ATLETA Fitness

Chronic Sports Injury Management – Part 3 of 3

There’s really nothing more annoying for your running than starting to suffer the effects of over-reaching and over-training, only weeks after starting out on a new program. Why does this happen to so many new and returning runners?

Optimized-Trail RUnning CHickPart 3 of 3 in our running and sports injury blog series looks at management methods for chronic running related issues and injuries (check out Part 1 and Part 2 here). What can we do about these issues once they start to occur, and how can we prevent it from happening? Let’s take a deeper look into the mechanics of gradual onset, chronic running injuries.

Chronic Injuries:

Chronic injuries are a common concern for regular runners, particularly for those clocking up large distances on pavement or road. Effectively, a chronic injury is an issue that develops over time due to poor running mechanics, poor muscle, joint action or excessive forces continually being placed upon certain areas or a combination of these factors. Common running related chronic injuries include ITB syndrome, achilles, patella tendon or hamstring tendinopathy, plantar fasciitis and shin splints.

ITB Syndrome:

ITB SyndromeITB syndrome occurs when large increases in running distance and loads are made over short periods of time. This is regularly seen in amateur half-marathoners, who go from 5km running weeks to 45km running weeks in the space of ~2-3 weeks. This causes a frictional inflammation and aggravation of the ITB (illiotibial band), the large muscular sheath running down the lateral side of your leg into the outside of your knee. ITB syndrome is synonymous with lateral knee soreness, pain in walking up stairs and pain while running, particularly when your foot lands (striking phase). The ITB is connected to the Gluteus Maximus and another smaller hip abductor, the TFL. Foam Rollers are a great way to massage the ITB and help remove inflammation. Do this by rolling the side of your thigh along the foam roller and applying firm pressure to noticeably sore points (ask our trainers for more help on this). This could help reduce the level of pain associated with ITB syndrome. A reduction in load for a 1-3 week period is also recommended, as this will take pressure of the knee and allow the glute and ITB to better recover. The number one thing for ITB syndrome is time – time to recover before re-loading the affected knee.

Tendinopathy:

general_tendonitis_achilles_anatomy03Tendinopathy is a term used to categorise a collection of tendon inflammation conditions, where the tendon swells up and becomes inflamed in response to overuse and repeated poor muscle mechanics. Achilles, patello-femoral (patella tendon) and high hamstring are the three most common running related tendinopathies. Tendinopathies generally require lengthy rehabilitation, and can remain an issue for many months. Initially, rest will be the most useful course of action, but following on from sufficient rest the injured site needs to be mobilised. Light activation, such as light resistance training and passive mobility exercises, are a great way to get the site moving again. Following initial RICER treatment, Neurofen, Voltaren and other Non-steroidal Anti Inflammatory drugs (NSAIDs) can help to minimise inflammation and keep the swelling to a minimum. The application of sports tape to restrict and manage movement is also important during rehabilitation and even once the issue has been dealt with, both to help facilitate movement post-inflammation and limit excessive tendon activation post-injury. Kinesio tape can be a great tool for the hamstring, as it can restrict or help facilitate muscle function. This level of restriction can be adjusted to suit the individual’s level of inflammation, soreness and recovery. Effectively, time, preventative taping, NSAIDs and slow movement progression are the best ways to deal with tendinopathy conditions, and ensure both a speedy and effective recovery.

Plantar Fasciitis:

Plantar-Fascia-StrainA condition similar to a tendinopathy, plantar fasciitis (PF) occurs when the fascia, or protective sheath covering the muscle under-foot, becomes inflamed and begins to tear, usually near the heel. Rehabilitation and treatment is similar to that of a tendinopathy, in terms of RICER, NSAID use, light mobilisation and preventative taping. Tennis and golf balls are great tools to help massage and mobilise the underside of the foot. Start by rolling around a tennis ball and applying pressure to particularly sore areas under-foot. Once this feels easy or pain has subsided substantially, progress to using a golf ball which will provide a harder and more focused massage. Orthotics are a good idea for PF, as they can help to keep your arch high and limit excessive stress on the plantar fascia during foot strike. In particularly severe cases, a ‘moon boot’ or foot cast can be used to limit tightening up of the PF overnight. Often the condition is worst when you first wake up, as the PF is cold and not particularly pliable. A moon boot can help to overcome the PF morning stiffness.

Shin Pain/Splints:

shin splintsShin splints and shin pain are often considered interchangeable terms, however, proper shin splints are far worse than shin pain. Proper shin splints occur when micro stress fractures in the tibia shed small pieces of bone, which aggravate and inflame the muscular sheath around the front of the shin. This can be a serious and significant condition if not treated fast and effectively, so see your healthcare professional as soon as possible. Shin pain often occurs after sudden increases in training load, running distance or when large portions of your running occur on hard surfaces. RICER should be applied to the affected shin/s, and then rest undertaken. Initial rest followed by a substantially decreased running load will help to alleviate the condition. When starting back running, also consider running on softer surfaces first (such as grass or athletics track) to allow your shins to get used to the load and impact again. Also consider running with a shorter stride and focusing on your technique, to ensure more of a mid-foot running strike.

Time: time is the major factor to consider when looking at chronic, over-use injuries. Rest is your friend here, and will allow you the best chance at a good recovery. There’s no point going out too hard too early, and ruining your chances at a fast recovery. If you need further help through your recovery then it is best to contact a sports medicine professional. Get in contact with our team to let us help you through your rehabilitation, and we’ll make sure to return you to running as soon as possible.
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