By Megan Advani, P.T., D.P.T.
Running has seen a surge in popularity this year. The COVID-19 pandemic has prompted people to lace up their sneakers and head outdoors for this socially distanced exercise that is good for both the body, and the mind.
But while the physical and mental benefits of running are many, there remains a risk for injury, no matter if you are a long-timer runner or just recently picked up the sport as a pandemic past-time.
Penn Medicine Princeton Medical Center Princeton Rehabilitation offers a physical therapy program for runners for the assessment and treatment of running-related injuries with a focus on running biomechanics and injury prevention.
From Your Hips to Your Feet
A recently released study by the American Academy of Orthopaedic Surgeons (AAOS) found that at any given time, 25-36% of runners have a running-related injury.
Most running-related injuries are chronic and the knees are affected most often, though injuries to the calf, ankle and foot are also common.
In the large majority of cases, these injuries develop over time due to weakness in the hip, or more specifically the gluteal muscles, the main hip muscles that act as the powerhouse for your legs.
Weakness in these muscles can cause your body to compensate and overuse or strain other areas while running. One of the most common injuries that runners develop due to gluteal weakness (specifically the gluteus medius muscle) is iliotibial tendonitis – or in runners’ parlance, IT band tendonitis.
The condition occurs when the iliotibial band – the tendon that runs from your pelvis to just below your knee – is overused and becomes tight and pulls, resulting in inflammation and pain on the side and front of your knee.
Injuries to your ankles and feet are often related to overpronation, a condition in which the feet roll inward when walking and running.
Overpronation can lead to tendonitis in the foot, ankle and lower leg as well as pain on the inside of the ankle and foot. Additionally, overpronation can lead to shin splints.
Tips for Preventing Injuries
• Keep your hips strong with exercises that target your gluteal muscles and core. This can include lateral leg lifts, squats, bridges, and one-leg balance activities. Also, sitting for too long or in one position, such as with your legs crossed, can cause your hip flexors to shorten and gluteal muscles to weaken over time. If you sit most of the day, be sure to get up and move around at least once an hour to give your hips a break.
• Wear the proper footwear. The AAOS recommends selecting a running shoe that offers good shock absorption and construction that will provide stability and cushioning to the foot. Make sure that there is a thumbnail’s width between the end of the longest toe and the end of the shoe. Buy shoes at the end of the day when your foot is at its largest size.
• Warm up before you head out. An active warm up can help loosen up your muscles and prepare your body for a run. Make squats and lunges part of your warmup routine.
• Save static stretching for your post-run cool down. Hold stretches for at least 30 seconds to allow your muscles to stretch properly. Figure four stretches (for the piriformis and gluteal muscles) and hip flexor stretches are good to perform after running.
• Choose forgiving surfaces. If possible, try to run on softer surfaces like dirt paths and trails, to reduce the impact on your joints. Concrete is the least forgiving surface for runners.
• Vary your route. Do you run on the same side of the road or take the same path each time you run? Typically roads and paths are banked to one side, which means so is your body. Over time this can lead to injury.
• Do not run through pain. Toss out that old saying “No pain, no gain.” If you experience pain while running, stop and give your body a break. If the pain continues, it might be time to see a physical therapist.
• Keep a training log. Logging your activity and noting when and where pain first starts can help your physical therapist identify the cause of the problem and develop an effective treatment plan.
Rehab for Runners
Injuries happen, and when they do, it is important to seek medical treatment. In many cases, physical therapy can help treat the condition and prevent future injuries.
The Princeton Rehabilitation Runners’ Clinic and Rehabilitation Program provides each patient with a running specific evaluation, including:
• Assessment of posture, range of motion, strength and flexibility.
• Video analysis of running technique on a running treadmill (posterior and lateral views) using a camera and running analysis software.
• Comprehensive home exercise program.
Follow up sessions include:
• Manual techniques as needed.
• Specific stretching and strengthening exercises as well as closed chain activities.
• Instruction in running technique and injury prevention.
Patients can also expect to receive a comprehensive home exercise program.
To learn more about the Princeton Rehabilitation Runners’ Clinic and Rehabilitation Program, call 609-853-7840.
Megan Advani, P.T., D.P.T., is a doctor of physical therapy and outpatient rehabilitation manager with Penn Medicine Princeton Medical Center Princeton Rehabilitation.