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5 Common Runner's Injuries That Can Be Treated by Physiotherapy

Colourful running shoes in a circleWhether a recreational, sporadic weekend runner or a dedicated marathon runner, using your body for repetitive motion, often on hard surfaces and for extended periods of time can take it’s toll on your body.

Up to 70% of recreational and competitive runners sustain overuse injuries during any 12-month period.

Below are a few examples of common injuries often found in runners and how our physiotherapist can diagnose & treat these injuries. We want to help you get back to doing the things you love.

 

 1- Plantar Fasciitis (also known as plantar fasciopathy)

Runners will usually complain of pain in the arch or the heel of their foot. The plantar fascia is the thick connective tissue at the bottom of your foot that connects your toes to your heel. Plantar Fasciitis can occur in one of two ways, either through compression (squishing) or traction (over-stretching). The foot will be sore in the morning but pain reduces once up and moving around. The condition arises due to the plantar fascia becoming irritated and inflamed when it is overloaded.

Ways to diagnose plantar fasciitis

The physiotherapist will test movement and function as well as manually test the local area around the foot to identify the source of pain as well as discuss habits and recent activities.

Treatment for Plantar Fasciitis

Initially it will include an assessment of foot biomechanics, then may include rest and progressive loading (starting activity again slowly), stretching of the Achilles tendon, strapping and taping of the foot to restrict movement and aid in recovery, prescribed stretches and exercises to strengthen the calf muscles, prescribed orthodics or referral to a podiatrist.

2- Gastrocnemius or Soleus tears

The calf muscles runs from the back of your knee to your ankle and plays an important role when it comes to running. Having strong calf muscles helps you propel yourself forwards and is vital for being able to run at your best. You can tear these muscles if you have an underlying weakness in these muscle and you overexert yourself when running. Equally, the muscle can be over-extended from sudden over use such as stopping and starting running during sport such as tennis, squash or netball.

Ways to diagnose Gastrocnemius

he physiotherapist will ascertain the location and nature of the pain, test the ability to stand on the tip-toes, pain present when contracting the muscle and identify localised bruising or swelling.

Treatment for Gastrocnemius

Immediate treatment for a soft tissue injury such as a muscle tear is to follow the RICER method (Rest, Ice, Compression, Elevation & Referral) for 20 minutes, every 2 hours for the first 48-72 hours after the injury. Reducing the bleeding and swelling to the area will assist the body in healing faster. Compression bandages also often aid in speeding up healing.
Once the pain has diminished it is ok to begin gentle exercise and stretching under the supervision of a physiotherapist. Specific strengthening exercises can be prescribed to help strengthen the affected muscle. We do not recommend starting exercise without supervision from a sports medicine professional for fear of reoccurring injury.

3- Achilles Tendinopathy

The Achilles tendon runs from the heel up the back of the leg to the calf muscle. It has elastic properties which allow it to store and release energy to propel you forwards as you run. Unfortunately your Achilles tendon may start you become inflamed and irritable if you rapidly increase the amount of running you do. So it’s important to gradually increase the distance you run to prevent an Achilles tendinopathy from developing.

Ways to diagnose Achilles Tendinopathy

The condition is graded from 1 (mild) to 4 (severe) by a physiotherapist depending on the severity of the injury. The physio will test movement, the achillies’ ability to bear load, check for swelling and bruising, decreased strength in the leg and pain during movement.

Treatment for Achilles Tendinopathy

Initially the treatment is the same as for a soft tissue injury so follow the RICER protocol (Rest, ice, compression, elevation and referral) for the initial 48-72 hours. Avoid heat, alcohol, exercise and massage to reduce localised bleeding and swelling.

After the pain has reduced, gentle exercise and stretching can re-commence as well as a look at sports footwear and running surface & frequency to prevent re-injury.

 

Common runner injuries

4- Patellofemoral pain (knee cap pain)

The patella (knee cap) is a common source of pain in runners due to the knee cap being the largest joint in the body. As well as this, it is a very mobile bone over the top of a large joint connected between your thigh bone and shin bone with ligaments and tendons. Also- depending on the shoes you wear and how you run can affect the alignment of your legs and consequently your knees causing misalignment and tightness in muscles around the joint. This can cause irritation and swelling around the knee and make movement painful and restricted.

Ways to diagnose Patellofemoral pain

Pain can be experienced during periods of activity or after periods of inactivity. Often swelling and clicking may be present and often stairs are uncomfortable. The physiotherapist will discuss symptoms and test movement, check the alignment of the knee cap as well as assess the biomechanics of the foot.

Treatment for Patellofemoral pain

Initially the RICE method (rest, ice, compression & elevation) is recommended for the first 48-72 hours of onset of pain. Anti-inflammatory medication is also often beneficial. After pain has settled or if it doesn’t we recommend having the alignment of your knee cap checked by a physiotherapist. They will check horizontal and vertical alignment, identify primary cause of issue. Often, the reason the knee cap becomes misaligned is through one muscle in the leg being stronger than another causing the imbalance or not stretching the muscles around the legs and glutes before and after exercise. Our physio can loosen up tight muscles, help realign the patella and prescribe stretches and strength exercises for the quads and glutes.

5- Trochanteric Bursitis (Hip pain)

A Bursae is a small fluid-filled sack that acts as a cushion in the joints of the body. Bursitis is the inflammation of the bursa. The Hip has two bursae that can become inflamed and painful when your hip is overloaded in provocative positions. Trochanteric Bursitis affects the bursa that sits between the bony part of the hip bone on the outside of the hip joint. This type of injury can arise due to weakness of the hip and thigh muscles which are responsible for hip stability, unequal leg length or rheumatoid arthritis.

Ways to diagnose Trochanteric Bursitis

Hip pain can initially present as sharp but become more dull and widespread if left un-diagnosed. The physiotherapist will check range of motion and identify cause of pain by testing ability to stand up from sitting, lay on affected side and ability walk. The physio will also assess the strength of the glute muscle, core muscle strength and hip joint to see whether the hip itself is causing the pain.

Treatment for Trochanteric Bursitis

Treatment may include splinting to restrict movement to the joint, application of heat or cold packs depending on which the body best responds to and anti-inflammatory medication to combat swelling. Often- if treatment from the physiotherapist does not cause the pain to completely disappear, further investigation may be necessary. We can refer to have MRI and x-ray scans done or refer you to your GP for an ultrasounds scan. On occasion, more serious treatment such as a cortisone injection or surgery may be necessary, however, this is generally the last resort after all other options have been exhausted.

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