Five Common Running Injuries To Avoid

How to avoid these five common running injuries.

When you’re a runner, you get used to your legs hurting. Whether you’re striding up a hill as lactic acid besieges your quads and calves, or carefully walking down stairs sideways for a few days because of post-workout muscle soreness, there’s a level of discomfort that runners learn to live with. But just as important as the determination it takes to push through the pain to the top of the hill, is being able to recognize when the pain that’s been lingering in your legs is not just tired muscles but maybe something more serious, perhaps even requiring the attention of your doctor. From shin splints to chronic exertional compartment syndrome, there’s a bunch of ways running can take a toll on your legs. And since the majority of the issues runners face are overuse injuries, it’s best to get out in front of these things. Here are five common running injuries, and the info you need to identify and avoid them.

Shin Splints
Medial tibial stress syndrome, or “shin splints,” occurs when the tissue surrounding the tibia becomes inflamed as a result of excessive stress on the inside of the shinbone.  The pain—a dull but persistent ache—is usually felt in the middle of the shin. It’s relatively common in runners—especially those who overpronate—and often stems from changes in running surface, footwear, or intensity. Fortunately, recovery can be as simple as taking a few days off running. And cross-training activities like cycling, swimming, aquajogging, and using the elliptical can actually help speed recovery. To help prevent shin splints in the future, make increases in your training gradual and realistic, keep the muscles on the outside of your legs strong with therapeutic band exercises, stretch your calves regularly, and consider talking to your podiatrist about orthotics.

IT Band Syndrome
The most common location of overuse injuries in runners is the knee, and the most common cause of lateral knee pain is iliotibial band syndrome (ITBS). Often the result of increased mileage or hill training, ITBS is caused by friction in the long band of soft tissue, or “fascia,” between the IT band and the outside of the knee. It’s best described as a sharp pain on the outside of the knee that worsens with going down hills or stairs and will in most cases bench a runner entirely. To remedy the condition, IT band stretching exercises are recommended, as is rubbing ice cups on the area. Over-the-counter anti-inflammatory medications can help, and in cases where pain does not go away after six to eight weeks, a cortisone shot may be prescribed. To prevent ITBS, your best bet would be to strengthen the gluteal and abductor muscles (the muscles around your butt) and improve hip alignment with exercises like walking lunges, wall squats, leg presses, and step-ups.

Stress Fracture
Here’s your worst-case scenario. The most concerning injury in the lower-leg region is a stress fracture. The most recognizable symptom, a sharp pain localized to the front of the shin, initially comes in toward the end of runs, but soon starts to occur earlier and continues with regular walking and possibly also at rest or at night. Rest is key to recovery from a stress fracture. Crutches and a walking boot may be needed to fully rest the area, and in some cases surgery is required. One thing to avoid if you think you might have a stress fracture is the early use of anti-inflammatory medications as it could decrease bone healing. In terms of prevention, your best bet is regular strengthening and stretching of the calf muscle, as less calf muscularity has been attributed to increasing the risk of a tibial stress fracture.

Functional Popliteal Artery Entrapment Syndrome 
Here’s one you may not have even heard of. Functional Popliteal Artery Entrapment Syndrome (FPAES) is where the calf muscles—the gastrocnemius-soleus complex—activate and cause compression on the popliteal artery, which is located behind the knee and is responsible for supplying blood flow to the calves. The result: cramping and pain in the calves, and possibly coldness and numbness in the feet. The pain initially resolves when your run is over, but it can worsen over time and eventually last for hours. To treat FPAES, your doctor may recommend surgery, or use a guided botulinum injection to paralyze the area of the muscle compressing the artery. Since FPAES originates with the calf muscles, symptoms can be alleviated or avoided by less-explosive running, training on a flatter surface, and avoiding calf-intensive workouts involving hills or stairs.

Chronic Exertional Compartment Syndrome
If you routinely feel an aching or burning pain in the front or sides of your lower legs (usually both legs) that increases with activity and dissipates with rest, or even numbness or burning in your feet, chronic exertional compartment syndrome (CECS) could be to blame. To understand CECS, first understand that our muscles are encased in a thick film, or “fascia.” Muscles expand during a workout as blood supply increases to them, but fascia is inelastic tissue and cannot always expand to meet the muscle capacity. If the fascia does not expand along with the muscle during exercise, the muscle can become constricted and unable to receive its full oxygen supply. The result is pain and a decrease in performance. CECS is diagnosed by taking pressure measurements in the muscle “compartments” after exercise. Treatment includes avoiding running on hard surfaces, changing up footwear, icing, myofascial release, and improving running form. However, surgery in the form of releasing the compartments is the definitive treatment. To help prevent CECS, cross-training with cycling and swimming is encouraged, as is icing post-exercise. Appropriate arch supports and running-shoe fit is recommended, too, along with running on grass or trails instead of pavement or cement whenever possible.

This article was prepared for NBC Universal.

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