To Run or Not to Run

Are you having pain with running?

You are running on a warm sunny day on your favorite trail, which you have been doing for probably a few months. Everything is going awesome with your run (music, sweat, stress buster) and suddenly you feel some pain or discomfort in your heel or maybe your hamstring, back, shin or knee. You continue with the run, come home and research which guides you with some stretches and you can go run for a few days without pain. The pain reappears and you think it’s probably the miles I have put on my legs or maybe I should just take a break for a few days or switch to some other exercise.

A comparative study was done between 45 long-distance runners and 53 controls (mean age 58) from 1985–2002 to see whether there is a progression of arthritis in runners vs non-runners. Radiographs were done periodically to collect data. The conclusion was long-distance running among healthy older individuals was not associated with accelerated arthritis. These data raise the possibility that severe arthritis may not be more common among runners. On the contrary, the runners with higher BMI or preexisting arthritis showed an increase in arthritic changes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2556152/

But for the purpose of this article, let’s talk about runners without preexisting conditions who often feel the pain. What might be causing it? Running just like other sports has its own share of injuries associated with it. Here is a list of common running injuries, the reason they occur, and what you may feel:

1. Plantar fasciitis: The plantar fascia is a thick band of connective tissue that extends from your heel to toe. When this gets inflamed, it causes plantar fasciitis. You might feel pain in the bottom of your foot/heel when your foot contacts the ground or right when you are propelling forward.
2. Ankle Sprain: The common mechanism of an ankle sprain is when your foot is rolled especially inward. It occurs mostly on an uneven surface or rugged terrain. Weak ankle stability and strength or overstretched ligament can lead to an ankle sprain. You will most likely feel pain on the outside of your foot/ ankle
3. Medial tibial stress syndrome (shin splints): Contributing to 15% of runners’ injury, the shin splints are caused due to irritation of the muscles around your shin. It is caused due to decreased stability or strength in the muscles of the ankle or foot or can be due to biomechanical reasons. You may feel an ache on the inside of the shin or at the ankle.
4. Patellar femoral syndrome (runner’s knee): It is caused by the irritation of the cartilage on the underside of the patella (kneecap) Nearly 40 % percent of running injuries are runner’s knee. It is caused due to weakness, tightness of quads, hips or glutes, or biomechanical reason (TRAIN VS TRACK). You might feel pain under and around the knee cap.
5. IT band syndrome: This band lies on the outside of your thigh and runs from the hip to the knee and shin. It rubs on the side of the femur (thigh bone) during running. It contributes to 12% running injuries. Mostly caused by weak hip abductors and biomechanics. You may feel pain and tightness on the outer side of the knee or knee cap.
6. Hamstrings Tendinopathy: The hamstring muscle is located on the back of your thigh to your knee. Hamstrings tendinopathy occurs due to weak, tight, or overstretched muscle. You will feel pain at the buttocks or back of the knee.
7. Runner’s Leak: Extremely common among female runners (with a more common occurrence in women who have given vaginal birth). About 40% of Elite runners have experienced a leak at some point based on a 2014 study. This unintentional loss of urine occurs due to an increase in intraabdominal pressure while running because of weak or overactive pelvic floor muscles, prolapse, or a weak core. You may feel a loss of urine (drops or volume while running). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4327384/

How can you help relieve this pain and continue running? Most of the pain with running is not caused by direct trauma but by an improper mechanism.

1. Muscle mobility: Appropriate stretching or foam rolling is the most efficient way to improve muscle mobility
2. Hip strength: Improve gluteal strength by doing bridges, plank, side planks.
3. Balance: While running you need to land on one leg to propel the body forward. Improve balance by standing on one leg with eyes open and closed for 30 seconds. To make it more challenging practice on an uneven surface.
4. Core awareness: Core muscles are especially important for proper co-ordination and stability. Awareness is important during the starting phase of running as it gets difficult to maintain as fatigue sets in.
5. Avoid overtraining: It is suggested to increase mileage only 10 percent per week to allow the body to adapt to an increase in exercise volume without breaking down.
6. Increase number of steps: Running technique is the most significant way of reducing stress on the joints to prevent or improve an injury. The simple way is by increasing the number of steps taken.
7. Proper footwear: It is important to have the right footwear while running for good biomechanics.Are you having pain with running?