‘Running’ is a hobby that is becoming increasingly popular, especially here in London. More and more people are eager to improve their physical and mental well-being, and with running being a very easily accessible form of exercise, with minimal financial input, it’s easy to see why so many are getting involved.
However, both elite and recreational runners are susceptible to injuries and the following list identifies some of the most common running injuries people sustain:
The reasons why people sustain these injuries is vast. From the latest evidence collated we are aware of certain causes that increase the risk of sustaining these injuries and as clinicians, it is our job to try and understand these reasons to enable us to get runners back on their feet as soon as possible.
What are the potential causes of pain?
High incidences of running injuries are thought to be as a result of ‘training error’, due to either a sudden increase in distance or intensity of running, or returning to a previous running distance after a long break. Our body comprises of tissues that are very good at adapting to increasing loads; however, when overloaded too quickly, injuries can arise.
Tolerance is defined as “the capacity to endure continued subjection to something such as a drug or environmental conditions without adverse reaction”. Our bodies’ tissues, whether bones, muscles, tendons or ligaments can withstand a certain tolerance, so if we overload these too quickly without adequate time for rest, recovery and adaptation, problems can occur.
There are correlations between certain muscle groups being weak, and specific injuries. In relation to runners, our body needs to be able to endure the continued extra forces put through it, so if there are areas in the lower limb (hips, knees, and ankles) that are weak, they can be more susceptible to injury.
Running gait mechanics can vary considerably from person to person. Research shows that there doesn’t appear to be a style of running that causes pain. However, there are indications that show how certain running ‘styles’ can put different bodily structures under more load than others. This may not be a problem but if there are structures that are weak and painful, a certain running style could be contributing to the presenting symptoms.
There is evidence to suggest that restrictions at certain joints can affect the rest of the kinetic chain (other joints and muscles of the leg) putting stress on other tissues. For example, ankle stiffness has been linked with plantar fasciitis (heel pain), one of the common injuries listed above. There may also be a difference in tissue length on one side of the body, which may not have been addressed correctly from a previous injury and ultimately causing pain or affecting performance.
Alternatively, sometimes having too much functional range of particular joints during running can also increase the stress certain tissues are put under.
This is, however, not an exhaustive list of why injuries occur when running. Pain is very complex and could be a result of several other physical and psychological factors.
What should a running assessment include?
Firstly, a subjective history should be taken. This would typically include some of the following questions:
Questions like these help towards building a picture of why someone may be experiencing pain. As identified earlier there can be several causes for pain, so a detailed history is an essential part of the assessment process, which will help towards developing an appropriate treatment plan.
This part of the assessment considers a collection of physical data including observation of the following aspects:
Once you’ve had an initial assessment, treatment will usually consist of a mobility/flexibility programme, muscular strength/loading programme and running cues. This will vary from person to person depending on the presenting issue.
In summary, there are numerous ways people become injured, and not knowing what to do can become increasingly frustrating.
It is important, therefore, to get to the root of the cause through a detailed, subjective and objective assessment so that an individualised plan can be developed to treat the issue correctly.