What follows is a detailed injury prevention guide to begin to address this issue, taken from The Runner's Repair Manual, by Dr. Paul Weisenfield. The five most common running injuries are discussed and methods of evaluating, preventing, and addressing them are described. You can also learn more about these injuries here.
What it is: Common overuse injury. Pain on either side of the knee.
The test: Sitting on a chair, stretch your leg out straight onto another chair. Have a friend squeeze your leg above your knee while pushing the outside of the kneecap towards the center. At the same time, tighten up your thigh muscle. If there's pain, it's runner's knee.
Questions to ask yourself:
- Are you running on banked surfaces making one leg effectively much shorter than the other (Check your actual leg lengths as well, they could be different!)
- Did your mileage increase drastically?
- Had you been doing a lot of hill or speed work?
Short term: Put an ice cold wrap around your knees after your run for 15 minutes to reduce inflammation. At bedtime, you could put something warm on them for up to 30 minutes. Can take aspirin with meals and at bedtime, but never before running.
Support your feet. Corrective foot support, available at any drug store. If it has to do with your feet this will reduce the pain. If the pain started as soon as you began running, it's the knee, if it took a while to present then it's the foot.
Strengthen your thigh. Knees need a balance of strength from the thighs to operate well. Two exercises for this: Foot press: sitting with legs flat on ground, press one foot on top of the other foot pushing with top foot and resisting with bottom foot for ten seconds, Switch and repeat five times. Inner and outer thighs: Legs out flat in front of you, stretch both legs out with knees straight, feet flexed back towards knees, feet turned in towards each other. Tighten thighs and turn feet out from each other holding for ten seconds, then turn in for ten seconds. Repeat five times.
Check running habits. Coaches, podiatrists, running stores can all help with issues with form. Watch out for the sloped sides of streets and indoor tracks.
What it is: This is moderate pain that happens in the front or inside of the lower leg along the shin bone (tibia)
What to do about it: Stretch the calf muscle and strengthen the front leg muscles.
Front of the leg (anterior) shin splints are caused by inflammation of the anterior muscles or the bone sheath. Back off on running, ice before run, heat any other time. If arches are flattening out when standing or are painful, you may have weak feet. Solve this with arch supports, putting your weight more on the outside of your feet, and with limited barefoot running (ideally on grass). Check to see if your shoes are too big, grasping toes can lead to shin splints.
Inner side of the leg (posterior) shin splints are generally caused by fallen arches or weak feet. Feet presses and wall pushups- stretching the back of the leg by pressing hands against a wall with knee bent a little- are also helpful.
What it is: If there is pain in the lower part of the calf near where the Achilles tendonis attached to the heal, you probably have Achilles tendonitis. Check this by pinching along the tendon from close to the heel along up to where the tendon enters the calf muscle. If there is a little swelling and a lot of pain, its Achilles tendonitis.
What to do about it: Something is pulling too hard on either end of the tendon, likely a calf muscle that is too short and a heel that's too far away from the calf muscle. Put something under your heel to lift it up so it won't be pulling down so hard, such as sponge rubber. Stop running for a couple days to a couple weeks until the pain is a lot better, then do Wall Pushups as discussed in the section on Shin Splints.
What it is: Many micro-fractures caused by continual strain, and the pain and fracturing build up gradually. The only way to know you have one is through an x-ray of the area. If there is moderate to severe pain, it may be a stress fracture. If recommendations made under the assumption that the affected area does not have a stress fracture (for shin splints for example above) do not impact the level of pain within three days, then it may be a stress fracture.
What to do about it: Go to a doctor, get it X-rayed. Follow doctor instructions, which will likely involve a cessation in running.
What it is: Muscle in pain. Symptoms can include bruising, swelling or redness. There can be pain at rest or when the muscle or joint in relation to the muscle is used. There may be weakness of the muscle or tendon, or inability to use it at all.
What to do about it: Stop running, rest up. Gentle stretching, and if your own remedies bring no relief in one to three days, go see a doctor.
What it is: If you've done it, you know. You turn your ankle and suddenly there is quite a bit of pain. There will be swelling and the ankle may even get black and blue.
What to do about it: Stop running right then! The first 24 hours are critical. Elevate the ankle and get ice on it. Keep it elevated as much as possible the whole time, and keep using the ice, ten minutes on and ten minutes off until bedtime. If its still swollen and painful the next morning, get it X-rayed. It may be fractured or have torn ligaments and may need support or even a cast.
What it is: “Fallen arches” where the fascia bridge across the arch of the foot is stretched too hard and hurts. Closely related to heel spurs and bursitis, which can accompany it. Plantar fasciitis is distinguished by feeling pain in the middle of the heel pressing into the foot, as opposed to pain in where the heel meets the arch which indicated heel spurs and/or bursitis.
What to do about: All three are aggravated by running on hard surfaces, on the balls of your feet, or too much time spent running. Tight calves and hamstrings make it worse, as well as inflexible shoes. With inflammation, ice feet ten minutes on ten minutes off right after running. Can take aspirin after running. Arch support, a heel pad (sponge rubber) and strapping your foot to give support to the arch are very helpful.
Arch supporting strapping is first thing to do, for three weeks. Wrap tape from behind little toe around heel to along the outside of the foot to behind the big toe. Then partially overlap three 4” thick strips of Elastoplast across the bottom of the foot, starting behind the little toe to behind the big toe. Tape down the edges to anchor the entire taping, making sure not to leave wrinkles in the taping in any of these steps. Never wrap the tape all the way around the top and bottom of your foot. Replace every three days, wear for three weeks. Try this alone or in any combination with a heel pad and arch support, and if that doesn't work try a heel cup. If that doesn't work go see a sports podiatrist.
So there you have it! A beginning guide to injury prevention.