and ensuring that you are not taking too large of a stride are a couple of pointers to stay injury free. 


One way to ensure that you have proper mechanics and can decrease risk of injury is to maintain flexibility. This can also help post run soreness and help maintain mobility. Tightness in hips, hamstrings or calves can limit range of motion and promote poor mechanics with running. A proper warm up including walking, dynamic stretches (ie heel toe walking, high knee walking, butt kicks) to get muscles moving and heart rate elevated pre-run is good practice to prevent injury. Stretching quads, hamstrings, gluteal muscles and calves after a run can help promote mobility and decrease pain as well. 


Finally, proper footwear is important to ensure you maintain proper running mechanics as well as provide support from the “ground up”. When fatigue sets in, especially with endurance runs, our mechanics will start to falter. Proper support in footwear that is individualized to your needs is important for injury prevention. 


As a runner, your Physical Therapist can be your best friend. Your Physical Therapist can provide you with an assessment and tailored strength and mobility programs to keep you running pain free. Your Physical Therapist is also an excellent resource for you on education for proper footwear to keep you logging miles. Not only can your Physical Therapist help prevent or recover from injury, they are equipped to provide hands on recovery techniques including soft tissue mobilization, dry needling and stretching to help optimize your training routine


Come see us at Dynamic Physical Therapy and Wellness TODAY and we will enhance your training and running experience! 


REFERENCES: 

  • Runningusa.org. 2020. 2020 Running USA U.S. Running Trends Report. [online] Available at: <https://runningusa.org/RUSA/News/2020/-Running-USA-Releases-Latest-U.S.-Running-Trends-Report.aspx> [Accessed 21 October 2020].

  • Maselli F, Storari L, Barbari V, et al. Prevalence and incidence of low back pain among runners: a systematic review. BMC Musculoskelet Disord. 2020;21(1):343. Published 2020 Jun 3. doi:10.1186/s12891-020-03357-4

  • Nielsen RO, Nohr EA, Rasmussen S, Sørensen H. Classifying running-related injuries based upon etiology, with emphasis on volume and pace. Int J Sports Phys Ther. 2013;8(2):172-179.

  • “A Physical Therapist Guide to Healthy Running. Move Forward. Physical Therapy Brings Motion to Life.” American Physical Therapy Association. 2011;1-11. http://nationalphysicaltherapy.com/files/pdf/guide-to-running.pdf.

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