Running injuries and what to do about them

Running, like golf, exploded in 2020 with the COVID-19 pandemic happening.  Recommended to stay home and maintain a safe 6 feet apart from others outside our household would make anyone go crazy and look for another outlet both physically and mentally. Unlike basketball and football, golf and running are naturally social distancing sports. Hence, they exploded in the pandemic.  

It is springtime in Utah and runners are coming out in full force road once again.  It’s warming up in Provo and Orem and we want to enjoy the outdoors. Running has many different health benefits, physically and mentally.  The ability to drop everything and just go enjoy the outdoors is a fabulous trait of running.  For some, running can be addicting. 

For many of these reasons, this is why it’s so depressing when you are hurt and cannot run like you would like to.  Not being able to run due to pain goes beyond physical in-capability, but more of the mental relief that you get from running.  

  This is where taking care of your body comes into your physical and mental health. So what are the physical injuries/pain that could limit your ability to run. 

• ITB syndrome
• Runners knee (Patellofemoral Pain Syndrome)
• Plantar Fasciitis
• Lower Back Pain
• Femoral Acetabular impingement (Hip Pain)
• Shin splints (Posterior or Anterior)
• Stress Fractures

If you’re running, you have heard of all these before maybe you have experienced them first hand.  So what can you do about them? I’ll share with you what I do (experience and research) to help athletes overcome these injuries so they can get back to the activities they love.  

Iliotibial Band (ITB) Syndrome

What it is: This typically will show up with pain along the outside of your knee and even along the outside (lateral) side of your thigh.  Pain can increase when you increase your mileage.  

Misconception: You have  ITB Syndrome because your IT band is too tight.  Your IT band is built to be a tight band for lateral stability. It is there so that you can stand on one leg and not fall to your other side.  So foam rolling your IT Band will just hurt, it doesn’t have any therapeutic benefit to it.  

How to Treat it: ITB syndrome most likely occurs because of some tight muscles that are attached to the IT Band near your hip.  Putting a foam roller or a LAX ball to your Tensor fascia Lata (TFL) and gluteal muscles (more emphasis on the TFL) is where you need to start.  Then strengthening some hip abductor muscles, like the gluteus medius, which will create a more favorable muscle balance between the hip and knee. Mobilizing/adjusting the pelvis, lower back, hip and ankle/foot has also shown to be helpful in the recovery of ITB syndrome. 

Runner’s knee (Patellofemoral Pain Syndrome)

What it is: A runner may experience pain along the front part of the knee and more commonly just under the kneecap.  This commonly is because your knee is coming inward (valgus stress) when you are in the stance phase of running.  This puts more stress on the knee itself.  

Misconception: Something is wrong with the knee when you are dealing with Runner’s knee. Pain is experienced in the knee (source of pain), but the cause of pain is most commonly coming from some muscle and joint imbalances that you may have above and below the knee.

How to Treat it: Correct the muscle imbalances.  Myofascial release (massage, Instrument assisted soft tissue manipulation (IASTM, aka. scraping), trigger point therapy, fascial stretch, Active Release Technique (ART)) to detect trigger points and fascial tightness from your lower back to your toes.  Regularly adjusting your lumbar spine, pelvis, hips, knee, ankle/foot where needed has also been shown to reduce knee pain over 4-6 weeks.  Strengthening/rehab exercises to your core, hips, knee, ankle/foot will help the treatment that you receive last and you can continue to move forward with treatment.  

Plantar Fasciitis

What it is: Inflammation on the bottom of your foot and pinpoint pain on your heel. This pain is worse in the morning and gets better as you walk on it.  

Misconception:  Pain on the bottom of your foot is always because of the plantar fascia.  Oftentimes this pain gets mis-diagnosed for plantar fasciitis, but could be because of some nerve pain in the foot itself or some nerve irritation between your foot and your lower back.  

How to Treat it: Making sure to clear any nerve irritation before treating the Plantar fascia is key.  Roll a LAX along the bottom of your foot to help the tightness along that fascia.  Strengthening the deep inner muscles of the foot is important. This will help take some stress off the plantar fascia and direct it more on the muscles, where the stress belongs.  Adjustments to the small joints of the foot and ankle will also help put your foot in a  more favorable position to heal and work as it’s supposed to.  

Lower Back Pain

What it is: Lower back pain is pretty self explanatory.  It can come from many structural issues in the lower back.  Joint pain, disc irritation, muscle strain, or ligament sprain.  If your lower back is hurting from running it is probably because you have some muscle/joint imbalances below your lower back, possibly tight hips, or ankles.  This will force your lower back to do more work than it was built for while running. You’re using your back to run, not your legs.

How to Treat it: First we need to correct the muscle/joint imbalances while we reduce the pain in the lower back.  Tailored mobility and strengthening routines for you to do at home will help dramatically.  Myofascial release techniques like IASTM, Active Release (ART) will also be effective.  Adjustments to the joints that show restrictions will be crucial to recovery.  You will also need to perform corrective exercises throughout the day so treatment continues to move forward.

Femoral Acetabular Impingement (Hip Pain)

What it is: The ball-in-socket joint of the hip is not centered properly and causes a pinching feeling deep in the hip. This could be in the front of the hip or the back of the hip.  This could be because of a bone overgrowth on the pelvis or the femur itself.  These could also be mistaken for a labral tear in the hip. A true hip impingement is there because your pelvis isn’t sitting in a neutral positive throughout the day, running or not.  We see this a lot with those who work at a desk or those who tend to sit most of the day. 

How to Treat it: You guest it, correct the muscle imbalances that are causing your pelvis to rest in the disadvantageous position.  Stretch the hip flexor muscles, lower back muscles, and strengthen the core and gluteal muscles.  Adjustments to the pelvis, lower back, hips and ankles should be performed as needed.  This will also help reset the nervous system (like resetting your computer) so the muscle imbalances mentioned before will be effective.  

Shin splints (Posterior or Anterior)

What it is: Shin splints could be many different things.  It could be a stress fracture to the lower leg bone, strain to the tibialis muscle (front or back), or chronic compartment syndrome (lack of blood flow to the lower leg muscles). These usually come with a dramatic increase in mileage that you are physically not ready for.  

How to Treat it: Myofascial release with IASTM, Active Release, Cupping, KT Tape or RockTape is key because it’s a strain or compartment syndrome of the muscle.  Adjustments to the ankle and foot have also shown to be beneficial.  Rest is also needed in the early stages to allow yourself some time to heal.  A slight increase in mileage is what you need to get back to running healthy.

Stress Fractures

What it is: Dramatic increase in mileage or constantly running on hard services can lead to small stress fractures. These can appear in the foot, ankle, knee or hip.  

How to Treat it: Hate to say it to a runner, but the best thing to do, is to rest.  I know that telling a runner to rest and not run is like death, but you do have to give the bone some time  to heal.  
These are some of the most common things seen in our office in Provo, Utah at Uintah Spinal Health.  We work with many other healthcare providers to help you recover as needed.  If you are a runner or know someone who is, and are dealing with injury, send them our way. We would love to help them recover and get back to the road again and enjoy that mental and physical break that running offers.