It's that time again! The sun is out, the weather is warming, and at Dr. Vail's everyone is hoping for an injury-free summer. In order to fulfill our goals, we need everyone to address their injuries as soon as they experience any kind of pain. Dr. Vail can help you out on multiple situations and he would rather see you sooner than later.
#1 Sciatica- Sciatica is caused by a strain to the sciatic never, a long, ropelike nerve that starts on each side of your lower back and winds its way down your buttock and the back of your leg to your foot. Though strains can have many causes, sciatica in the runner tends to be brought on by the constant jarring of running, combined with flat feet, high arches, knee problems, and leg-length discrepancies.
The initial pain is subtle: a dull ache in your lower back, your buttock, or the back of your thigh. It may subside for several hours, but it returns with each run.
To help prevent sciatica, keep your spine flexible by stretching your lower-back muscles as part of your warmup and cooldown. Strengthen your abdominal muscles because they lend to support to your back.
If you feel you might be developing sciatica, stop running. To speed recovery, apply moist heat to the tender area.
#2 Runner's Knee- Runner's knee occurs when the kneecap becomes misaligned and rubs on an underlying surface of cartilage. Usually the pain is described as a soreness around the kneecap; it is aggravated by running or by climbing stairs. In most cases, you can relieve runner's knee with rest, proper shoes, and a good training regimen. When the pain is gone, you can resume running, but intersperse it with walking. Stay on level surfaces and avoid hills and stairs. Don't do deep knee bends. To forestall further injury and strengthen your quadriceps muscles, which give muscular balance and support to your kneecap, add some progressive resistance exercises (with your knee exstended).
After exercising, ice your knee for 8 to 10 minutes. In the evenings, apply moist heat.
#3 Iliotibial Band Syndrome- The iliotibial band is a sheet of connective tissue that runs down the outside of your thigh from your hip to the side of your knee; it acts as an important stabilizer for your knee.
Iliotibial band syndrome (ITBS) is a friction injury caused by the iliotibial band rubbing over the outside of the knee, a normal motion that becomes a problem under the pressures of hard running. The initial treatment is rest.
ITBS can result from a number of causes: bowed legs, excessive pronation (turning in of your foot), and leg-length differences. Hard downhill running or excessive speedwork can precipitate the condition. So can a single hard race of 10 kilometers or longer. Running exclusively on the same side of the road can bring on ITBS in the curbside knee. The best course for recovery is to stop running immediately. Rest for 2 weeks. Meanwhile, reduce inflammation by icing three times a day. Begin a stretching program to loosen the band.
Before you try running again, check your shoes to see if there's excessive wear on the outside of the heels. If there is, buy new ones with ample heel support and rearfoot cushioning. At first, run only on soft surfaces. Avoid hills and speedwork. If your knee hurts at any point in the run, stop immediately and stretch. Ice the knee and try running again the next day, after more iliotibial band stretches.
#4 Muscle Strains
Hamstrings- An acute strain of the hamstring muscle is a classic example of a muscle tear. It is often dramatic-a sudden, searing pain and tightness at the back of your thigh accompanied by the inability to bear full weight on the affected limb or to bring it through the normal range of motion.
Two factors usually lead to this injury: (1) strong quadriceps muscles but weak hamstrings, and (2) lack of flexibility in the hamstrings. To prevent hamstring strains, use weight training to strengthen your quadriceps and hamstrings equally. And with each run include a warmup and cooldown with stretches for the hamstrings.
If you do strain a hamstring, check with your doctor before running. Once he gives the okay, start with short jogs; then very slowly and cautiously increase the number of jobs and the distances you cover each day. Before doing high-speed running, be sure that the injured leg is equal to the other leg in power, strength, and endurance.
Quadriceps- The quadriceps muscles lie on the front of the thigh and are the principal stabilizers of the knee joint. These for muscles are more powerful than the hamstrings and are less frequently strained, but they may be torn by an explosive sprint. Use the same methods as for preventing and treating hamstring strains.
Calf- A strain of the calf muscles can strike at any time, especially if you're older than 35. Occasionally your calf will signal trouble by cramping a few times, but most often the strain will occur without warning.
The standard treatment for a calf strain is to apply ice and a compress and to elevate the injured leg. Use crutches to rest the muscle. Within the limits of comfort, very gently stretch your calf and point your toes.
For a first-degree or a mild second-degree strain, start walking normally-no limping allowed- with heel lifts in both shoes. A third-degree tear will most likely require physical therapy.
