Runners training for long races often have to deal with a number of injuries and issues with their feet, legs, knees, and hips. As a middle-aged triathlete and soccer player, I’m too familiar with these issues.
Some of the most common maladies for runners are plantar fasciitis, runner’s knee, IT band syndrome, and shin splints. I’ve dealt with each. Here are some tips for how you can get through these so they don’t derail your race.
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My first advice is: if you’re encountering persistent soreness or sharp pain in your knees or feet, consult a specialist. They can examine you and take an x-ray or MRI to make sure there isn’t any structural damage. You don’t want to try to run through a stress fracture or strained or torn MCL (Medial Collateral Ligament).
Recently when I was training, I started feeling a sharp pain on the side of my right knee when I ran. Every time I made a quick cut in soccer, I feared that I’d shred the knee and be out of commission for a year. With four kids under the age of 10, my wife would just love it if I were relegated to the couch while she ran around chasing the minions.
I visited an orthopedic knee specialist at OrthoVirginia who examined the knee and took an x-ray. He ruled out any structural issues or breaks or tears. So what was it? The diagnosis was iliotibial band, or IT band, syndrome.
Iliotibial Band Syndrome
I had never heard of it, though it is a condition that mostly affects people who participate in intense physical activities…such as running, biking, and other intense sports. Long-distance runners are particularly prone to IT band syndrome, as it accounts for about 12% of running injuries.
The iliotibial band itself is a strip of fibrous, flexible tissue, essentially a tendon, that extends down the outside of the upper leg. It begins at the top of the pelvis, at a bony prominence called the iliac crest, and travels down the outside of the thigh, continuing over the outside of the knee joint. The bottom of the IT band attaches to the top of the tibia (shinbone). One of its functions is to help stabilize the knee joint.
Iliotibial band syndrome happens when the IT band gets irritated or swollen from rubbing against your hip or knee bones. The IT band is meant to be flexible and elastic. When you run a lot, it can tighten and begin to rub against your bones – particularly your lateral epicondyle on the outside of your knee – when you flex and extend your knee. This friction causes swelling and irritation that causes aching and burning pain.
There are many reasons why your iliotibial band might tighten, such as cooling down too quickly after exercising or running downhill or on a tilted or curved surface. Mine was tightening because I wasn’t stretching enough before running and exercising.
So how did I fix this problem?
Many experts recommend rest. But we action-addicted runners aren’t very good at that. What worked for me and kept me running is stretching the IT band specifically and my legs in general.
I met with a physical therapist each week to work on loosening my muscles and tendons – getting them to “release.” She really helped me lengthen and loosen my IT band to decrease the tension and friction. I also stretched at home and used a foam roller on my legs after a run or workout, followed by 20 minutes with an ice pack on the sore spots.
This stretching, foam-rolling, and icing regimen helped and the soreness began dissipating after a few weeks. Now I stretch and visit the physical therapist regularly to ensure that my IT band remains, to quote Tom Brady, “pliable.”
Runner’s knee is a little different than IT band syndrome. Runner's knee is a dull pain around the front of the knee. It may be caused by a structural defect or a certain way of walking or running. It can also be caused by weak thigh muscles and tight hamstrings or Achilles' tendons.\
Symptoms include pain, and rubbing, grinding, or clicking sound of the kneecap. Your knees may also stiffen after resting or sitting for a long time with your knees bent.
Experts recommend avoiding any intense running, such as long runs, intervals, or speed work, as these may cause further damage to your knee and increase inflammation.
In addition to rest, other treatments for runner’s knee include icing, compression, elevation, and stretching. It’s also worth seeing a physical therapist to strengthen the muscles surrounding the knee and hip and to stretch tight muscles.
A chiropractic adjustment can also be helpful to ensure that your hips, feet, legs, spine, and shoulders – let’s just say your entire body – are in alignment. I get chiropractic adjustments regularly. Finally, visit an orthopedist or a reputable run store to see if you need arch supports or orthotics for your shoes in case you have flat feet or other issues.
