The 115th running of the Boston Marathon took place on April 18th, 2011. Over 25,000 runners participated in the event, which brings to mind all of the overuse running injuries that can occur with running 26.2 miles. In the spirit of the marathon, here is a brief review of the 5 most common running injuries that I see in my clinic:
1. Iliotibial Band Syndrome: Iliotibial band syndrome (ITBS) occurs when there is repetitive friction of the iliotibial band, a thick mass of tissue that courses down the outside of the thigh from the hip to the front of the knee. Irritation of the ITB usually causes intense burning pain in the outside portion of the kneecap.
2. Piriformis Syndrome: The piriformis is a muscle that resides deep in the hip and serves to rotate and stabilize the hip. Irritation of the piriformis muscle can cause hip and buttock pain. The piriformis muscle courses over the sciatic nerve, and tightness in the piriformis muscle can cause pain that runs down the leg, much like sciatica.
3. Patellofemoral Stress Syndrome: This common knee problem occurs with improper tracking of the kneecap in the groove of the femur and causes pain around the kneecap. It can be caused by tightness in the iliotibial band, weakness in the thigh muscles, or weakness in the hip muscles.
4. Shin Splints: Shin splints are caused by inflammation of the anterior tibialis tendon in the front of the shin. Symptoms of shin splints include pain, numbness and burning in the front of the shin.
5. Plantar Fasciitis: The plantar fascia is a thick band of tissue on the bottom of the foot that helps form the arch of the foot. Irritation of the plantar fascia can cause pain on the bottom of the foot near the heel bone.
Treatment of any of the above mentioned problems includes applying the R.I.C.E. principle during the acute phase of the injury. This is typical during the first few days after injury. R.I.C.E. is an acronym for rest, ice, compression, and elevation. About one week after onset, gentle stretching and light activity is warranted with a gradual return to running over the next 4-6 weeks. For symptoms that last more than 4-6 weeks, a visit to your doctor or physical therapist may be necessary to analyze the biomechanical factors that may be causing the problem and to devise a treatment strategy to help return to normal activity.
