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June 2006: Running Into Trouble

01 Jun 2006

Dr. Joseph Fillmore is board certified in Physical Medicine & Rehabilitation and Pain Management. His areas of expertise include interventional pain procedures, electrodiagnosis, musculoskeletal and sports medicine. A treatment plan is developed for each individual patient to address his or her specific needs.

Running Into Trouble

Dr. Joseph Fillmore
APAC Centers for Pain Management
Weiss Memorial Hospital
4646 N. Marine Drive, Eighth Floor
Chicago IL 60640

Now that the warmer weather is here, runners are increasingly seen on the lakefront and city streets. Soon Chicago Marathon training programs will be in full swing. As recreational runners as well as competitive marathoners increase their running distances, lower leg injuries can stop runners in their tracks.

Injuries can occur because of over training, poor biomechanics, falls, improper foot wear and repetitive running on hard or cambered (uneven) surfaces. Persistent high-intensity training without low-intensity (easy days) is one of the most common training errors. Some runners fall into the trap of ‘more is better’ and avoid necessary light days, rest, and cross training, which promote muscle recovery and ensure muscle strength and balance.

Common biomechanical problems include both excessive foot pronation and supination. While these are normal motions of the foot, excesses can place stress on the lower leg muscles and tendons causing pain and injury, particularly as running distance increases.

Running shoes that do not fit properly (poor arch support, for example) or that are worn out, can lead to foot pain and increased biomechanical problems resulting in additional lower leg injuries. The type of shoe is also important. Straight shoes are more appropriate for runners who are pronators and curved shoes are better for supinators.

Persistent training on asphalt or concrete surfaces can lead to increased mechanical stress causing overload injuries of the lower leg and foot muscles, tendons and joints. Excessively soft surfaces on the other hand, can lead to hypermobility of the joints, muscles and tendons, also leading to overuse injuries. Ankle twisting sprains can result from running on uneven, rocky or slippery surfaces. Repetitive running on canted surfaces (such as certain running tracks and banked roads) can cause functional leg length discrepancies that result in injuries.

With these potential runner’s pitfalls in mind, following are several preventative measures that can help minimize injuries:

First, training and running regimens should include both high and low intensity days. This allows for appropriate recovery and lessens the chance of injury. Mileage and intensity increases should be kept within 10 percent and should never be increased at the same time. A carefully planned training program may be the best way to increase running distance and speed without sustaining injuries.

Second, runners may know if they are prone to supination or pronation. A formal running analysis, which is often videotaped, along with a consultation by a sports medicine specialist, can identify and correct these problems and minimize further injury.

Third, running shoes should be replaced at least every six months or 300 – 400 miles. They should also be examined regularly for wear and replaced if holes, tears or worn soles are noted.

Fourth, to avoid a repetitive running surface injury, the runner should avoid running exclusively on concrete or asphalt. If running on a cambered (uneven) surface, the direction should be altered each run to avoid repetitive stress on the uphill or downhill leg.

With the right training program and proper shoes, runners can enjoy their summer without having to worry about injuries that can have them sidelined for the season. If you need help with an injury or would like help in avoiding sports-related injuries, call (773) 564-5205 for more information.