Three common running injuries and how to avoid them

This month is prime training season for runners participating in spring and summer events. It’s also the season when John Baldea, MD, a sports medicine and orthopedic physician at Indiana University Health Physicians, must occasionally prescribe an unwelcome treatment for patients who run. “One of the hardest things I have to tell people is not to run,” says Baldea. 

Year after year, he meets novices and experienced runners alike who develop training-related injuries. Usually, they heal with conservative measures like ice, anti-inflammatories and up to six weeks of rest. But that’s long enough to sideline many runners from seasonal events they’ve been looking forward to for months. As a runner himself, Baldea understands their disappointment.

Here, Baldea shares three common running injuries and how you can avoid them.

Patellofemoral syndrome

Weak core muscles, specifically the gluteus medius, can cause improper tracking on the patella in front of the femur, allowing the knee to move inward. That places stress between the patella and the femur, causing inflammation and pain.

Patellofemoral syndrome can occur in anyone, but it’s more common in women than men. “I see it a lot in people who are relatively new to a workout regimen,” Baldea says. “They may be trying to lose weight and get in better shape, so they are upset when they have to quit training.”

How to avoid it: Exercises that develop strong deep abdominal muscles, quads and glutes not only minimize your risk; they are also good treatment for the injury.

Stress reactions of the metatarsals and tibia

Stress fractures begin as pain that worsens with activity. They usually surface for the first time at the end of a workout. It may progress to the point that pain is noticeable at the start of a run. At its worst, a stress fracture may be painful even at rest.

“Stress fractures are usually the result of people trying to do too much, too soon, too long with running that they’re not accustomed to,” Baldea says. “Their bones aren’t accustomed to it either, so they develop fluid in the bone––basically swelling within the bone, caused by too much stress.” When people continue to run through pain, they can cause a fracture.

How to avoid it: Pay attention to your pain. At the first sign, start a conservative treatment of rest, ice and non-prescription anti-inflammatories like naproxen. Whether you’re a novice or an experienced runner, allow yourself plenty of advanced training time and set goals that are reasonable for your physical condition. “If you’ve never run before, you may need a good six months of training, even for a half-marathon,” says Baldea.

Achilles tendonitis

Achilles tendonitis is common when people use minimal footwear or barefoot running. “They spend more time up on their toes, which puts stress on the two muscles that form the Achilles tendon,” he says. “It shows up as pain in the back of the heel that worsens with activity, especially when raising up on the toes, climbing stairs or jumping and landing.”

How to avoid it: Runners may minimize their risk for Achilles tendonitis and other injuries with a mid-foot running strike, landing most of their body weight on the middle part of the foot. Eccentric stretching is a good preventative measure that may also be part of Achilles tendonitis treatment plans for some patients. How to do it: with a straight or bent-leg, stand on a stair. Raise and lower the heel, above and below the forefoot.

When an injury persists

With all these injuries, Baldea says runners should see a physician if the injury doesn’t respond after one to two weeks of conservative treatment at home. If possible, ask your physician for a referral to a sports medicine specialist who can guide you through sports-specific treatment options for your injury. 

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