If you’re a runner and you’ve never had a running-related injury, then buy a plane ticket to Vegas and hit the high-roller tables ASAP, because the odds are clearly on your side. Okay, you might not want to go to that extreme—but all jokes aside, most estimates suggest that about 70% of runners will become injured at some point.
Unfortunately, most runners are conditioned to endure pain and discomfort. Otherwise, they’d never make it through a marathon—or even a 5K or 10K. But that exceptional tolerance for pain makes it tough for runners to distinguish between normal aches and twinges and those that might indicate something more serious. And before they know it, they’re laid up on the couch without a clue as to what went wrong or how to fix it.
Luckily, physical therapy (PT) is highly effective in treating and rehabilitating running injuries. But before we dive into the ins and outs of PT for runners, let’s go over some of the most common running-related issues.
Common Running Injuries
Patellofemoral pain syndrome: Also known as “runner’s knee,” this condition is characterized by pain around and underneath the kneecap, particularly after extended periods of sitting or while ascending or descending stairs and inclines. The soreness results from irritation of the cartilage around the kneecap, often due to poor biomechanics. Specifically, overstriding—which occurs when the foot lands too far ahead of the body—puts undue stress on the upper leg and knee, often leading to this injury.
Iliotibial (IT) band syndrome: Those suffering from IT band syndrome typically experience an aching pain on the outside of the affected knee. Generally, this pain becomes worse throughout a run. IT band syndrome is an overuse injury in which the IT band—the thick piece of tissue that goes from the outer hip to the front of the knee—becomes inflamed at the point where it crosses the knee, producing a burning sensation whenever the knee bends. There are a variety of causes associated with this condition, including muscle weakness in the glutes, bowed legs, over-pronation, leg length discrepancy, running on uneven surfaces or circular tracks, and major jumps in training mileage or intensity.
Shin splints: Formally called “medial tibial stress syndrome,” this injury is characterized by pain and tenderness in the front and/or inside areas of the lower leg. The condition is most common among runners whose bodies are not yet accustomed to the stresses of running. Because shin splints are aggravated by impact, those suffering from this issue may want to switch to lower-impact training activities—such as biking or swimming—until the pain subsides.
Achilles tendinitis: This injury involves inflammation and pain in the Achilles tendon, which connects the heel to the muscles of the lower leg. Common primary causes of this injury include sudden increases in training volume, excessive hill running, and improper footwear. However, it’s important to note that runners with extraordinary tightness in the posterior muscles of the leg—including the hamstrings and calf—are at a much greater risk for developing this condition. Without proper treatment, Achilles tendinitis can become a chronic problem.
Plantar fasciitis: Pain in the bottom of the foot or lower heel often results from strain of the plantar fascia, a band of tissue that runs from the heel to the toes. Inflammation in this area leads to an achy soreness that is usually most severe in the morning, immediately after getting out of bed. The pain is most noticeable when the affected foot bears weight or when the toes push off of the ground while walking or running. Runners with flat, flexible feet or high, stiff arches are most prone to this injury. Improper or worn footwear can also lead to this condition.
Stress fractures: Most common in runners under the age of 30, stress fractures are tiny breaks in the bones. Runners often sustain stress fractures in the foot and lower-leg bones—especially the second metatarsal, which is the longest bone in the foot. Typically the result of excessive training—especially on hard surfaces like asphalt roads or cement sidewalks—a stress fracture is very serious injury that requires an extended period of total rest to heal.
What to Do if You’re Injured
If you believe you’re injured, absolutely do not try to run through the pain. In some cases—especially if the injury is in its early stages—a short break is all you will need to recover. Taking time off from running will allow the inflammation to subside, thus giving the tissue a chance to repair itself. In some cases, you may be able to substitute low-impact cross training (e.g., swimming or biking) if such activities are not painful. However, please note that even after the pain goes away, you should not simply return to your full training load as if nothing happened. Doing so could lead to reinjury. If your injury is inflammatory in nature, a regimen of icing and ibuprofen may help reduce the pain.
Even though self-treatment can be effective in some situations, the vast majority of those plagued with running-related injuries would benefit from professional guidance—particularly from a musculoskeletal expert such as a physical therapist. With that in mind, let’s go over some of the ways PTs can help runners not only recover from their injuries, but also emerge stronger and fitter than they were before.
Therapy Treatment for Running Injuries
Physical therapy is a very popular mechanism of injury treatment among runners. Sure, it takes time—not to mention hard work and dedication—but runners tend to be a pretty self-disciplined bunch. And as with running, you truly get out of therapy what you put into it. Furthermore, it’s a much more attractive option than surgery, which can take you completely off of the road, track, or trails for several months.
When selecting a physical therapist, look for someone who specializes—or has substantial experience—in working with runners. That way, you can be sure he or she not only understands the physiological effects of your injury, but also the psychological impact (i.e., your desire to resume training as soon as humanly possible).
During your first visit to therapy, your PT will conduct a thorough assessment of the injury to determine its severity and identify possible causes and contributing factors. This assessment will involve a variety of strength, mobility, balance, and pain tests.
Once your physical therapist has a good understanding of your particular situation, he or she will develop a personalized rehabilitation program—also called a plan of care—to rehabilitate your injury and alleviate your pain. This plan will feature a variety of exercises designed to improve strength, mobility, and flexibility as well as correct any deficiencies noted in these areas. Active therapy treatment often involves the use of therapy equipment such as:
- Pilates reformers and chairs
- Stability devices
- Resistance bands
- Free weights
- Foam rollers
- Steps of different heights
Your PT also may use passive treatment methods such as ultrasound or electrical stimulation to reduce pain, increase blood flow, and stimulate muscles. In many running-related injury cases, manual therapy—including massage, mobilization, and manipulation—may be appropriate. Your therapist also may recommend the use of supportive devices—such as crutches, canes, or braces—to take pressure off of the injured area, thus promoting healing.
While the frequency and duration of your PT sessions will vary depending on the type and severity of your injury, you can expect to attend therapy two or three times a week for several weeks. Your treatment plan also will include a home exercise program, which is a set of therapy exercises and activities that you are responsible for completing at home. It is absolutely crucial that you follow this program carefully and patiently. The greater your commitment to your treatment plan, the faster you will heal—and the sooner you can lace up and hit the road.