Injuries

Running Injuries (Lower Extremities)

Knee Injuries

Knee injuries are the most common. Both acute and chronic are thought to account for about 40% of all running and running related injuries.

• Old Meniscus Tears - Medial more common. Results in periodic bouts of swelling and pain. Usually symptomatic periods will decrease. If not meniscus surgery may be warranted.
• Patellofemoral Pain Syndrome - Muscle imbalances, patella tracking errors and chondromalacia patella.
• Stress fractures - Pain made worse while weight bearing, may be pinpoint. Need bone scan for definitive diagnosis.

Illiotibial Band Syndrome (ITBS)

Iliotibial Band Syndrome or ITBS (Sometimes called ITB), is a common, painful condition that occurs on the outside of the knee and/or hip. The pain can be described as extremely sharp, enough to prevent one from running. The causes are numerous. Increase in distance, increase in downhill, old-worn shoes or orthotics, excessive or limited pronation, are all common causes. ITBS is commonly misdiagnosed then mistreated by many so-called "Sports Medicine" practitioners. Lateral knee pain or outside knee discomfort commonly occurs with long distance running. Simple measures can be taken to allow the runner to train with and through the pain.

The first step to treating ITBS is proper diagnosis. Some other common causes of lateral or outside knee pain are low hamstring strains and lateral meniscus tears. Diagnosing ITB can only be done by a doctor and should not be done by a shoe store. Many patients who we treat after-the-fact, missed their marathon/event goals and could have easily been fixed by our office had they not received ill advice from running shoe stores and/or friends prior to seeing us. Many runners have also taken NSAIDS (link) allowing their problem to worsen. Most patient I have treated for ITBS or ITB recount a similar story. They go to their doctor and are told not to run or to stat taking aspirin, Ibuprofen, Tylenol, Motrin, etc. They then proceed to worsen the condition and either stop running or go to a running store and begin to receive inaccurate/poor information on shoes, over the counter inserts (link to research) or various braces, yet to no avail. Sadly so, there is so much mis-information on ITBS on the internet, at physical therapy/rehab centers, sports clinics, MD's and Chiropractic offices, and running-related stores.

Signs and Symptoms

• Lateral knee pain that progressively gets worse.

Differential Diagnosis

• Popliteal Tendonitis/Tendonosis - resisted internal rotation of the tibia may cause pain. Tenderness posterior to lateral collateral ligament.
• Meniscus Tear - locking, clicking, painful squatting, pinpoint pain and mild swelling.

Etiology (Cause)

• External variables (hills) especially downhill running.
• Shoes
• Excessive Pronation

Treatment

• Orthotics
• Arch taping/leg taping
• Stretching
• Physiotherapy therapy modalities (ice, massage, ultrasound).
• Manual therapy (motion release, foot, knee and pelvic adjustments).
• Foam roller

Plantar Fasciitis

Signs and Symptoms

• Sharp heel pain
• Radiating pain along the bottom of the inside of the foot
• Pain is often worse when getting out of bed in the morning
• Differential Diagnosis
• Stress fractures - Usually in the forefoot. Pinpoint pain.
• Heel spur - May result due to long term fasciitis.
• Tarsal tunnel syndrome - Numbness and tingling across the bottom of the foot.

Etiology (Cause)

• Excessive Pronation
• Training errors
• Bad shoes

Treatment

• Orthotics
• Arch taping
• Stretching
• Physiotherapy therapy modalities (ice, ultrasound, massage)
• Manual therapy (motion release, foot adjustments)
• Kinesio Taping