1. Runner’s knee
Patellofemoral pain (PFP) has been reported as the most frequent running injury. Thus, it is not surprising that PFP is also known as “Runner’s knee”.
The pain is characterized by insidious onset anterior knee pain that is exaggerated under conditions of increased patellofemoral joint stress because the overuse, the misalignment of the patella-femur angle, problems with your feet, weak or unbalanced thigh muscles or a direct hit to the knee, like from a fall or blow [2,3].
According to the scientific literature, to prevent this injury we must have an adequate education on the management of symptoms based on training modifications. That is to say, to have a correct training in the first place. And second, make a protocol of exercises aimed at strengthening and controlling the lower extremities after running .
2. Achilles tendinitis
It is the most common Achilles tendon disorder, with the highest incidence among runners. Achilles tendinopathy can be acute or chronic. In the acute phase, the cardinal symptoms are morning pain and stiffness and pain at the beginning and end of exercise sessions, with relief in between. The tendon is diffusely swollen, and there may be palpable crepitus. Tenderness is maximal 2–6 cm above the insertion. In chronic tendinopathy, the tendon remains painful with exercise but the tendon is nodular and thickened rather than swollen and oedematous. Intrinsic and extrinsic aetiological factors interact in the genesis of Achilles tendinopathy. Intrinsic risk factors include demographic factors (sex, age, weight and height) and genetic polymorphisms; and local anatomical factors include leg length discrepancy, malalignment and decreased flexibility. Extrinsic factors comprise therapeutic agents (corticosteroids, antibiotics), environmental conditions, and physical activity-related factors, including training patterns, technique and equipment , so there is not much specific information on how to prevent this injury unless you have strong calves for protecting your tendon and not overload the area using flip flops or stretches too aggressive in training that can produce a tissue break. Also the R.I.C.E. strategy (rest, ice, compression, and elevation) are the best ways to get back on the path to recovery .
3. Plantar fasciitis
Plantar fasciopathy is an inflammation, irritation, or tearing of the plantar fascia. The plantar fascia is a band of connective tissue that supports the arches of the foot, specifically the longitudinal arch, and provides shock absorbance for the foot. Plantar Fascitis is an enthesopathy of the proximal insertion of the band, resulting in heel pain that is classically worse on starting activity or in the morning and frequently self-limiting. There are certain factors that can predispose to its development. Risk factors usually reported in the literature as leading to an increased risk include high body mass index or anatomical abnormalities such as pes cavus or leg length discrepancy. Prolonged standing and reduced ankle dorsiflexion have also been shown to influence the development of Plantar Fascitis . For preventing this injury stretch and massaging the plantar fascia several times a day. In the morning, hang your feet over the edge of the bed and roll your ankles. Also make sure your shoes fit your foot type by getting an analysis at a running shoe store or from a podiatrist or physical therapist and don’t use flip flops [6,7].
4. Shin splints
“Shinsplints” refers to medial tibial stress syndrome (MTSS), an achy pain that results when small tears occur in the muscles around your tibia (shin bone).
Previous studies have reported that 15.2% of high school runners developed MTSS during the 13 weeks of cross-country season. These studies indicated that prevention or treatment for MTSS is important.
A magnetic resonance imaging study has indicated that MTSS is a lesion in the junction of the periosteum and fascia and that elongational stress of the lower limb muscles, such as the soleus, flexor digitorum longus, or tibialis posterior increased strain in the tibial fascia. As larger navicular drop and excessive pronation during running are considered as risk factors of MTSS, it is assumed that MTSS is related to overuse of ankle inversion muscles . Thus the easiest and best way to avoid MTSS is to increase mileage gradually and to make sure you are in an appropriate shoe for controlling the ankle inversion .
5. Iliotibial band syndrome
Iliotibial (IT) band syndrome in a common condition that causes lateral knee pain in runners, with a reported incidence rate of 1% to 12%. Generally, proposed etiologies of ITB friction syndrome include friction of the ITB against the lateral femoral epicondyle during repetitive flexion and extension activities, compression of the fat and connective tissue deep to the ITB, or chronic inflammation of the ITB bursa.
The prevention of the IT band syndrome is easy with continued exercises and foam-rolling. You can also change directions every few laps while on a track, and limit how often you do hilly routes [6, 10].
By Aranzazu our Physiotherapist.
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1. “The effects of a multimodal rehabilitation program on pain, kinesiophobia and function in a runner with a patellofemoral pain.” By: Samuele Passigli, et als.
2. “Patellofemoral Pain.” By: Dutton RA, et als.
4. “Effects of rehabilitation approaches for runners with patellofemoral pain: protocol of a randomised clinical trial addressing specific underlying mechanisms.” By: Jean-Francois Esculier, et als.
5. “Biomedical Risk Factors of Achilles Tendinopathy in Physically Active People: a Systematic Review.” By: Maria Kozlovskaia, et als.
8. “Prognostic Value of Diagnostic Sonography in Patients With Plantar Fasciitis.” By Fleischer A, et als.
9. “Ankle and toe muscle strength characteristics in runners with a history of medial tibial stress syndrome.” By: Saeki J, et als.
10. Intra-articular Fibroma of Tendon Sheath in Knee Joint Associated with Iliotibial Band Friction Syndrome: Rare Occurrence in a Teenage Girl Sameer Rathore, Vasil Quadri, et als.