Avoiding Running Injuries
By Andrew Getzin, M.D.
When warm weather approaches, runners take to the streets and local outdoor
tracks. Running provides people with many health benefits, camaraderie, and a
temporary escape from their day-to-day lives. Unfortunately approximately 45 to
70 percent of runners are injured each year. I am frequently asked questions
about running injuries by my patients and running partners.
How can I increase my mileage and
There are few limitations to the distances people are able to safely run. I
know of seventy-year-olds who complete marathons. Most experienced runners can
safely increase their training by up to ten percent per week. However, runners
often forget that there are two ways to increase: either an increase in
training mileage or in training intensity.
What are the most common injuries and
how are they treated?
Most injuries in runners are not from acute trauma but from repetitive
ground forces over time. Three common running injuries are patella femoral
syndrome, iliotibial band syndrome, and medial tibial stress syndrome. I urge runners to pay attention to
the onset of pain and to seek medical advice early, because injuries are most
responsive to treatment before they become serious or chronic.
Patella femoral syndrome (PFS) or
"runner's knee," typically appears as pain behind the kneecap that
increases with prolonged sitting or walking downstairs. People with PFS often
report having noisy knees that pop or crack and sometimes experience episodes
of the knee buckling. PFS occurs when the muscles are fatigued, which allows
the kneecap to move out of its normal tracking. It is treated by activity
modification, icing, stretching, formal physical therapy, and using a knee
sleeve to maintain the patella in its normal position.
Iliotibial band syndrome (ITBS) is a common injury
in Tompkins County because of the hilly terrain. The
iliotibial band is a fibrous band that runs along the
outside of the thigh from the hip to the knee. It can become inflamed with increased
downhill running, running in the same direction on a track, or with running on
roads with steep shoulders. Pain over the outside of the hip and knee may be an
indication of iliotibial band syndrome. Treatment
includes icing, flexibility exercises, strengthening of the hip muscles, and in
some cases, steroid injections.
stress syndrome (MTSS), sometimes referred to as shin splints, is caused
when overworked muscles inside the lower leg tighten and pull at the bone. Pain
initially occurs after running. If this injury is ignored, it progresses to
cause pain during running and ultimately all the time. Activity modification,
calf-strengthening exercises, ice massage, and sometimes shoe orthotics can
effectively treat this injury.
What other steps can I take to prevent
Most importantly, listen to your body. If you notice pain during running
that lasts for a few days or recurs during future runs, see your doctor.
Consider cross training. Biking, swimming, cross-country skiing, and pool
running are very good alternate activities for runners that can help improve
fitness and decrease the number of miles of actual running needed to adequately
train for long races. All runners should feel comfortable with some form of
cross training so they do not try to "run through" injuries. Running
shoes should be replaced approximately every 300-500 miles depending on the
individual runner. Keep a daily record of your training to avoid increasing
your mileage too rapidly. Finally, consider adding strength training.
Injured runners are often reluctant to see a doctor for fear that they will
be told not to run. Physicians who understand the runners' mentality prescribe
active rest, where activity is maintained but in a way that diminishes harmful
forces on the injury and allows healing. Good
communication between the runner and the treating physician is important,
especially about training goals and upcoming races. This understanding will
allow a timely return to an appropriate running schedule.
is board certified in family practice with a Certificate of Added Qualification
(CAQ) in sports medicine. He is on the medical staff of Cayuga Medical
Center and in practice at
Cayuga Sports Medicine. He is head team physician at Ithaca
College and founder of the Ithaca Triathlon Club.
Dr. Getzin is medical director at Island Health and
Fitness in Ithaca.