Running Injuries
To start out it’s important to note that I’m not a doctor or trainer. It’s always best to consult a doctor to address any notable pain since ignoring pain while running can delay recovery or lead to serious injury. Since I’ve been talking about training and the races I’ve run, I felt it made sense to share the experiences I’ve had overcoming some common running injuries.
Iliotibial Band Syndrome
When I first started feeling the sharp pains along the outside of my knee, I had never heard of the IT band. The Iliotibial band is a fibrous tissue that runs from the hip to just below the knee. The pain results from the IT band rubbing on a bone near the knee causing irritation and inflammation.
In my case, the injury developed after a pretty bad ankle sprain. I didn’t give it very long to heal and it affected my form. I would start out with no pain but about an hour into an activity the pain would come on suddenly and aggressively. No knee braces or ace bandages would relieve the pain but it would go away quickly once I stopped running. The first time experienced Iliotibial Band Syndrome, I was able to treat it with some rest and about a week of consistent Ibuprofen. Taking an NSAID, like Ibuprofen, helps reduce swelling which allows for healing.
A couple years later, the IT band pain began again when I tried to increase my mileage training for the mud runs. This time around I didn’t have time to rest and the Ibuprofen wasn’t working. There aren’t many stretches that effectively target the IT band but it’s important to reduce the tension in the tissue to prevent rubbing. Tightness in the Iliotibial band can often be the result of muscle adhesions and knots that can be released with deep tissue massage. If you don’t have a masseuse around to help with this, a foam roller can be very effective in treating IT band syndrome. I used my body weight on a soccer ball to knead out the length of my thigh from the hip to just above my knee. It can be pretty painful working out the knots in the beginning but as the tissue loosens up as you continue treatment. I would roll it out after every run and began to see improvement within a week.
I also bought a Pro-Tec IT band strap to wear during my runs. It’s a pretty simple neoprene strap that goes above the knee to help prevent the IT band from rubbing. It’s hard to tell whether it was the strap or the massage that allowed the injury to heal but between the two, I was able to complete a marathon with no IT band pain.
Peroneal Tendonitis
After running the Chicago Rock and Roll Half Marathon as part of my marathon training, I ended up with Peroneal Tendonitis in my left ankle. I had started the race too aggressively and my form suffered and injury followed. After taking a rest day following the half marathon, my ankle was pretty tender during a short 3 mile run. The next day’s 7 mile run was predictably worse so I rested the next two days. The pain was along the outside of my left ankle and felt a little like a sprain. As I began a run, the pain would be quite noticeable but it would ease up once I was warmed up. Unfortunately, the pain would creep back in the longer I ran. I knew that if I wasn’t able to address this injury, it would threaten my marathon aspirations.
I also paid a visit to a local running store to be fitted with proper running shoes. I had been kicking away in some cheap Nike cross-trainers that were well over a year old. Knowing nothing about running shoes, I relied on the expertise of the professional. She was quick to notice some instability in my arches and brought out some options with more arch support. After finding a pair that fit well, I was recorded running on a treadmill to confirm there wasn’t any roll with my foot falls. I ended up buying a pair of Mizuno Wave Inspire 7 shoes for about $90.
I continued with the marathon training and within a week any trace of pain was gone. The peroneal tendonitis was caused by poor form and worn out shoes. Once those issues were addressed, the injury healed quickly and completely.
Achilles Tendonitis
They say that humans are built for distance running because of our strong Achilles tendon. Some also claim that a torn Achilles tendon is one of the most painful injuries one can experience. I had never felt even a minor pain in my Achilles tendon. Often injuries to the Achilles tendon develop from increasing mileage and speed or hill training. Though my mileage increased rapidly during my marathon training, I didn’t have any issues until was in my taper period. With two weeks left before the Wisconsin Dells Marathon, I noticed a bit of stiffness in my Achilles during a 12 mile run. There wasn’t any real pain and it didn’t get any worse during the course of the run but with little time left, it was disconcerting.
After the run, the hint of stiffness turned into a creaking feel with a bit of pain at a full flex or full point. I took ibuprofen and iced the injury but there was little change. I focused on stretching and massaging my calves to take some of the tension off my Achilles and took a couple extra rest days to allow for healing. The injury didn’t get any worse but there weren’t any signs of recover either. I ran the marathon with little pain and went two weeks without running afterwards to treat this injury. When I started running again, that same Achilles creaking set in.
The Achilles Tendon is notoriously slow to heal because it has limited blood supply. Also, Achilles Tendon overuse injuries are actually not a tendonitis (inflammation of the tendon) but a form of tendonosis (degradation of the tendon). Since both icing and NSAIDs treat inflammation, they aren’t as effective at treating tendonosis (though icing does stimulate blood flow which promotes healing). Tendonosis is caused by microtears in the connective tissues in the tendon which makes it more prone to rupture.
Correcting this issue required a slightly different approach. First, I bought a pair of Sof Sole Gel Heel Pads for use both walking around and while running. Using a heel lift reduces the stress on the Achilles tendon by shortening the tendon during activity which promotes healing. Ideally, the heel lift would have been more firm than the gel pad but there weren’t any better options at the running store.
Second, I began doing eccentric calf muscle exercises. These exercises are basically reverse calf raises. You use your good calf to raise yourself to your toes, shift your weight to the injured leg and slowly lower your heel. Doing these with your toes on a stair allows you to drop all the way down into dorsiflexion and fully stretch the Achilles Tendon. These exercises help strengthen muscles connected to the tendon which can protect it from injury during the running motion.
Between the heel pad and eccentric exercises, the majority of the discomfort was gone within two weeks and I was able to put in 10 mile runs without pain or that worrisome creaking feeling.
Avoiding Injury
Rather than treating running injuries, it’s better to avoid them in the first place. There are several components to a good running program that will help reduce the risk of injury. The most important practice it is to develop and observe good running form at all times. As your runs become longer and more intense, it can be easy to let your form get sloppy.
Stretching and a proper warm up are other important elements in a running program. Before a run, dynamic stretches are recommended instead of more traditional static stretches.
Finally, proper equipment is important. It is recommended that running shoes are replaced every 300-500 miles. More people are advocating minimalist running shoes like Vibram Five Fingers instead of more supportive shoes. I know people have had great success in both traditional and minimalist shoes so it’s a matter of personal preference and making sure you follow the manufacture’s recommendations for whatever gear you choose.
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