Speaking of feet, another injury common with runners is plantar fasciitis. Plantar fasciitis typically causes a sharp or stabbing pain in the bottom of your foot near the heel, but it can manifest elsewhere on the foot, too. It is one of the most common causes of heel pain and involves inflammation of a thick band of tissue that runs across the bottom of your feet and connects the heel bone to the toes. This tissue, or fascia, supports the arch of the foot and absorbs shock when you walk or run.
Too much tension or stress on the fascia can cause small tears, which can become irritated or inflamed. What is an activity that places a lot of stress on your heal and the tissue attached to it? You guessed it – long-distance running. This is particularly true for people between the ages of 40 and 60. Flat feet or a high arch can also put additional stress on the plantar fascia.
Treatment for plantar fasciitis is similar to treatment for runner’s knee: icing the area, stretching, and rest.
Stretching is one of the best treatments for plantar fasciitis, and there are a few good exercises you can do to stretch the plantar fascia and Achilles tendon. Stretching your calves regularly will also help. Plantar fasciitis is aggravated by tight muscles in your feet and calves. Stretching your calves and plantar fascia is an effective way to relieve the pain. There are many stretches you can do for your calves. Find some and do them each day.
One other remedy I’ve found very effective is putting a golf ball on the floor and rolling my foot over it. I keep a golf ball under my desk at work and roll my foot over it throughout the day. A tennis ball or lacrosse ball also works. You can also freeze a bottle of water and roll your foot over that for about 20 minutes a couple of times a day. This massages the tendon and helps keep it pliable.
ff-the-shelf or custom-fitted arch supports can also distribute pressure on your feet more evenly. Shoes with thick soles and extra cushioning can reduce tension and pain from standing and walking. Go to a serious, specialized running store and have someone test your running gait.
A knowledgeable salesperson will evaluate your stride and find the correct shoe for you. I went to Potomac River Running in Washington, DC. They have you run on a treadmill and make a slow-motion video to examine your gait. Then they find you a shoe from their wide selection that complements your individual movement.
Shin splints are also common in runners. They often happen in athletes who have recently intensified or changed their training routines and they are caused by repetitive stress on the shinbone and the connective tissues that attach your muscles to the bone.
You’re more likely to get shin splints when you increase the duration, frequency or intensity of exercise, or if you run on uneven terrains, such as hills, or on hard surfaces.
If you feel soreness or pain along the inner side of your shinbone or have mild swelling in your lower leg, it is most likely shin splints. If you’re not careful and you keep training, it could lead to a stress fracture.
Shin splints, like the other injuries covered here, can be treated with rest, ice, and other self-care measures. Wearing proper footwear with the right support also helps. Arch supports can help prevent shin splints if you have flat feet.
You may have to simply pull back on the running and other high-impact activities for a few weeks. You can cross-train with a sport that puts less impact on your joints and muscles, like swimming or biking. I often will ramp up swimming and biking and pull back the running to give my knees and feet a break. I also mix in strength training to strengthen the muscles that provide stability during running.
SummaTape from SummaForte has also become a big part of my prevention and recovery routine. SummaTape is a lightweight, stretchable kinesiology tape that reinforces and rehabilitates muscles, joints, and ligaments while helping to avoid overextension, enhancing dexterity, and facilitating faster recovery.
Unlike other kinesiology tapes, SummaTape delivers CBD and menthol through the skin, providing a cooling sensation and producing a triple anti-inflammatory effect. The menthol stimulates blood flow in inflamed areas and works with CBD, which interacts with receptors in the inflamed area, to accelerate muscle repair and improve circulation to help heal injuries.
I have used SummaTape on my knees and along my IT band to provide extra support and to help reduce inflammation so my recovery time is shorter. I also use it on my feet for the same reason. SummaTape has become my secret weapon to keep me running pain-free.