By Star Physio Todd Lonie.

All around Perth lately there has been a huge increase in numbers of people giving running a go for not only recreational fitness but also competing in fun run events and even marathons at the other end of the spectrum!

Along with this running boom, and due to the repetitive nature of running itself, there is also an increase in running-related injuries that can be prevented as well as efficiently managed to get you back out on the track.
The top five sporting injuries related to running include:

Patellofemoral Pain Syndrome
Definition:
Usually involves the mal-tracking of the patella under repetitive loading causing pain in and around the knee region. Can be caused by trauma or repetitive sub-maximal loading.

Symptoms:
– Pain can be aggravated with stairs, cycling, squats and running
– Mild swelling may be evident
– Nil restriction of knee range of movement (flexion/extension)
– Tenderness over patellofemoral joint margins

Prevention:
– Gluteal activation/ strengthening exercises
– Release of lateral structures including ITB and TFL (foam roller exercises)
– Quadriceps strengthening exercises, particularly VMO

Plantar Fasciosis
Definition:
Involves a non-inflammatory stress reaction underneath the heel of the foot. Usually caused by excessive pronation of the foot and collapse of the medial arch.

Symptoms:
– Gradual onset of burning/ache in arch of foot
– Aggravated by weight bearing activities
– Local, mild swelling (if acute tear is involved)
– Tenderness over medial calcaneal tubercle (inside of heel, under arch)

Prevention:
– Adequate footwear
– Avoid exacerbating exercises
– Adequate stretching exercises for calves and plantar fascia

Ilio-Tibial Friction Syndrome (ITBFS)
Definition:
Impingement or compression on the iliotibial bursa and lateral epicondyle of the femur leading to inflammation of the iliotibial bursa.

Symptoms:
– Pain over lateral aspect of knee, may radiate along lateral thigh
– Aggravated by running, steps, downhill running
– Pain worse at approximately 20-30 degrees of knee flexion (knee bending)
– Localised swelling of lateral epicondyle of the femur

Prevention:
– Gluteal strengthening exercises
– Adequate footwear
– ITB stretching exercises (foam roller exercises)

Ankle Sprain
Definition:
Commonly reared to as being a “rolled ankle”, an injury to the ankle joint where one or more ligaments are torn or partially torn.

Symptoms:
– Pain in/around ankle joint
– Particularly tender over any damaged ligaments
– Swelling and bruising may be evident
– Usually occurs with trauma to the region or sudden rolling over of ankle (e.g. uneven ground)

Prevention:
– Proprioceptive/balance exercises (both double and single leg)
– Local muscle strengthening to the ankle joint (invertors/evertors of the foot, calves)
– Sports Taping: Ankle stability

Medial Tibial Stress Syndrome
Definition:
Commonly referred to as “shin splints” and is usually caused by excessive pronation of foot or overactive/tight calf muscles.

Symptoms:
– Pain along the medial (inside) border of the tibia
– Swelling may be evident along the tibial border
– Pain sometimes can go away during exercise however usually re-presents post activity/next morning and worse

Prevention:
– Adequate footwear
– Stretching exercises for calf muscles
– Gradual increase in running distances

In all of the above situations, acute management is essential and should follow the below guidelines.

Support the injury. If possible, keep immobile until further medical assessment has been made to determine severity of damage. Try using a bandage or sports taping.
Protect yourself from any further injury! This means removing yourself from the game/training and adhering to medical personnel instruction.
Rest the injured body part to allow healing to take place.
Ice the injury for pain relief as well as reducing the inflammation that may be present. General rule: Ice for 20 minutes followed by rest for 40 minutes. Repeat as required.
Compress the area if able with bandage/s to reduce the inflammation.
Elevate the injured body part to help reduce inflammation. Try to elevate the body part above heart level if able.
Medication may be helpful – Seek advice from medical personnel.
Mobilisation of the injured body part may be possible to begin the rehabilitation process. Only gentle movements within pain limits are encouraged after medical assessment if appropriate.
Modalities such as ultrasound or electrical stimulation may be useful in rehabilitation to aid reduction of inflammation associated with the injury.

Physiotherapy can make a difference to all of the above injuries in terms of rehabilitation as well as prevention. At Star Physio we can:
– Create/modify rehabilitation programs to suit your requirements
– Carry out soft tissue therapy to aid progression of healing
– Utilise and teach supportive sports taping
– Educate and perform acute management for your injury
– Assess severity of your injury and if required, refer onwards to specialist treatment

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