Analysis: Here are the four most common injuries that runners experience, why they occur and potential ways to avoid them.
Long distance running season is officially upon us, as we observe the resilient and motivated runners pounding the roads and pavements across the width and breath of the country.
Marathon running is a particularly demanding sport placing significant stress on the body. Completing a marathon is no mean feat, but it does come with a high risk of injury. Below, we will delve into the four most common injuries that runners experience, why they occur and potential ways to avoid them.
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From RTÉ Brainstorm, What happens to your body when you run a marathon?
Runner's Knee
Runners knee is the lay-man’s term for "patellofemoral pain syndrome". It is characterised by pain behind or around the kneecap, especially when descending stairs or sitting for prolonged periods. The repetitive motion and impact forces associated with long-distance running can lead to the kneecap rubbing against the femur (thigh bone) underneath, leading to irritation of the joint. Several factors have been proposed to contribute to this injury:
- Imbalance within the quadriceps muscles – having stronger muscles on the outside of your quad results in the kneecap tracking more towards the outside of its groove. This isn’t ideal, and can cause friction and irritation at the joint, which is further compounded when doing high mileage.
- Poor running form – Landing on your heels during running can place higher impact forces through the knee joint every time you contact the ground. If the muscles around the knee are unable to tolerate this high loading, there will be increased stress on the joint.
Achilles Tendinopathy
The Achilles tendon is a pivotal structure that connects the calf muscle to the heel bone. It acts like a spring during running and often becomes injured due to sharp increases in training loads or poor recovery between running sessions. Factors that predispose runners to this injury include:
- Sudden increase in training load – jumping through the gears too quickly in training (e.g. increasing the training distances in a short space of time) can result in microtears in the tendon. The body will naturally breakdown in response to a training stimulus, however if inappropriate time is given for recovery, the body’s structures may not heal in time for the next overload to be applied. This can result in further damage and ultimately the tissue may fail and breakdown even further.
- Changing footstrike pattern – runners often believe that they would be better off landing on their toes when running. This stems from anecdotes and opinions across the literature and internet, whereby it’s thought that landing on your toes results in decreased injury risk and a more efficient running economy. However, if transitioning to land on your toes is your focus, this requires a significant period of time for your body to adapt to the new demands that are being placed on your calf and Achilles. Transitioning too quickly may result in an overload and ultimately injury to these structures.
Shin Splints
Shin splints present as pain along the inner side of the shin bone (tibia). It is a progressive injury whereby it may often begin as a dull ache, but left untreated, can result in severe debilitating pain. It’s important to note that shin splints is not a diagnosis, it is an umbrella term for several pathologies than can affect the shin region (e.g. stress fracture, chronic exertional compartment syndrome and medial tibial stress syndrome). Some practices in running that may put runners at greater risk of shin splints include:
- Poor footwear – Running shoes that have poor shock attenuation or cushioning properties may lead to the runner experiencing greater impact forces through the shin bone.
- Running on hard surfaces – Surfaces such as the road and footpaths can impose high impact forces on the body upon landing. Exposure to these high forces over long distances, multiple times a week, may result in the body’s inability to tolerate the degree of stress associated with this training. Training on a slightly more forgiving surface such as track or grass may assist with lesser cumulative high loads.
Iliotibial Band Friction Syndrome
The Iliotibial band is a thick band of fascia that runs from the outside of your hip to the outside of your knee. It can often become tight, and leads to pain and irritation that is felt at the outside of your knee, particularly with downhill running. Factors that have been found to predispose runners to this injury include:
- Poor running technique – As you run, your feet, knees and hips will naturally rotate inwards during your stride. Much of this rotation is normal. However, if excessive rotation occurs at the knees, this can place an extra strain on the Iliotibial Band, leading to friction where it interacts with a bony prominence on the outside of your knee. This combined with fatigue and long-distance training can further provoke the pain experienced at the knee.
- Weak hip muscles – if your glute muscles are weak, you will lack stability at the hip during running. Your hip is then subjected to increased motion, which can have a knock on effect at the knee, altogether putting increased strain on the IT Band.
Overall, overuse or lack of recovery is largely responsible for most running injuries. Ensuring that you have given yourself adequate time to train for a marathon is imperative, or you may find yourself picking up some niggles along the way. Whilst running technique is quite important, caution is advised when changing to other techniques, as these transitions can take months for your body to adapt rather than switching overnight.
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The views expressed here are those of the author and do not represent or reflect the views of RTÉ
