Bridgeman fitness training aims to provide top quality fitness training advice, exercise information and educational resources for all fitness enthusiasts.  Expert fitness advice Bridgeman Fitness Home Running Injuries – Changing trends and demographics (part 2 of 2) SEARCH THIS SITE FACEBOOK Part 1 of this 2 part article on running injuries is here. Specific running injuries The knee Knee injuries include Iliotibial band (ITB) syndrome, patello-femoral syndrome PFS and meniscus injuries. It is suggested ITB syndrome may be more common than PFS, certainly in older or more competitive runners. Some interesting points: - Studies have shown an association with hip abduction and hip flexion weakness with injuries to lower extremity in runners. - Strong evidence that correcting weakness in hip abductor strength is effective for ITB syndrome. - Moderate evidence that Vastus Medialis and hip abduction weakness associated with PFS. - Treating PFS with orthotics led to similar results as physical therapy treatment. The two interventions combined were no better than either alone. At some point I may have to look further into the research on orthotics. If physio is identifying possible causes and treating them successfully what are orthotics doing? Yes, I like to question things! - Doctors may caution against running after meniscus injuries, lets be honest if you are really into something you will find a way of doing it anyway, regardless of such advice. Calf/Achilles This can include Achilles tendon injuries and muscular tears. These are suggested to be more common in older runners, and those with over 10 years experience. Some interesting points: - Etiology for Achilles tendinopathy lacks rigorous evidence, although some attribution of inflexible Achilles-calf complex are suspected. - Muscular tears can occur with excessive training, less likely to tear lateral head of gastrocnemius due to toe off phase of gait directing most of the force along the medial aspect of the leg. - Chronic soleus pain may be related to too high a mileage for their fitness level. Little extra detail was available on this, certainly with regards to what type of fitness – strength perhaps, or is there limited recovery training to allow repair and regeneration…or what about supercompensation to allow one to realise their fitness gains? Sounds technical but these are the things that run through my mind. - Physical therapy beneficial for treatment as were eccentric exercise protocols. Find a physiotherapist/sports therapist that actually knows about sport! Shin Pain, stress fractures and muscular injuries This includes medial tibial stress syndrome, compartment syndrome and tibial stress fractures amongst others. Shin splints is also included as a nonspecific type of injury. These are common in young runners. The writer suggests most evidence points to rates of stress fractures being higher in females. (Chris Beardsley from the garage gym online references injury rates in females in his article on core stability and lower extremity injuries. In fact, he has some expertly written articles recently in relation to running so do check out his site.) When I used to run regularly (many years ago) and experienced shin pain I was told by one physio that my bones were the wrong shape!!! Another one gave me a handcrafted piece of foam to wedge in my shoe to support my arches. What treatment worked? Strengthening my anterior tibialis and reducing my running. Some interesting points: - Inexperienced runners can develop stress fractures at modest amounts of running mileage. See a good running coach! - Shock absorbing insoles have been shown to reduce risk. I wonder if running in a less “impact generating” way could achieve the same thing. - Calcium and vitamin D supplementation reduced risk of injury in female Navy recruits. Charles poliquin writes about Vitamin D. - Hill training associated with muscular injuries (increased forces running downhill). - Hip rotators such as piriformis may have greater stress when there is relative gluteus medius weakness. - Treatment of muscular injuries requires a program that incorporates the eccentric strength required to run effectively. The final messages If you want to run to get fit and are currently inactive do consider a training program that prepares you to run. If you currently run a lot, and have been injured the chances are you may get injured again. If you run a lot and have not been injured the data shows it is likely you will get injured. - Follow a planned strength training program (planned means it is not a random turn-up-at-the-gym-and-see-what-kit-is-free type session). - Include specific glute strengthening and stabilisation exercises. - Do not neglect the eccentric portion of the lift (lowering the weight slowly), you can always increase the speed of lowering later. - Work out how you could reduce training volume and supplement with strength training to prevent or reduce chance of injury, and also make you run faster and more efficiently. - Read what Chris Beardley has to say on running and core stability training. - Read what I wrote about strength training for runners. More running related info: