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A PT Solution to Common Running Injuries

Chris Billiar is a physical therapist at Clayton Medical Park.

Walking and running are some of the only popular sports where people receive no formal training. But, walking or running can cause injuries leading to long-term issues if left untreated. Several weeks ago I teamed with Dr. Jonathon Chappell with Wake Orthopaedics to host a running clinic to evaluate runner’s gaits and provide information on common running injuries.

In no particular order, here are the most common running injuries, their causes and possible strategies to address the issues.

Plantar Fasciitis

Plantar Fasciitis is inflammation of the fascia, a thick connective tissue band that attaches from the ball of the foot to the heel.  Plantar fasciitis causes pain that starts first thing in the morning and continues to be bothersome the more you walk or run throughout the day.  Plantar fasciitis can be caused by many things, including tight calf muscles or hamstrings. 

Plantar fasciitis often causes intense pain first thing in the morning because the normal position of comfort overnight is for your feet is to drop and relax. This drop causes the fascia to become tight.  Wearing a night splint or a Strassburg sock while sleeping, can be a good solution to keep a constant stretch on the fascia, preventing it from becoming tight.

There are also some stretches and deep tissue massage techniques that can be helpful.  It is important to treat plantar fasciitis because it could eventually lead to a heel spur.

IT Band Syndrome

IT Band Syndrome can cause pain at the hip or the knee joint due to tightness in the large muscle that spans from the hip to the outside of your knee. 

Physical therapy is a good place to start if you have IT Band Syndrome.  We can work on flexibility and loosening the muscles around the hips that are tight like the hamstrings.  We may also be able to identify certain muscles that are weak and can be strengthened to address imbalances that might cause pain.  Finally, we can use ultrasound to decrease inflammation. 

If IT Band Syndrome goes untreated, it could become a chronic condition, which often leads to people being less active, which causes muscles to get weak, which causes more pain and ultimately can lead to a cycle of inactivity.

Pain Under Knee Cap 

Pain Under Knee Cap, or patellofemoral pain – is literally a painful feeling under the knee cap.  Often it hurts more when you are going up or down stairs or when you have gone some distance during a run. 

The knee cap is like a wedge and matches the groove inside the leg bone.  If there is a muscle imbalance at the knee, then the knee cap can come out of the groove a little.  This causes the surface of the knee cap to rub against surfaces that are not supposed to rub, causing pain.  Muscle imbalances, tight hamstrings, weak quads or a tight IT Band can cause this abnormal pull on the knee cap.  Sometimes a tracking problem can be caused by your foot position as well. 

So, the first step in treating Pain Under the Knee Cap is to determine the cause.  Then, we generally use a taping technique to reposition the knee cap in an effort to make the muscles work with the knee cap in a good position to correct the muscle imbalance.

Running and walking are excellent forms of exercise.  They are inexpensive, and you can exercise virtually anywhere with just a good pair of sneakers.  But, exercising with pain is not enjoyable and could potentially lead to chronic conditions.  And, exercising with pain is not necessary because there are many simple solutions to address the problem. 

I am happy to entertain specific questions that you may have or other topics you would like for me to address.  Please feel free to email me.

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4 thoughts on “A PT Solution to Common Running Injuries

  1. Are there any specific exercises for IT Band Syndrome you could suggest. My current regimen is weighted sumo squats (focusing on letting my hips do the work), RDL with barbell, cable kickbacks and weighted lunges. I have two different IT band stretches that I have been taught.

  2. At the 1.5 mile point during my run my rt foot, toes, began to tingle and get numb…if I walk about 1/4 mile the numbness goes away…is there a way to correct this…it seems the more I run the longer it takes for the numbness to begin but it hinders my running progression…

  3. Bryan –

    Thank you for your comment. Unfortunately, your problem is hard to diagnose without actually seeing you. There are multiple reasons why this could be happening. You could have a problem with your back where a nerve is getting pinched. You may also have a muscle imbalance (tight or weak muscles ) anywhere along your leg which may be causing your running to be impacted. Your particular problem can also be caused by improper fitting shoes, poor alignment of your foot, etc. I would recommend being fully evaluated by a Physical Therapist to access your strength, flexibility and running form.

    -Chris

  4. Hi, Terry-

    There are a couple of stretches that can help your IT band tightness.

    The first stretch should be done laying on your good side. Let the involved leg hang back over the edge of the bed, so that you can feel a stretch on the outside of your leg. Hold this position for 30-60 seconds, 3-5 repetitions. If pain increases, stop.

    The second stretch is done in standing with the involved leg closest to a wall. Cross over the uninvolved leg in front and lean towards the involved side. Hold stretch for 30-60 seconds, 3-5 repetitions.

    Another good stretch to do is to roll a foam roll back and forth across the outside of the leg.

    I would also suggest getting evaluated by a Physical Therapist because there may be other muscle groups that are tight or weak, causing an abnormal pull on the outside of the leg.

    -Chris

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