Download Scottish Half Marathon - how to avoid running injuries

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Running Injuries For All
Shapes & Sizes
Claire Kennedy
Senior Physiotherapist
Running Injuries
Prevalence of running injuries
65 per cent of regular runners are hit by injury per year
11 injuries occur per 1000 hours of running
However…..both of these statistics can be significantly reduced through
injury prevention
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Running Injuries
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Most common running injuries
Achillies Tendonopathy
8%
Shin splints
8%
Patellar Tendonitis
8%
Planter Fasciitis
13%
Meniscal injuries
8%
ITBFS
14%
PFPS
ITBFS
Planter Fasciitis
Achillies Tendonopathy
Shin splints
Other
15%
PFPS
26%
Patellar Tendonitis
Meniscal injuries
Other
ITBFS – The Iliotibial Band
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Very common overuse injury
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Pain is often experienced over the
outer side of the knee joint
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ITB is a thick strip of fascia that
attaches from the pelvis to the top of
the fibula and runs down the outside
of the thigh
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It lies in front of the femoral
epicondyle (bony point at the end of
thigh bone) with the knee straight
And moves behind it when the knee
bends.
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ITBFS – The Friction Syndrome
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Friction can occur when a
person repetitively flicks the
ITB in front and behind this
epicondyle (bend and
straighten the knee) e.g.
running.
The friction can accumulate
and cause an inflammatory
reaction within the ITB tract
or the underlying bursa.
The friction normally occurs
as the foot strikes the
ground.
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Why does friction occur?
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Muscle Weakness: quadriceps / hamstrings /
abductors which reduce the ability to ‘brake’ –
thereby increasing the support required from
the ITB;
Flat feet – which causes the shin to rotate
inwards and thereby altering the angle of the
ITB;
Sudden increase in training (over 10% per
week);
Excessive lateral pelvic tilting – caused by
weak core stability & weak hip abductors.
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Impact of Extra Weight on ITBFS:
Muscle Weakness:
Fat cells can infiltrate the muscle fibres – making
the muscle fibres less efficient;
Physiotherapy Treatments:
•  ITBFS is often resolved with physiotherapy treatments:
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Soft tissue release
Ultrasound
Acupuncture
Biomechanical assessment
Strengthening – especially for the quadriceps / hamstrings / abductors
Discuss weight issues
Refer to Consultant if required
What Can You Do:
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Cross-training – e.g. cycling; swimming; weight training, core stability
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Correct warm –up and cool down
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Stretching – there are some leaflets at the physiotherapy table if you need
ideas on how to stretch the ITB
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Correct footwear
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Seek professional help if symptoms occur.
Plantar Fascia (PF):
•  Plantar Aponeurosis – attaches from the
heel to the base of the toes;
•  Offers static support for the arches of the
foot plus dynamic shock absorption.
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Plantar Fasciitis
Overuse Condition
Causes:
Altered arches within the foot cause the PF to
alter its angle. This increases the pressure through
the heel attachment.
Flat Feet:
This results in the PF struggling to maintain a
stable arch during propulsion
High Arches:
This results in the PF struggling to absorb the
shock when the heel strikes.
Impact of Extra Weight On Plantar Fasciitis:
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Unstable Arch: Decreases propulsion and places more pressure on the
joints and ligaments thereby increasing the risk of other injuries;
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Shock Absorption: the pressure imposed onto the feet during running may
be increased with an overweight person if compared to a normal weight
person – the shock generated will therefore be higher.
The PF will therefore be further stressed with this increase in shock.
Physiotherapy Treatments:
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Activity modification
Soft tissue release or DTFM
Ultrasound
Acupuncture
Biomechanical assessment and correction
Home exercise programme – stretching to the PF and calf muscles; selfmassage; ice therapy
Advice on the use of heel pads, correct footwear, weight loss.
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If required:
Corticosteroid Injection
Surgery
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How Can You Help Yourself:
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Correct footwear – one type of shoe will not fit all therefore regular
assessment by a running shoe shop is recommended;
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Rest;
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Ice- bottle of water in the freezer
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Assessment by a health professional.
Running Injuries
How physiotherapy can help
Assessment/Diagnosis
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Assess injury & diagnose the injury – site of
pain is not always the cause of the injury.
Prevent & Treat
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Early intervention can :
*Prevent more complex injuries
*Prevent secondary sites of pain
*Reduce the number of treatment sessions
required
*May prevent the need to rest from the sport
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Rehabilitation
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Reduces the chance of re-occurrence
Ensures that the cause of the pain is targeted
as well as the source of pain.
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