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Running Injuries

Added: 31 January 2014

Running Injuries: read the small print ...

As everyone knows, running is a tough sport. It's tough on your mind and it's tough on your body. It's an unfortunate consequence of a tough sport that sometimes things go wrong and injuries happen.

When things start to hurt whilst, there seems to be a pattern that most people adopt. Firstly, they try running through the problem. If that doesn't help then they rest for a bit. However if this doesn't work then the next step is usually to see someone about it. This may be a GP, a physio, a sports therapist, a masseuse; anyone who makes sense at the time. This person will invariably put a label on the problem so that you can tell your mates down the track, club or pub why you're not running.

These labels are often fairly generic and not always accurate, partly because there doesn't seem to be enough labels to go round. I've noticed that there are about five popular labels out there which seem to cover nearly every possible problem. But my issue, i'snt the label, it's the accuracy of the label and the effect it has on people.

My first example of this is also a thinly veiled form of ageism. Regardless of whether you run or not, if you are over the age of 40 and have pain around your joints, i'm pretty sure that you've been told that you have ...drum roll... "Arthritis". However, if you haven't reached 40 yet and you have joint pain then you probably haven't received this label YET. Just wait till you reach the prime of life and see if the diagnosis changes.

Of course there are lots of things that cause joint pain from soft tissue inflammation like bursitis or synovitis, cartilage problems, movement dysfunctions, all of which would be considered as a potential diagnosis if you were 25. However it would seem that these things stop becoming relevant as we get older when the term "Arthritis" will do.

Working through the top five misnomers, my next biggest gripe about mis-terminology, specifically in runners is the "hamstring strain". If you've ever had pain in the back of your legs during excercise i'm pretty sure you've been diagnosed with a pulled hamstring. Now just to be clear, pulled hamstrings definitely happen and are very painful. However if you are a distance runner your chances of tearing your hamstring are a lot less. Unless you've had a sudden onset of pain, the chances of you tearing the hamstring muscle without over-striding or suddenly changing speed are low.

There are of course other problems which cause pain in the hamstring that are often mistaken. In distance runners I would say the most common of these is a problem with the lower back. This might be due to a nerve entrapment, an irritated joint or in some cases a disc problem. Most people have heard of the term sciatica because its such a common problem in the general population, yet the running eqivalent seems to be forgotten.

I would say the next most common running ailment is the notorious "Runner's Knee". This is another umberella term that doesn't really mean anything. Unfortunately, telling you that your knee hurst wgen  you run isn't a diagnosis. Incidentally, I have just Googled the search term "Runners Knee" and found 3 different conditions listed in the first three hits!

Anyway my point is that the term "Runners Knee" seems to cover so many things that it's become a useless term. The usual location of pain is on the outside of your knee or around the knee cap.; Why it matters is because different problems around the knee have very different treatments. Disorders effecting tendons, the infamous ITB and the patella are all treated differently and have different implications for running. Unfortunately, the Runners Knee label doesn't really help this process.

My next gripe is with "Plantar Fasciitis". Obviously, not the coniditon itself but with the label. It seems to be that if you have foot pain then you have plantar fasciitis. Unfortunately it isn't that simple. Classical plantar fasciitis is characterised by localised pain to the inside aspect of your heel particularly with getting out of bed or after periods of immobility. This pain then usually gets easier with movement. If this isn't you then you probably have something slightly different.

Staying at this end of the body, if you have ankle pain then you're likely to be told that you've sprained ankle ligaments. What is meant by a sprain is that a ligament or soft tissue has been disrupted in some way. Fortunately, injuring a ligament isn't that easy to do and takes an incident such as a trip, twist or memorable event. You would be very, very unlucky if you injured a ligament without trauma.

And finally if you do have any of these problems then the structure that commonly gets the blame is your foot, in particular that it "pronates". And to confirm this right now, I can tell you that yes, you almost certainly do pronate. However this does not mean that it is causing you any problems. Pronation is a very necessary part of your gait cycle and there is a fairly strong argument that the most important thing your foot does is pronate. It has to happen to allow your foot to meet the ground, accept it, adapt to it and propel you away from it again.

If pronation didn't happen we would all walk continuously on the outside border of our feet. And before you say "Oooohhhh I do that", I mean you would ONLY walk on the outside of your feet and your big toes, in fact any of your toes, would never touch the ground. You would also get very offensive comments about the way you walk. The only person I have ever seen walk like this was an unfortunate individual who has suffered a stroke and had a permanently altered tone in her foot. So yes, you do pronate and only sometimes do you need to worry about it.

But the moral of this story is that if you do suffer from a recurrent problem and someone has put a label on it, read the small print carefully and make sureyou ask a few questions because very often things aren't always what they seem.

Happy cross country season!!

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