Running injuries (or running-related injuries, RRI) affect about half of runners annually. The frequencies of various RRI depend on the type of running, such as speed and mileage. Some injuries are acute, caused by sudden overstress, such as side stitch, strains, and sprains. Many of the common injuries that affect runners are chronic, developing over longer periods as the result of overuse. Common overuse injuries include shin splints, stress fractures, Achilles tendinitis, Iliotibial band syndrome, Patellofemoral pain (runner's knee), and plantar fasciitis. Proper running form is important in injury prevention. A major aspect of running form is foot strike pattern. The way in which the foot makes contact with the ground determines how the force of the impact is distributed throughout the body. Different types of modern running shoes are created to adjust the foot strike pattern in an effort to reduce the risk of injury. In recent years, barefoot running has increased in popularity in many Western countries, because of claims that it reduces the risk of injury. However, this has not been proven and is still debated.
Overview "The causes of running injuries are so multifactorial and diverse, and apparently vary greatly from individual to individual, that any preventive measure proposed would probably be of help to only a small minority. The only obvious exception would be, of course, the reduction in jogging activity itself. A recent study came to the same unspectacular conclusion. … We suspect, however, that it would be as difficult to motivate determined joggers to decrease their injury risk by cutting down on mileage as it would be to motivate the sedentary population to decrease its cardiovascular risk by taking up activities such as jogging."
"A prospective cohort study of 300 runners followed for two years showed that 73 percent of women and 62 percent of men sustained an injury, with 56 percent of the injured runners sustaining more than one injury during the study period."
A prospective cohort study of 76 runners followed for one year showed that 51 percent reported an injury. Injured runners were heavier. "Over 60% of male injured runners and over 50% of female injured runners had increased their weekly running distance by >30% between consecutive weeks at least once in the 4 weeks prior to injury."
"… an evolutionary perspective indicates that we did not evolve to run long distances at fast speeds on a regular basis. As a result, it is unlikely there was selection for the human body to cope with some of the extreme demands runners place on their bodies."
Acute injuries
Side stitch A side stitch is an intense stabbing abdominal pain under the lower edge of the ribcage that occurs during exercise. It is also called a side ache, side cramp, muscle stitch, or simply a stitch, and the medical term is Exercise-related Transient Abdominal Pain (ETAP). It sometimes extends to shoulder tip pain, and commonly occurs during running, swimming, and horseback riding. Approximately two-thirds of runners will experience at least one episode of a stitch each year. The precise cause is unclear, although it most likely involves irritation of the abdominal lining, and the condition is more likely after consuming a meal or a sugary beverage. If the pain is present only when exercising and is completely absent at rest, in an otherwise healthy person, it does not require investigation. Typical treatment strategies involve deep breathing and/or manual pressure on the affected area.
Strains A strain is an injury that occurs to a muscle, tendon, or both. Generally, the muscle or tendon overstretches and partially tears, under more physical stress than it can withstand, often from a sudden increase in duration, intensity, or frequency of an activity. Strains most commonly occur in the foot, leg, or back. Immediate treatment typically includes five steps abbreviated as PRICE: protection, rest, ice, compression, elevation.
Sprains A sprain, also known as a torn ligament, is the stretching or tearing of ligaments within a joint, often caused by an injury abruptly forcing the joint beyond its functional range of motion. Ligaments are tough, inelastic fibers made of collagen that connect two or more bones to form a joint. Sprains can occur at any joint but most commonly occur in the ankle, knee, or wrist. The majority of sprains are mild, causing minor swelling and bruising that can be resolved with conservative treatment, typically summarized as RICE: rest, ice, compression, elevation. However, severe sprains involve complete tears, ruptures, or fractures, often leading to joint instability, severe pain, and decreased functional ability. These sprains require surgical fixation, prolonged immobilization, and physical therapy.
Morton's neuroma Morton's neuroma is a tightening of the tissues surrounding the nerves leading into your toes. This is caused by wearing shoes with a narrow toe bed, like high heels, or in high-impact activities like running or jogging. Treatments can include switching to a shoe with a wider toe bed, the use of inserts in your shoe, cortisol shots, or in extreme cases, surgery can be done to remove the affected nerve.
Overuse injuries
Causes and prevention
In general, overuse injuries are the result of repetitive impact between the foot and the ground. With improper running form, the force of the impact can be distributed abnormally throughout the feet and legs. Running form tends to worsen with fatigue. When moving at a constant pace along a straight path, a symmetrical gait is considered to be normal. Asymmetry is considered to be a risk factor for injury. One study attempted to quantify the change in running form between a rested and fatigued state by measuring asymmetrical running gait in the lower limbs. The results showed that "knee internal rotation and knee stiffness became more asymmetrical with fatigue, increasing by 14% and 5.3%, respectively." These findings suggest that focusing on proper running form, particularly when fatigued, could reduce the risk of running-related injuries. Running in worn-out shoes may also increase the risk of injury, and altering the footwear might be helpful. These injuries can also arise due to a sudden increase in the intensity or amount of exercise.
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