#5 Achilles Injuries- The Achilles tendon is a tough, elastic cable through which the muscles of your calf transmit force to your foot. Injuries to it come from sudden tearing or microtearing (tendinitis). Sudden tearing that leads to partial or even total rupture is triggered by an isolated incident, and it often requires surgical attention. Microtearing, signaled by gradually building pain, can progress to partial and even total rupture if there is no healing. Symptoms include pain and stiffness that are at their worst when you awaken. The pain diminishes as you warm up, and it may even disappear when you run. When you cool off, though, the pain returns. The next day you're even stiffer.
Most injuries to the Achilles tendon come from improper footwear, gout, inadequate flexibility, or severe, uncorrected pronation. The key to recovery from microtearing is rest and modified exercise with gentle stretching. Follow this procedure for a week to 10 days. When you resume running, build up your mileage gradually, train on alternating days, avoid hill running, and make sure you have proper shoes.
If your injury has led to partial or total rupture, cease running and see your physician. Follow his or her advice for recovery and rehabilititation.
#6 Ankle Sprains- Ordinary sprains- stretching, partial, or complete tears of the ligaments surrounding the ankle- often occur in runners who run on soft or eneven surfaces.
The first thing to do if you sprain an ankle, however slight the sprain, is to stop running. If the pain disappears completely after several hundred yards of walking, it's usually safe to resume running. If the pain does not subisde, forget the rest of your workout.
Apply ice to the affected area as soon as possible and elevate your ankle. Place ice packs on the swollen area or 20 to 30 minutes every 4 to 6 hours. If the pain persists, continue the ice treatments for 2 to 3 days. When the ankle is not wrapped in ice, use an elastic bandage to give the weakened ligaments some support.
A serious sprain may require the use of crutches or a cane to aid in walking. If swelling persists longer than 2 to 3 days, have an x-ray taken to rule out the possbility of a fracture.
#7 Shinsplints- This term can refer to any of three types of pain in the lower leg: anterior shinsplints, stress fractures of the tibia, and posterior shinsplints.
Anterior shinsplints, characterized by pain on the outside of your lower leg along the shin, usually result from injury to your shin muscles. A frequent cause is the extreme difference in strength between shin and calf muscles. You can help prevent this injury by strengthening your shin muscles. Here's one way to do it: Fill a bucket with water and wrap a hand towel around the handle. Then sit on a tabletop and dangle your legs over the side. Next, place the bucket handle over the tongue of your shoe and slowly bend your ankle to raise and lower the bucket 10 times. Rest, then do two more sets of 10.
If you are injured, stop runningl switch temporarily to a different activity. When you return to running, build your mileage gradually.
A stress fracture of the tibia is the probable injury if touching the inner side of your shinbone causes pain. Usually these fractures occur when you suddenly place repeated jarring demands on your legs. The treatment for a stress fracture is the same as that for anterior shinsplints. It will take from 6 weeks to several months to heal.
Posterior shinsplints, damage to the muscle on the inside (medial) portion of the lower leg, cause pain in the soft tissue behind the bone. Most come from overpronation. Should you feel this kind of pain while running, stop. Resume running only when you can do so without pain. Switch to bicycling or swimming and strengthen your muscles with exercises. Consider using arch supports to keep from overpronating.
#8 Plantar Fasciitis- The plantar fascia is a band of tough connective tissue that runs from the base of your toes to your heel bone and supports the bottom of your foot. Plantar fasciitis occurs when this band tears near the bottom of the heel. This injury is most common in runners who overpronate or who have high arches or flat feet. Initial treatment includes taping your foot and applying ice.
Pain from plantar fasciitis starts in your heel and then radiates into the midsection of your foot. Usually the pain is severe in the morning and as you start to run, becoming more tolerable as you walk or run. But an hour or so after you stop running, the pain returns. Plantar fasciitis worsens gradually; so early recognition can prevent a serious case. To relieve discomfort from plantar fasciitis, tape your foot before running. After running, use an ice massage. For additional relief, consider using a customized orthotic. If, despite treatment, your pain becomes severe, stop running and switch to another sport until you can determine the cause.
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For more information on injury preventation and treatment, contact these organizations:
American Academy of Orthopaedic Surgeons
aaos.org
American Academy of Podiatric Sports Medicine
aapsm.org
American Chriopractic Association
amerchiro.org
American College of Sports Medicine
acsm.org
American Massage Therapy Association
amtamassage.org
American Osteopathic Academy of Sports Medicine
aoasm.org
American Physical Therapy Association
www.apta.org
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