Knee, Foot and Ankle Care for Runners
Running has been touted as the most accessible sport or form of exercise in the world as all you actually need to run is a pair of shoes. To maintain one’s health or improve it, adults need to do two types of physical activity each week – aerobic and strength exercises. According to the National Health Service (UK), exercise time of at least 150 minutes per week is recommended for adults aged 19-64. Running or jogging will fulfil the aerobic criterion. However, as with all physical activities, there is a certain level of care required, as overexertion or fatigue will lead to injuries.
Injuries Associated with Running and Their Treatments
The high-impact nature of running is associated with many sports injuries, such as repetitive stress injuries, due to an inadequate amount of time allocated for recovery or running with improper form. Injuries that are common among runners include patellofemoral pain syndrome (PFPS), iliotibial band syndrome, patellar tendinopathy, and medial tibial stress syndrome (MTSS). In addition, a change in running pace may also cause Achilles tendinitis, and plantar fasciitis.
PFPS or Runner’s knee, is characterised by mild to severe knee pain. Symptoms can start and progress gradually, or be caused by a single incident. It is commonly associated with dramatic increases in training time, distance or intensity. The pain is due to the rubbing of the posterior surface of the back of the kneecap (patella) with the thigh bone (femur). Treatment for PFPS involves resting and physical therapy, including stretching and strengthening exercises for the legs.
Iliotibial band syndrome is a leading cause of lateral knee pain, and the symptoms range from a stinging sensation above the knee, to swelling and thickening of the affected area. The iliotibial band stabilises the knee during running. The repetitive rubbing of the band in addition to the repeated flexion and extension of the knee during running may cause the area to become inflamed. Treatment involves resting, putting ice on the affected area, and compressing and elevating it. This can be followed by massage therapy.
Jumper’s knee or patellar tendinopathy affects athletes in many sports, and is categorised as an overuse injury from overloading the extensor mechanism of the knee. Among the associated risk factors are low ankle dorsiflexion, weak gluteal muscles, and muscle tightness, particularly in the calves, quadriceps muscle, and hamstrings. For treatment, a physical therapist should be consulted. The recommended treatment normally includes specific exercises and stretches to strengthen the muscles and tendons.
MTSS, also known as shin splints, is categorised as an overuse injury. It is an injury in the middle to lower thirds of the inside or medial side of the tibia, which is the larger of two bones comprising the lower leg. Regarded as the most prevalent lower leg injury, the typical symptom of MTSS is pain along the inner edge of the shinbone (tibia). Treatment includes rest, putting ice on the affected area, strengthening the area and gradually returning to activity. It is important to reduce pain or swelling before returning to any activity.
Achilles tendinitis, also known as Achilles tenosynovitis or Achilles tendinopathy, affects the Achilles tendon, and is an overuse injury caused by repeated stress and strain, especially common in endurance runners training under less than ideal conditions. Symptoms include aches or pains in the ankle area, or a burning sensation in the whole joint. To prevent Achilles tendinitis, one must be consistently physically active, which will improve the elasticity and strength of the tendon. Treatment involves applying ice, and cold compression therapy, wearing heel pads to reduce the strain on the tendon, and an exercise routine for strengthening the tendon.
Plantar fasciitis is a condition where there is pain in the heel and bottom of the foot. It is usually most painful with the first steps of the day or after a period of rest or inactivity. Pain is also frequently brought on by bending the foot and toes up towards the shin and may be worst in afflicted people with tight Achilles tendons. Risk factors for plantar fasciitis include overuse such as from long periods of standing, an increase in exercise, and obesity. Treatment involves resting, changing activities, taking pain medications and stretching. If the symptoms persist unabated, those afflicted might consider physiotherapy, orthotics, splinting, or steroid injections. Another form of treatment involves light to medium compression around the ankle and lower calf by wearing elastic bandages throughout the day.
Although there are potential injuries associated with running, they can be prevented with proper warming up before running, wearing the proper footwear, and taking measures not to overexert oneself. It is also a good idea to join running camps to learn the proper running techniques to avoid injury for a better outcome.
