The Runner...and Common Injuries, Part 2

Running injuries of the lower extremity are primarily due to training errors and the accumulation of excessive mileage. Reducing the weekly running distance and decreasing the amount of hard surface running may therefore be reasonable suggestions if you have recurrent running related injuries. Running more than 40 miles or more a week was the most important predictor of injury for men.

Other important factors include proper shoe fit and recognition of excessive shoe wear to prevent injury. Since the foot often widens with age, shoe size should be reexamined at each time of purchase. Width should be determined while standing. Women in particular should be sure that the heel provides adequate support since women’s heels are typically much narrower than those of men. New shoes lose approximately 40 percent of their cushioning after running between 250 and 500 miles. Running shoes should be changed every 350 to 500 miles.

Orthotics can be helpful for runners with excessive pronation or rolling of the foot, leg length discrepancy, foot pain and/or plantar fasciitis, inflammation of the Achilles tendon, shin splints or knee and knee cap disorders. For most runners, over the counter orthotics should be just fine. Others need specialty made ones. In my experience the quality of these being made is quite variable.

Prompt evaluation for foot, ankle, and knee pain should be done. There are many possibilities. Absolute rest from running, or at least a reduction in pace and running mileage, is the basis of an effective treatment plan for most running-related injuries. Runners can frequently maintain cardiovascular fitness through alternative non-impact activities, like biking or swimming. It is essential to identify biomechanical stresses and correct them as well as perform active warm-ups.