How to spot and fix IT band syndrome running injuries What is sciatica and how can it affect runners.
Stress refers to putting stress on a body part – muscle, ligament, joint, for example – that is unprepared for it and can’t handle it, while muscle imbalance refers to an inconsistency in the strength of your muscles, which means your body isn’t properly trained for the activity you’re doing.
Overuse injuries happen when you work your body too hard, resulting in it breaking down. They happen when runners don’t listen to their bodies and back off when needed.
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One of the best ways to prevent injuries is by strengthening your kinetic chain – your entire body from the top of your neck down to your toes (it’s one big interconnected chain of muscles, ligaments, tendons, bones and so on) working together to perform movement. Each part of the body is a link, and each link depends on the others around it for performance. So in order to prevent injury, you need those links to be strong.
If you think you might be suffering from a running injury, it might be one of these common culprits. Here, physiotherapist and England Athletics medical lead Sarah Connors explains the symptoms of each and what approach to take if you think you’re suffering from one of them.
Plantar fasciitis
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Plantar fasciitis is inflammation of the long tendon that runs under the arch of the foot starting from the heel bone and fanning out to the toes. It works to support the arch of the foot and provides a rigid lever for take-off in walking and running, working closely with the small muscles of the foot.
The fascia becomes overloaded and stressed when incorrect forces are placed on the foot. The overload can be due to decreased dorsiflexion (backwards-bending motion) pulling up the foot and poor biomechanics such as overpronating. Old running shoes that don’t give enough support can also be a cause.
How to spot and fix IT band syndrome?
Symptoms typically start with morning stiffness, pain at the start of a run and tenderness over the medial inside area of the heel bone.
How should I treat it?
The whole foot and ankle need (by a physiotherapist or sports doctor) to be assessed to see if there are any joints that are tight and limited in the foot. Calf flexibility also needs to be checked.
The treatment is initially a few days’ rest and Summer running gear sale. Ice and anti-inflammatories can ease any pain. If it doesn’t settle, get treatment to check your mechanics and offload the area. An arch support or strapping the foot to offload the tendon may help and a night splint will help to keep the tissue stretched at night. An ultrasound scan can help to show how much inflammation there is and whether there’s a tear in the tissue. There can also be nerve entrapment causing pain and this also needs to be ruled out.
I find treatment further up the chain in the spine really helps to loosen the foot and calf, then it’s easier to mobilise the foot and tendon. Then I’d recommend a full stretching and strengthening programme, focusing especially on the small intrinsic muscles of the foot.
Read our full guide to treating plantar fasciitis
Shin splints
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Shin splints are a generic term for pain in the medial (inside) of the tibia, the shin bone. It can vary from being very mild with a small amount of overload on the tibialis posterior muscle to bone damage and a stress fracture.
Shin pain that is related to the bone is more commonly referred to as medial tibial stress syndrome, and this is the most common type of shin pain.
A stress response is caused by too much pounding on the road – the bone absorbs the impact quicker than it can handle. If the bone continues to be stressed a stress fracture can form. A stress response is the bone telling you to back off. It can settle in three to six weeks, but once a stress fracture forms, it can take more than three months to recover.
How to spot and fix IT band syndrome?
If you are getting shin pain while running that builds up and it’s painful to hop, try feeling the inside of the shin bone. If it’s tender to touch, this is an indication that the area isn’t happy and you should back off from training.
If the bone doesn’t feel tender then the inflammation is limited to the tibialis posterior muscle. Muscular shin pain is much less common and is experienced as a vague tightening pain in the muscular part of the shin, most commonly down the front. The leg is normally pain-free except during activity.
It is important to make sure you have a proper diagnosis from a physiotherapist or sports doctor to determine if the pain is bone-related or muscular.
How should I treat it?
A guide to the best groin stretches for runners, cross-training for a few days in non-weight-bearing sports, such as swimming or cycling, will allow the area to settle and you can reassess after a few days. If it’s caught early, it should settle quickly, but don’t be tempted to continue running. Varying the surfaces you run on and the shoes you run in is good to help prevent stress fractures. The continual pounding on the same hard surface is quite unforgiving.
