Though running is well-known to improve cardiovascular and orthopedic health, it does pose some risk to the lower extremities because of the movements it entails. It’s a repetitive exercise that involves using the same muscles for long periods, with continual impact of the foot against a hard surface. The resulting stress can lead to a number of painful chronic orthopedic conditions. Below, we discuss four of the most common runner conditions and treatment options for each one.
Runner’s knee, clinically known as patellofemoral pain syndrome, is an overuse injury characterized by pain or tenderness under or around the patella (the kneecap). Principally caused by frequent exertion of the affected region, there are also a number of factors that can elevate your risk of developing this condition, such as:
The pain associated with runner’s knee can range widely from mild to severe. Both activity and prolonged sitting may exacerbate symptoms. One may notice some crepitus with flexion or extension of the knee, particularly after extended stationary periods. A physical examination is usually sufficient to diagnose runner’s knee, but imaging may also be necessary to rule out acute conditions like sprain or fracture.
Anyone diagnosed with runner’s knee should immediately stop the activities contributing to their condition until their symptoms improve. Other first-line treatment options may include:
Other elements of treatment may depend on individual health factors such as the patient’s age, medical history, and overall health, as well as the severity of their symptoms. Once their symptoms do improve, the patient can prevent recurrence by strengthening the muscles around the patellofemoral joint, wearing proper footwear, stretching before activities, practicing proper running form, and maintaining a healthy weight.
Plantar fasciitis refers to inflammation of the plantar fascia, a ligament that connects the heel to the base of the toes. Its most characteristic symptom is pain or a burning sensation at the heel or the arch of the foot. The pain is often at its worst upon waking or after long periods of sitting. For runners, the pain may subside somewhat during a run but then return afterward.
Like runner’s knee, plantar fasciitis is an overuse injury with a variety of risk factors, including:
Physicians typically diagnose plantar fasciitis through patient history and physical examination. During the physical exam, the physician will palpate areas of the foot to localize tenderness. Normally, imaging is necessary only to exclude other diagnoses, such as bone spurs.
Treatment for plantar fasciitis is usually conservative. The patient should avoid or modify activities that cause pain and manage their symptoms with icing, stretching, over-the-counter anti-inflammatories, and shoe inserts. In some cases, the physician may recommend additional treatments, such as physical therapy, night splinting, or a walking boot. If symptoms don’t improve with conservative measures, one or several of the following treatments may be indicated:
Shin splints affect the inner portion of the shinbone, which is reflected in the clinical term for the condition — medial tibial stress syndrome. Along with pain, patients with shin splints may experience soreness, tenderness, and swelling in the affected region. The pain can vary, ranging from dull to sharp. It may arise during and after physical activity and be exacerbated with palpation.
The most common causes of injury are repetitive use or hard exercise, which may inflame the muscles, tendons, and other tissues around the tibia. Often, shin splints arise after sudden changes in one’s exercise regimen, such as increasing the frequency or intensity of training. Flatfeet, rigid arches, and improper footwear are risk factors as well.
As with the other runner conditions already mentioned, the diagnosis of shin splints is normally based on the patient’s medical history and a physical examination. The physician may order imaging to rule out a stress fracture.
Shin splints normally self-resolve with conservative treatment, as with rest, ice, and over-the-counter anti-inflammatories. It’s not necessary to stop all physical activity, but the patient should stick to low-impact exercises such as swimming, bicycling, and elliptical training. One can resume normal activities once the pain is gone. However, if symptoms persist after two to four weeks, medical intervention may be necessary.
A stress fracture is a broken bone resulting from repetitive force. Among runners, stress fractures most commonly affect the navicular bone (at the interior arch of the midfoot), the calcaneus (heel), the tibia, or the metatarsals. The act of running puts pressure on these bones. Without sufficient time to recover between runs, the bones accumulate stress, weaken, and eventually break. The fracture itself is small but painful, with associated tenderness and swelling. The pain typically worsens with activity and is more noticeable at rest.
Diagnosis of a stress fracture begins with a health history and physical examination and is confirmed with imaging. Stress fractures may not initially appear on X-rays, so a bone scan or MRI may be necessary.
Treatment for a stress fracture often begins conservatively, with ice, elevation, compression, and over-the-counter anti-inflammatories. The physician may also recommend immobilization or crutches to prevent continued stress on the injured area. If the bone doesn’t heal with conservative measures, the patient may undergo a surgical procedure called a fixation, which bonds the bone with pins and plates.
If you’re an avid runner experiencing any of the symptoms described above, we encourage you to reach out to us at Gurnee Podiatry & Sports Medicine Associates. Over decades of practicing sports medicine and podiatry, Dr. Schoene, Dr. Bever, and Dr. Joseph have helped countless athletes preserve their physical health and maintain their physical activity. Make an appointment online or call one of our offices to get the help you need.