Conditions and Injuries are Significantly Common in Runners

Conditions and injuries are significantly common in runners due to the constant forces that the lower limbs are subject to through the running cycle. The most important management to ensure a healthy return to activity is an accurate diagnosis with a supportive rehabilitation programme that is tailored to the patient's specific needs.

Here are a few common injuries that occur with runners:

Plantar Fasciopathy
Plantar fasciopathy is a condition that is also commonly known as plantar fasciitis. This is a common condition that is very painful at the heel or at the arch of the foot. Patients will report that it is most painful when they first get out of bed in the morning but subsides with activity. Plantar fasciopathy can be caused by a range of things, such as trauma to the plantar fascia (e.g., standing on something), inadequate footwear, a sudden increase in activity, or overuse of the plantar fascia. This can be treated conservatively with footwear advice, education, taping, padding, a home exercise programme, and more. More in-depth management includes Extracorporeal Shockwave Therapy (ECST), Custom Foot Orthoses, and a corticosteroid injection if applicable.

Achilles Tendinopathy
Achilles tendinopathy is another common injury with runners because the Achilles takes 6–8× our body weight in load during running. Patients with Achilles tendinopathy can present with pain at the back of the heel where the Achilles attaches or along the Achilles tendon. This can occur due to overuse, chronic stress at the Achilles, a pronated foot type, trauma, and more. Conservative treatment can consist of rest, icing, footwear advice, strapping, EVA heel raises, and padding. Further management includes Extracorporeal Shockwave Therapy (ECST), Custom Foot Orthoses, and a corticosteroid injection.

Medial Tibial Stress Syndrome
Medial Tibial Stress Syndrome (MTSS) is commonly known as shin splints. This is an overuse injury that causes pain along the inner edge of the tibia (shin bone) that is greater than 5 cm. It’s a frequent problem in runners and other athletes who engage in repetitive impact activities. Things that can contribute to MTSS include a pronated foot type, inadequate footwear, improper gait mechanics, hard training surfaces, and more.
Conservative management of MTSS includes taping, footwear advice, a home exercise programme, resting, and icing. If conservative management proves unsuccessful, custom foot orthoses may be indicated.

Stress Fractures
Stress fractures are caused by repetitive stress or overuse of bones. These are incredibly common in runners due to the nature of running being repetitive trauma to the lower limbs and are often missed. The most common places that stress fractures are located in runners are the metatarsals and the tibias due to the amount of repetitive forces through them during running.
Risk factors that are associated with stress fractures include a sudden increase in activity, inadequate nutrition, genetic factors such as osteoporosis, poor biomechanics, and inadequate footwear.
Patients that have a stress fracture will find their pain begins with activity and does not improve until they rest. They may even find they have night pain when not load-bearing. Other symptoms such as localized tenderness and bruising may be present in some cases.
Imaging is crucial for confirmation of a stress fracture.
Management of a stress fracture includes immobilization (e.g., moon boot), resting, icing, gradual return to activity, and addressing the root cause (e.g., biomechanics or nutrition).

Conclusion
Many complications and/or injuries can arise with runners; however, effective management of these conditions is imperative to return to activity.
An accurate diagnosis is key for proper rehab and return to running, as there are many differential diagnoses with pain. Therefore, come see a podiatrist for any lower limb pain so we can get you diagnosed and get you running pain-free!

By Lachlan “Lockie” Smith
Podiatrist

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