Overuse Injuries in Runners
by:  Jeff Erickson, MPT

Injuries in runners generally occur in the legs and low back.   The following are the most common along with some tips on how to prevent them from happening to you.

• Low Back Pain-  Eight out of ten Americans suffer from this.  Running uphill for too great a distance can contribute to this because the torso will be swayed back into an uncompromising position.  Running on uneven or hard surfaces can also cause back pain.  Uneven surfaces cause asymmetrical forces on the lower back region while hard surfaces increase stress on the area due to increased force of impact on the ground.         

• Hip or Buttock Pain- 
  1.  Trochanteric (hip) Bursitis-  This can result from increased stress to the outside of the hip as runners tend to overuse the muscles due to the one-legged stance

        2.  Piriformis Syndrome-  The piriformis is one of the deep
          rotators of the hip.  If this is tight, it can cause pain and
          increased pressure on the sciatic nerve as well as 
          shooting pain down the leg.

• Anterior Knee Pain-  This is common in most athletes, especially teenage girls.  It is often due to poor body mechanics, faulty muscular strength, or poor muscle flexibility.  This creates an abnormal tracking of the knee cap in the groove of the knee.  This is usually easy to cure, but may require physical therapy or even surgery.

• Iliotibial Band (ITB) Friction Syndrome- This is lateral knee pain along the outside of the knee down past the knee.  The one-legged stance in runners causes increased tightening of the ITB and will cause friction between it and the bony protuberances of the knee. 

• Shin Splints-  This is pain in the front of the shins.  It is debatable what causes this but one factor is usually tight calf muscles, especially the soleus.  Many hills can be the culprit of tight calves.

• Ankle Sprains-  Usually caused by turning the ankle on a curved or uneven surface.

• Asymmetrical Pain-  Pain in one sector of the back or one leg vs the other probably means you are running on uneven surfaces.  Many runners run on the crown of the road, so if you are always on the right side of the road, the left foot lands with the inside down and the right with the outside down.

In general, because of the repetitive pounding, battling elements, and the nature of runners to push themselves beyond limits, injuries will occur.  Many of these injures start slowly and gradually become worse.  Often there is not a specific cause of injury, which causes them to be overlooked until the pain limits activity. 

The best prevention is to address pain when it first starts.  To cure it, you may only need to do a few simple stretches, strengthening exercises, or maybe just changing running surfaces.  However, at the onset of pain, if it is significant and lasts for at least a week, consult a physician. 

Other Common Causes of Pain
1.  Improper Footwear
2.  Increasing intensity or distances too quickly
3.  Running while sick or fatigued 

****     Footwear Websites     **** 
1.  www.aapsm.org/runshoe.html
-athletic shoe recommendations
2.  www.defectiveshoe.com
-case studies of injuries in relation to manufacturer defects
-evaluation of shoes for defects