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Ray R. Valdez, M.D., Board Certified and Fellowship Trained Orthopedic Surgeon
The good news, however, according to Ray R. Valdez, M.D., board certified and fellowship trained in disorders of the foot and ankle, is that most overuse injuries don't require runners to stop training altogether. "If symptoms are minor and pain does not alter your running style, you'll likely find relief by cross training and/or reducing the intensity, duration or frequency of your workouts," Dr. Valdez explains.
Common Running Injuries
Exercise and activity help strengthen bones, muscles, tendons and ligaments, thanks to a process called remodeling in which tissues break down and build up again. "When athletes try to do too much, too quickly, however, the body does not have adequate time to recover, and break down occurs more rapidly than build up," Dr. Valdez explains. Poor technique can also contribute to injuries, as can anatomic or biomechanical factors.
Some common injuries for long-distance runners include:
Patello-femoral pain syndrome, also referred to as runner's knee, is caused by continuing irritation and wearing-away of cartilage located underneath the knee cap. It's often the result of poor strength in the middle quadriceps muscle or unsupportive shoes. "Treatment may include an orthotic (a foot-supporting device or insole), strengthening exercises and rest," Dr. Valdez explains. "Physical therapy and learning a few good stretches can also help. For chronic knee pain that persists or worsens, arthroscopic knee surgery is an option."
Stress fractures can be caused by overtraining, insufficient calcium or a flaw in your running style or body structure. They are more commonly seen in female athletes. A stress fracture requires swift treatment to avoid more serious injury. "Sudden, sharp pain is a signal to stop immediately and seek help," Dr. Valdez cautions. "A specialist can help make sure it doesn't get worse by screening for this type of injury early and starting treatment."
Iliotibial or IT band syndrome is one of the most common injuries for marathoners. It is named for the ligament that stabilizes the knee and hip during running, and can cause sharp or burning pain in the knee or hip when it becomes irritated by running long distances, on uneven terrain or inadequate warm-up or cool-down. Iliotibial band stretches and anti-inflammatory drugs can help relieve the pain.
Shin splints may be caused by a biomechanical problem in your foot or overtraining. The condition can often be improved by stretching calf muscles before and after running, as well as switching to a thicker or motion-control shoe. Medial tibial stress syndrome – the most common cause of shin splints – results when extreme overuse or overpronation of the feet causes irritation to the tendons where they connect to the tibia bone.
Muscle pulls, or small muscle tears, can affect nearly any muscle that is overused. "The best way to treat and prevent a muscle pull is to do more stretching before and after a run," says Dr. Valdez. "Ice and antiinflammatory medications can help soothe symptoms."
Ankle sprains generally occur due to inattention – a runner inadvertently steps off a curb or into a hole. Ibuprofen can help alleviate swelling and pain. Improving proprioception – the sense of the relative position of neighboring parts of the body – or balance helps to return the athlete to exercise.
Achilles tendonitis is a condition when the large tendon in the back of the ankle becomes irritated and inflamed. It is a painful, overuse injury more commonly found in middle-age runners. "The danger is that Achilles tendonitis may lead to small tears within the tendon, making it more likely to rupture, requiring surgical treatment ranging from releasing the ‘sleeve' around the tendon to direct repair of the tear," Dr. Valdez cautions.
Plantar fasciitis is the inflammation of the tissue that runs from the heel along the arch of the foot. Severe heel pain results, which is often felt while standing or walking, in addition to when running. Pain in the bottom of the heel, when arising from bed in the morning or after brief periods of rest, is typical of this condition.
The Road to Recovery
An orthopedic evaluation at Methodist Orthopaedic Specialists of Texas can help you stay in the race when overuse injuries threaten to slow you down. After conducting a health history, physical exam and diagnostics, Dr. Valdez can suggest modified workouts, appropriate warm-ups and cool-downs, as well as a specialized treatment plan and surgical options, if necessary, based on your injury. Call Dr. Valdez for a consultation at 866-567-4130.