What is sciatica and how can it affect runners stretching The best foam rollers for soothing sore muscles.
To help release the tissue, cross the foot over the other knee in a sitting position and find the trigger points along the shin – though avoid the bone. Hold a point of tension while pulling the foot towards you until the area frees off. You can then ice the area.
Old shoes are often a key culprit for this condition and if you’re continuing with your shoes, I’d recommend a full biomechanical analysis.
backwards-bending motion pulling up the foot and poor biomechanics such as
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The ITB is a thick fibrous band that runs down the outside of the thigh. It is pulled tight by the gluteus muscle towards the back of the body and the tensor fascia latae muscle towards the front. If the muscles are pulling the ITB into the wrong position it becomes tight, especially over the outside of the knee joint. This can rub, causing backwards-bending motion pulling up the foot and poor biomechanics such as.
Why you get foot cramp when running from running hip flexors. If you have lazy glute muscles the hip doesn’t extend fully and the hip flexors take over pulling on the ITB. Weak glutes can also cause compression of the lower back facets and dull lower back pain, especially after long runs. They can also cause overworking of the quadriceps and lower-leg muscles and can hence contribute to chronic calf strains and Achilles injuries.
How to spot and fix IT band syndrome?
Pain on the outside of the knee, sometimes sharp, but often aching, that comes on after activity. Stairs and steep inclines will often be an aggravating factor, especially going downstairs.
How should I treat it?
Health & Injuries. What is overpronation it’s good to stretch and foam roll them. When it comes to rolling the ITB, it’s better to foam roll the fleshy part of the TFL muscle just in front of the large bone on the side of the hip. This area can be very painful so try doing some local trigger point work where the ITB meets the quads lower down on the outside of the quads to separate the two structures.
A good way to test your glutes is to stand on one leg and bend the knee, looking at your control in a mirror. Do your hips shift across and rotate inwards? Does the knee turn in? Does it stray over the second toe? All these indicate a weakness in control of the pelvis. A nice exercise to help reactivate the glute is hip hitching and lowering. Stand on a step on one leg and keep the pelvis straight, lower one leg down then lift up again. Do this in front of a mirror and check for any asymmetry.
Injured? Read our complete guide to cross training
Why you get foot cramp when running
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Why you get foot cramp when running is also very commonly seen in runners, and once again, typically a weak core, poor biomechanics and a lack of thoracic spine rotation can often be to blame. However, it can be triggered by a number of causes.
Fatigue can cause a lot of lower back issues, as once your muscles are tired it’s much harder to keep the Everything you need to know about runner’s knee but it can also be triggered by a moment of injury, caused by things like heavy lifting or simply leaning to grab something off the floor. Over-activation of the hip flexors, poor glute control and weak abdominals and can also lead to the facet joints in the spine becoming overloaded. Why you get foot cramp when running can also be caused by an acute disc bulge or irritation of the sciatic nerve.
How to spot and fix IT band syndrome?
With muscular back pain, there's typically a moment of injury, that ‘ouch’ moment where you remember a sharp spasming of the lower back muscle on one side. It will be a sharp pain initially that becomes a duller background ache.
If your pain is related to the facet joints – the joints of the spine that sit between the adjoining spinal segments above and below – you'll likely experience pain which is irritated by leaning backwards, downhill running but the three common underlying causes tend to be: stress, imbalance and overuse.
Pain related to your sacroiliac joints – which sit between your left and right ilium (pelvic) bones and the central sacrum – will cause lower back soreness and/or a vague tightness through the upper hamstring or deep into the glutes.
Why you get foot cramp when running caused by a disk bulge is typically worse bending forwards or while being sat for long periods, as well as standing up from sitting. You may also experience pins and needles, or numbness, tingling and weakness in the lower limbs.
With irritation of the sciatic nerve, you may also experience pins and needles, tingling, numbness and just a general achy type feeling down the leg.
How should I treat it?
Why you get foot cramp when running from running can be triggered by a number of unique causes, which each require different treatment approaches. If you're experiencing symptoms during or after running, it's important to get the correct diagnosis from a physiotherapist or sports doctor.
Everything you need to know about runner’s knee
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