Injury Free Runing - 4 Common Injuries and How to Prevent Them

By Lance Watson, LifeSport.ca

July 19, 2005 -- Sport and injury often go hand in hand. While many injuries can be prevented by training smart and selecting the right equipment, there are times when even the most conscientious triathletes end up on the sidelines. Some injuries are caused by twisting your ankle on uneven terrain or experiencing a sharp pain on your back after changing your bike position drastically. These injuries, called acute injuries, are the result of trauma.

On the other hand, injuries from overuse are also observed. The more we exercise, the fitter and stronger our bones, tendons, ligaments and muscles become. We break down our muscles during use, and the strengthening process occurs as the tissue rebuilds. Injuries can occur when tissue breakdown is faster than the subsequent repair process. Overuse injuries typically occur due to excess training and inadequate recovery.

ITB syndrome, plantar fasciitis, Achilles tendonitis and shin splints are a few common injuries that can knock you out for a season. Here are a few strategies for dealing with these conditions:

Iliotibial Band (ITB) Friction Syndrome is caused by repetitive friction of the IT band across the outside of the femur. This injury typically presents itself with a sharp pain on the outside (lateral side) of the knee. This knee pain is related to inflammation of the distal (lowest) portion of the iliotibial band. The pain may cease after a mile or two of running but often returns even more sharply after the run. A common cause of this syndrome is worn out shoes and/or orthotics.

The best way to prevent this syndrome is by stretching the ITB, quadriceps, hamstrings and glute muscles. Each stretch should be done two to three times per day, holding every stretch for 20-30 seconds. Treatment for this syndrome include ice, heat, ultrasound, electrical stimulation and stretching. Massage is excellent as well. In any case, stop running! Catching an ITB injury early can be the difference between a short time off or a long forced rest.

Plantar fasciitis is an inflammatory condition affecting the fascia on the bottom of the foot. It may feel like a ripping or tearing sensation on the bottom or arch of the foot. Pain is usually worse in the morning, because during the night the tissues in the foot can tighten up. When stepping out of bed in the morning the fascia is suddenly stretched, and you can feel a sharp pain. Shoes, running habits and biomechanics are all possible contributing causes of plantar fasciitis.

Treatment is variable but may consist of ultrasound, current, orthotics and manipulation of the bones of the foot, along with stretching and exercise. Try rolling your foot on a tennis or golf ball. Make sure you gently warm up your foot in the morning before stepping on it with self-massage. A heating pad in bed can help. Frequent icing during the day can also be a good treatment. Ice massage under the sole of your foot for five to seven minutes or use an ice pack for 15 minutes. Soak with Epson salts for 10-12 minutes. Hot water and Epsom salts will draw inflammation out of the sore muscles. In extreme cases, bracing at night may be necessary to keep the lower leg and foot lengthened.

Shin splints refer to a painful condition that can develop along the inside (medial edge) of the shin (tibia). The usual location is along the lower half of the tibia, anywhere from a few inches above the ankle to about halfway up the shin. In the early stages of shin splints you may feel a pain that is present at the beginning of a run but which disappears as running continues. The pain will often return after exercise or the following morning. As the injury progresses, you will experience more time with the pain and less time without it. Eventually, if ignored and training continues, the pain may become quite sharp and may focus on a very small area of the bone, which might indicate a stress fracture.

Stretching the calf muscles can help prevent the injury from returning. The little muscle on the shin (anterior compartment) works hard to pull in opposition to the big calf muscle, and excessive muscle fatigue (due to tight calves) will cause you to absorb more direct pounding into the connective tissue and bone. Running on soft surfaces (such as trail or treadmill) can also help. The best treatment for shin splints is rest. Massage is great for keeping your calves loose. Depending on the severity of the injury, you might have to completely stop running for a period of time until you are pain free. Start back slowly.

Achilles Tendonitis is a painful inflammation of the Achilles tendon. It may be caused by a single incident or overuse and overstressing the tendon and sheath. Training infrequently and then adding speed work or faster hill running puts you at greater risk. Achilles Tendonitis often develops following sudden changes in activity level, training on poor surfaces, excessive pronation or wearing inappropriate footwear.

Warm up properly before any activity. Look for excessive training-shoe wear as well. Catch it early and reduce training, ice (two to three times a day for 10 minutes) and rest. Stop running if heel pain, tenderness or swelling occurs. Sometimes putting a heel lift in your shoe can temporarily alleviate the pain. Consult a good physio for this. Make sure to do proper stretching before and after every workout.

One of the benefits of being a triathlete is that we train for three sports. When a running injury occurs, you can keep fit cycling and swimming. As well, try and figure out what you can do -- water running, elliptical trainer, stair master, etc. This can help maintain fitness so that it takes less time to get back to form once you are running again.

LifeSport head coach Lance Watson has coached a number of Ironman, Olympic and age-group champions. He enjoys coaching athletes of all abilities who are passionate about sport and personal excellence.

Visit LifeSport.ca or contact Lance for more information.