By Dr. Corey Finan – Doctor of Chiropractic
Of course, running can result in injury. If you have been running for any length of time, you have probably experienced an ache, pain or injury along the way. Understanding how these injuries develop can help you make informed decisions about your training and recovery.
Where Do Running Injuries Occur?
Common areas affected by running injuries include:
- Knee
- Ankle and foot
- Lower leg and shins
- Hip and pelvis
- Achilles tendon and calves
- Upper leg
- Lower back
Some common injuries and conditions runners may encounter include:
- Patellofemoral pain, often called runner’s knee
- Iliotibial band syndrome, or IT band syndrome
- Plantar fasciitis
- Meniscal injuries
- Shin splints
- Patellar tendinopathy, often called patellar tendinitis
- Achilles tendinopathy, often called Achilles tendinitis
- Gluteal muscle or tendon injuries
- Tibial stress fractures
- Lower back pain and spine-related conditions
Why Overuse Running Injuries Can Keep Coming Back?
Many running injuries are overuse injuries. They can be difficult to manage because the painful area may be the result of an underlying issue involving movement, strength, training load or recovery.
The analogy here is a car with a wheel-alignment issue. The wheels are not properly aligned and start to develop a wear pattern in the tires that differs from normal. Over time, the wear pattern worsens until the drive becomes uncomfortable.
You check the tire and see that it is worn in an unusual pattern. However, the tire is not the only problem—the alignment is contributing to that wear. Simply replacing the tire will not correct the alignment issue.
Similarly, treating a painful iliotibial band may help with symptoms, but it may not address the factors that led to those symptoms in the first place. Fortunately, an assessment can help identify movement patterns and other contributors to repeated tissue overload.
The Overload Principle: Giving Tissues Time to Adapt
We need to introduce a concept here known as the overload principle.
The application of force over an area of tissue during movement creates stress. With an appropriate amount of stress and enough recovery, tissues can adapt, strengthen and improve their capacity.
Stress that is too high, applied too frequently or increased too quickly can exceed that capacity and contribute to injury.
Often, part of the problem is not allowing enough time for tissues to adapt to the demands being placed on them. Movement patterns can also influence how that stress is distributed.
For runners, this means considering both how you move and how much you are asking your body to do.
Running Mechanics and Shock Absorption
Running involves a repetitive series of single-leg impacts. Basically, one leg moves forward and contacts the ground, followed by the other.
When your foot hits the ground, there is a ground reaction force—think Newtonian physics and an equal and opposite reaction. During running, peak vertical ground reaction forces can reach approximately two to three times your body weight, depending on speed and other factors.
This creates a substantial demand on muscles and joints to control and distribute that force. This is where shock absorption comes into play.
How your body manages these repeated impacts can influence the load placed on different tissues.
Hip and Knee Strategies: How Your Body Shares the Load
One way to describe shock absorption is through a hip strategy and a knee strategy.
A hip strategy places more emphasis on the gluteal muscles and hip extensors to help manage force. A knee strategy places more emphasis on the knee extensors, including the quadriceps. The calf muscles also play an important role in managing running loads.
In reality, running requires these muscle groups to work together. The goal is to understand how an individual runner distributes the work.
Hip strength and control can help manage inward movement of the thigh and knee. For some runners, addressing these factors may help change the demands placed on the knee.
Why Strength and Muscle Control Matter
Some troubling injuries seen in clinical practice involve changes in muscle strength, flexibility or coordination.
Patellofemoral pain, patellar tendon pain and other running-related symptoms may involve increased demands on particular tissues. However, these conditions do not all have the same cause, and no single movement strategy explains every injury.
So why might someone rely more heavily on one strategy?
I don’t think people always consciously choose it. Sometimes, they may rely on the strength and control available to them—for example, when the hip extensors or hip stabilizers are not contributing effectively.
Your body finds a way to manage the task. These adjustments can happen without you realizing it, and over time may change where tissues experience the greatest load.
Running Injury Assessment and Treatment in Calgary
If pain keeps returning when you run, it may be worth looking beyond the painful area.
An assessment can consider your running mechanics, muscle strength, movement control, training load and recovery to help identify factors contributing to your symptoms.
At Active Sports Therapy in Calgary, our team of chiropractors and physiotherapists can assess your concerns and develop an individualized treatment plan to help you work toward your running goals.
Understand how you run, give your body time to adapt and KEEP YOU MOVING.
