Dealing with Running Injuries

Now you’re increasing distance and intensity on Week 5 of your Couch to Central Health Derby 10K Training Plan you can become vulnerable to a muscle, ligament or tendon injury, which may well be a pull, strain or even a tear.

I wrote about Injury Prevention during Week 2 of the Training Plan, and if you apply some of that advice then hopefully you will steer clear of injuries.

However, if you are unlucky then the injuries associated with running normally concern the hip, knee, ankle and feet. You can of course experience back issues, but the running injuries we most commonly see are:

  • Knee and Ankle Ligament Strains
  • Achilles Tendon Strains
  • Hamstring, Quad and Calf muscle strains
  • Plantar Fasciitis
  • Heel Spur

If you pick up any of these injuries, you will usually suffer with some form of pain or discomfort in the local area.

If you experience just pain with no obvious swelling, bruising or significant stiffness then you are most likely to have a pull or strain of some kind.

In this case the best advice is to:

  • Apply ice to the affected area for 10-15 minutes as often as you can in-case there’s any micro damage
  • Wear a support bandage, something like a Tubigrip
  • And most importantly, don’t work through your pain or re-produce your pain after completing your activity

If you experience swelling, stiffness (especially after being still for a while or first thing in the morning) and maybe bruising then you will have most likely caused a slight tearing of the muscle, ligament or tendon in the affected area. The more obvious and quicker the swelling and bruising, then typically the bigger the injury.

The best advice here is to follow the ‘RICE’ theory:

  • Rest
  • Ice – 10-15 minutes every hour or as and when you can.
  • Compression – a Tubigrip is good again here
  • Elevation

Runners may also develop overuse or repetitive strain problems, what as physios we might call mechanical overuse issues such as:

  • Runner’s Knee
  • Shin Splints
  • Anterior Compartment Syndrome

Runner’s Knee usually produces pain on the outside of the knee. This can be caused by the foot repeatedly inverting in a running shoe, or by repeatedly running the same route the same way every day, normally on the road with the slight camber of the road changing the foot position to affect the alignment of the outside thigh muscles. This makes those muscles work harder to stabilise the running leg, and then go tight and pull on the outside insertion of the tendon of the knee.

Changing your running shoes, running route and stretching regularly can help prevent this type of overuse running injury.

Shin Splints is usually associated with the running foot position and tightness that can lead to a slight tearing of the insertion of the front shin muscles onto the shin bone.

The best way to deal with shin splints is to stretch the muscles at the front of the shin regularly, apply ice down the front of the shin bone and try not to overdo it and re-produce your pain during or after activity.

Anterior Compartment Syndrome is when the anterior tibialis muscle itself grows with increased activity and puts pressure on the muscle sheath that surrounds the muscle. This can be caused by overuse or foot position.

The best way to deal with Anterior Compartment Syndrome is very much the same as with runner’s knee and shin splints.

In summary, general self-management advice for any running injury includes:

  • Do not to work through the pain
  • Do not re-produce your pain after your activity
  • Apply RICE if necessary
  • Stretch
  • Do some local strength work to load the affected area back up (such as squats or calf raises)
  • Build your activity back up gradually after injury (such as walking pain free for 20 minutes before running again)

At the Specialist Running Injury clinics available at Central Physio, once we have diagnosed and started treating a problem, we help patients to find a ‘base line’ for a symptom free return to activity (again, this could simply be 20 minutes of pain free walking). Once this is achieved, we start to reintroduce running – and integrate it into a programme where we work towards a ‘walk, run, walk, run’ 20 minute session to reload and rebuild the affected area.

The speed at which this is achieved depends on symptom free progress, where the walking and running elements of the programme are adjusted accordingly.

If you do experience a running related injury and are unsure about self managing the problem, or if it’s simply too painful to do so, please seek urgent help from your Physiotherapist or GP.

Entrants in this year’s Central Health Derby 10K can take advantage of a Free Injury Consultation at Central Physio, Central FootClinic and Central Osteopaths in Derby. Taking advantage of this is a great way to quickly get on top of any niggles and injuries before race day on 9th April. In addition, Central Health is offering race entrants discounts on all treatments until race day.

Article compiled by Kevin Huffington, Lead Physiotherapist and Clinical Director at Central Health


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