In January of 2014, a group of researchers from the Department of Kinesiology and Nutrition at the University of Illinois, Chicago published an evidence-based report naming the three most common running-related musculoskeletal injuries.
At the top of the list was medial tibial stress syndrome (MTSS), also known as "shin splints". Coming in second and third was: Achilles tendinopathy and plantar fasciitis, respectively.
Shin Splints/Medial Tibial Stress Syndrome:
MTSS results in pain along the inner part of the lower leg. Whether you're new to running or a seasoned pro, chances are good that you've experienced it. Despite its prevalence, the exact cause is still not fully understood. However, many experts agree that MTSS develops due to repetitive stress on the muscles, tendons, and fascia (connective tissue) that attach to the tibia (shin bone).
Certain factors can put a runner at an increased risk of developing MTSS including: increasing training intensity/volume too quickly, overpronation, running on hard or uneven surfaces, and wearing worn-out or inadequate footwear.
Prevention of MTSS is important, so it is suggested that runners participate in graduated running programs that increase volume slowly. Replacing your running shoes after 300-600 miles (depending on your body weight, running style, and training surfaces) can ensure that the integrity of your shoes is intact.
Furthermore, orthotics that prevent overpronation and absorb shock have been shown to decrease the likelihood of developing MTSS. Proper warm-up of the calf muscles (gatroc-soleus) can also help.
Achilles tendinopathy is also referred to as Achilles tendonitis or tendonosis, depending on whether or not inflammation is present. Pain, tenderness, and swelling near the Achilles tendon region at the back of the ankle are hallmarks of this condition. The pain often increases when you push off of your toes.
Similar to other running injuries, Achilles tendinopathy is caused by overuse, which results in irritation and, eventually, inflammation of the tendon. Risk factors for developing the condition include: increasing training volume too quickly, training on hills too often, having low arches/flat feet, overpronating, obesity, tight calf muscles with fascial adhesions, and tight inner thigh (adductor) muscles. If left untreated, the condition can weaken the tendon, predisposing it to tearing.
Increasing your mileage gradually, especially when running hills, can help prevent Achilles tendinopathy. Warming up properly before heading out on your run, as well as keeping your calves strong and limber, are important, too. Orthotics that elevate the heel, which reduce tension on the tendon, can decrease the discomfort associated with this condition.
Finally, plantar fasciitis, the third most common injury amongst runners, is another injury caused by overuse. Eventually overuse leads to repetitive microtrauma to the plantar fascia. The plantar fascia is a band of thick connective tissue located on the bottom of the foot (plantar surface). Once injured, the fascia becomes inflamed and painful, especially close to its insertion on the heel bone (calcaneus).
Increasing your training mileage or volume too quickly (notice a trend here?), having low arches/flat feet, being obese, and having decreased range of motion at the ankle all predispose an athlete to developing plantar fasciitis. Therefore, avoiding/improving these conditions can aid in prevention.
However, once you have developed plantar fasciitis, there are a few options for treatment. Kinesiotaping, instrument-assisted soft tissue mobilization (IASTM) to the plantar fascia, orthotics, night splints that keep the ankle at 90 degrees, and stretching of the calves and plantar fascia can be employed to decrease pain and increase function.
Conclusion- Prevention and Early Treatment are Key!
Prevention is the key to staying healthy and avoiding these frustrating injuries. Being familiar with their signs and symptoms can help you recognize the beginning of an issue before it develops into a side-lining injury. If you have any questions or concerns about these or other activity-related injuries feel free to call or email our office!
-Dr. Christine Major, MS, DC