The Most Common Running Injuries

The top three running injuries are periostitis, Achilles tendonitis and plantar fasciitis (Lopes, 2012).

Periostitis refers to localized pain along the distal two thirds of the posteromedial tibia (Winkelmann, 2016). They are generally caused by two possibilities. On the one hand, it is possible that repetitive contractions of certain muscles such as the posterior tibial may generate excessive stress on the tibia and would result in inflammation of the periosteum (Lopes, 2012). On the other hand, periostitis can also be caused by an insufficient remodeling capacity of the bones, which, in turn, would be caused by repetitive and persistent stress on the tibia, not only by muscle contractions, but also by the force applied to the ground during our stance phase of running (Lopes, 2012).

Secondly, tendonitis is considered to be inflammation of the tendon caused by too much repetition of a stimulus beyond the physiological tolerance of the tendon (Lopes, 2012). That being said, the Achilles tendon is composed of several tendons like the gastrocnemius and soleus (together form the calf). When running, we place stress on these muscles and if we repeatedly exceed their tolerance threshold, we are predisposed to developing tendonitis (Lopes, 2012).

Finally, plantar fasciitis is considered a degenerative process of the plantar fascia that causes pain over the medial tubercle of the calcaneus, which is an area of the heel (Lopes, 2012). The main symptoms usually occur when walking, running, standing, or in the morning when taking your first steps. The fascia is an envelope that surrounds every structure in our body (Bordoni, 2018). It allows structural continuity and gives shape to the tissues. The primary mechanism of plantar fasciitis seems to be difficulty enduring the load placed on the body (Lopes, 2012), so, again, overuse.

Good news! These injuries can be prevented and also treated if they do occur. For one thing, as we can see, these injuries are very dependent on our ability to manage good volume, intensity and, most importantly, recovery of our physical activities. So, for preventive purposes, the best advice would be to dose your running outings well, while leaving yourself some time to rest. We often see people who are inactive or deconditioned doing long first runs or picking up right where they left off before stopping. Rather than starting with a 5-10 km run once a week, I would recommend shorter, but more frequent runs during the week. It’s all about management. We could also include intervals of walking and running during the first outings to vary the intensity without asking too much of the body. Also, it can’t be said enough; muscle strengthening is necessary for a variety of reasons, such as a better running economy (Barnes, 2014) and to prevent running-related injuries (Snyder, 2009). Intensity, volume, rest, strength training, that’s a lot of variables to manage… This is where a kinesiologist becomes essential if you are serious about your training. They will be able to evaluate you and thus offer you a hyper-adapted training plan.

On the other hand, if you are already unfortunately injured, there are several treatments for the three injuries mentioned above. For Achilles tendonitis, eccentric exercises are recommended (Fields, 2010), which are exercises in which the muscles work against the stretch. An example of an exercise would be to do plantar flexions (calf raises), on the balls of the feet, controlling the descent (Arnold, 2018). Depending on the degree of tendonitis, it may be suggested to go lower than our toes, while in other cases, it is advised to stop when the ankle is equal to the toes (Arnold, 2018). Again, these are examples. If you have an injury, I strongly suggest the guidance of a kinesiologist and physical therapist. Together, they will offer you the best support. Consulting a health professional is key when dealing with injuries.

Have a good week and good training!