The Best Approaches To Treating Running Injuries

Whether you’re a devoted 10K enthusiast, a regular recreational jogger, or anything in between, you’ve probably come to love the benefits of regular running. Running offers an opportunity to savor the great outdoors; no gym membership is necessary; and when it comes to the number of calories you’ll burn per hour, it’s tough to beat.

But no form of running exercise comes without its drawbacks. Even with picture-perfect form and the best shoes on the market, running can take its toll on you. Running is a high-impact activity that can leave you with not only the lingering aches and pains of a hard workout, but also damage to joints, muscles, and tendons. The dilemma for runners experiencing pain and injury is deciding whether to rest from running or work through pain while attempting to correct the problem. You can avoid lasting damage and chronic pain by taking time and care to address minor injuries when they arise.

Another dilemma is deciding whether a running injury needs medical help or whether an injury can heal with extra rest, self-help treatment, and attention to proper training for intensity, muscle balance, and technique. With any type of injury, you have to consider the risk of using self-help treatment for your specific level of participation. If you are an elite athlete or you are potentially on the way to becoming an elite athlete, then the risk of long-term damage from self-help treatment is not acceptable. You need to get help promptly at a sports medicine clinic or complex that has a team of physicians and physical therapists that work together to treat athletic injuries. If you are a recreational athlete, you might be more likely to try your own remedies.

One more word on running — whether you’re an elite athlete or a recreational athlete: Running can take a toll on the body, even if you’re running injury-free for much of your “career.” There are many runners that have put in mileage of about 10 miles per day that have developed knee, hip or back problems later in life. These potential delayed chronic problems that may require major surgery, and may be reason to seek medical care to monitor your body for damage developing with excessive running mileage … before serious damage occurs. One runner interviewed, regretted running 10 miles per day during his younger years when he learned he needed hip replacement surgery for both hips.

Here is a general progressive response plan for running injuries, so that you can get back on the trails or running route as soon as you can. Keep in mind, there are many different types of common running injuries, including Achilles Tendinitis, Ankle Sprain, Hamstring Strain, IT Band Syndrome, Plantar Fasciitis, Runner’s Knee, Shin Splints, Stress Fractures. The specific treatments for these ailments can be quite different, but there are some characteristics and general strategies that are similar. Injury causes usually involve deficient anatomy, over-training, bad technique, muscle imbalances, and precipitating force trauma or accident. An injury can result from any single item, but often a combination of issues bring forth pain and injury.


Many running ailments have way of sneaking up on a runner. At the first sign of minor discomfort, you want to look at stabilization. Your foot and ankle, knees, hips and spine (core) are all involved in the mechanics of running. For the sake of simplicity, we’re focusing on the foot and ankle and knees for this article. When stability is considered, you can be running with too much motion or too little motion and force absorption during running mechanics. As an example an old running shoe with a collapsed sole can cause too much pronation or inward rolling of the foot and ankle during running. Injuries arise when muscles and tendons attempt accommodate the collapse or pronation with extra stabilization work. However, the stabilizing muscles and tendons and the joints involved generally take a beating. Then here comes the pain. If a runner catches pain-causing conditions early, the solution may be as simple as getting a new pair of shoes that enhance stabilization. Keep in mind different inherent anatomical “gifts” or deficiencies can make different individuals more susceptible or more resistant to pronation stress. Pronation is the inward roll of the foot toward the mid-line of the body while landing on the foot during running. Some people are more susceptible to excess forefoot motion and some are susceptible to excess rearfoot motion. Excess forefoot motion is more likely to get sprinters into trouble, while excess rearfoot motion is more likely to get long distance runners in trouble. A serious runner may need to get more complex advice from a specialist that analyzes gait and anatomy.


For most injuries, the RICE approach is the first line of attack once pain starts getting persistent. RICE is the acronym for Rest, Ice, Compression, and Elevation. RICE is especially helpful as first aid for injuries such as sprains and even ankle fractures, because it minimizes swelling and damage at the site of an acute injury. The scary factor to RICE heard by runners is Immobilization, because it means a temporary end to running. Immobilization results in some level of de-conditioning. That is, de-conditioning of the cardiovascular system and the local muscles involved in running, and especially near the injury site.

A fracture or a severe ankle sprain requires immobilization for a prolonged period, while a less severe injury or a chronic injury often requires motion with caution to encourage healing, accompanied by only temporary immobilization periods. Due to the high-impact nature of running, don’t be afraid to take a day off here or there to keep from aggravating small injuries. A switch to resistance exercises, including squats, hip extensions, knee extensions, leg curls, and standing and seated calf raises can maintain some level of conditioning, and can also help with healing and corrective mechanics.

Strengthening your anterior tibia muscles or anterior shin muscles using a Dynamic Ankle Resistance Device (DARD) can also be helpful. The device provides resistance to dorsiflexion, and helps develop motion control in your foot following the heel strike in running. Dorsiflexion is ankle motion that moves your foot and toes toward your head and upper body. When the muscles that perform dorsiflexion are strengthened, these muscles also become more proficient at controlling the descent of the forefoot to the ground after the heel strike. The motion is known as eccentric dorsiflexion action. The foot is moving in the opposite direction of dorsiflexion, but the muscles that perform dorsiflexion are tense while they control the “reverse” dorsiflexion. The outright opposite to dorsiflexion is plantar flexion, which is when your calf muscles contract to move your toes away from your head and upper body. Plantar flexor muscles primarily work and contract during the push-off phase of running. In the heel strike or foot-landing phase of running, runners can lose power in their anterior tibia muscles, which causes the forefoot to abruptly “slap” the ground after the heel strike. These fatigued muscle then fail at converting the foot to a proper push-off phase during running. This can also send harmful forces “up the line” of the leg — causing problems such as strain of the anterior tibia muscles, knee injuries and hip and back injuries.

Adjust Your Footwear

Now we’re re-visiting stabilization again. Some of those aches and pains could arise from shoes that aren’t right for your feet or that aren’t right for running at all. Soles that are too rigid can cause problems at the other end of the spectrum compared to soles that allow too much motion. Injuries can be caused by shoes that are too stiff or too flexible. Achilles tendinitis and plantar fasciitis are both common injuries for runners. In the case of the former, painful inflammation of the all-important Achilles tendon (involved in push-off and plantar flexion) makes it difficult to run or even walk. Inflammation of the Achilles tendon can also increase the risk of complete rupture of the tendon. The latter occurs when the plantar fascia, the tensile tissue that runs from the heel to the toes, becomes inflamed from long periods of standing or sustained impact common from running in overly rigid shoes or overly flexible shoes with improper force absorption. The force absorption is then forwarded to the soft tissue and bones involved in running. Overly flexible sole units can also cause plantar fasciitis, but instead of the soft tissue getting hammered by rigid shoes, the soft tissue gets over-stretched, as in a situation that collapses the arch in the foot. Remember, old shoes with collapsed soles can cause over-pronation. Sometimes even new shoes don’t provide enough help, and runners turn to inserts or orthotics to control excessive foot motion during running. Shoe inserts or orthotics or new shoes can go a long way in alleviating the symptoms of both of these conditions. Remember to replace your running shoes regularly as they wear out, and never run in shoes with worn-out soles.

However, once a runner gets to a critical point of injury, any slight deficiency in anatomical structure or muscle imbalance can make a runner susceptible to prolonged injury or recurrent injuries. Favoring an injury can even cause a new injury to pop up at another location in the body.

Get Medical Help Including Ultrasound Therapy

Treating pain from running injuries usually involves taking a couple of aspirin, icing down, and getting back out as soon as you can. But some injuries require speeding up the healing process. One way to expedite your healing from the comfort of your home is through low-frequency ultrasound. Handheld ultrasound devices emit sound waves directed at soft-tissue injuries and increase the flow of blood and lymph to the site of the injury. This not only relieves pain but also helps your body repair itself faster than it would without intervention. Seeing a physician and getting a prescription for ultrasound is the most common path to treatment with ultrasound therapy.

In Cases of Serious Injuries

Regrettably, not every running injury is one you can treat at home. Even the best ways to treat running injuries are insufficient in some cases. Significant injuries to joints and muscles may require physical therapy, steroid injections, or even surgery to repair damage. If an injury isn’t healing as it should be, or there is immediate, alarming pain, see your doctor.

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