Running Injuries
Leading up to the last major run of the year (Standard Chartered Marathon), we have seen an increase in injuries related to increased intensity of training. An important point to remember is that as your ?mileage? increases (the total number of kilometers you run in one week), any weak points like flat feet, leg length differences can start to magnify themselves. Hence a typical patient may have no problems when they were running 10-15 km per week, but as they increased to 20-25km per week and beyond, they started to experience more aches and pains. Does this sound like you? A lot of these aches and pains can be avoided and treated effectively with Physiotherapy, so that the runner CAN run pain free at these higher intensities.
Lets start with the feet. Asians generally have softer, wider feet and are more prone to ?over-pronation? (also referred to as collapsing arch, low arch, pes planus, flat feet). This picture shows the 3 types of feet, from left to right (normal, high arch and low arch). You can make your own comparison by checking out your footprints after you come out of the shower.
A common injury related to over-pronation is PLANTAR FACIITIS. The plantar fascia can be seen in this picture in pink, and it?s role is to support the arch. But feet that are flatter tend to over stretch the plantar fascia, and typically people will start to complain of pain near the heel. It will hurt more in morning, but as you warm up the fascia will get more flexible and the pain will go away, only to return after a period of rest! Stretching your calf muscles, massaging the plantar fascia (by rolling your foot on a golf ball) will help. Ultimately, it is proper foot wear with good arch supports that make the biggest difference. Some people might benefit from using an insole like the one pictured here. Often a generic insole, that sells for about $60 can do the trick. If all else fails, we recommend trying a sock-like device that you can see at www.thesock.com
For our patients who are regular runners, we normally recommend them to Feder Sports at Peninsula Plaza. Ask to speak to Jeffrey as he fits many of the national athletes and high level runners and triathletes. His knowledge in footwear and choosing the best shoe for your feet is unparalleled. Simply put? he knows his stuff! Remember, different feet have different needs. E.g.. Low arched feet need shoes with good arch support, whilst high arched feet need shoes with good cushioning.
Now lets move on to the knees. The most common knee injury in runners is called RUNNER?S KNEE (surprise surprise). It may also be known as Knee-cap Pain, Chondromalacia Patellae (CMP) or Patello-Femoral Pain Syndrome (PFPS). Caused by friction behind the patella, it commonly hurts to walk up or down stairs, and to run (especially up or down hills). It may be associated with some swelling, and almost certainly is associated with quadriceps muscle weakness. As common as it is, this injury can be treated very effectively, and should not require a long period of rest.
Strengthening your quads will help. We recommend going to the gym 1-2 times per week and taking on a strengthening program. This is especially important for those individuals who run more than 20km per week. The Leg Press is particularly useful in building up quads strength. We suggest you avoid the Knee Extension machine (also called Quads Rack), as it places a lot of strain on the kneecap. Also training each leg separately is a good idea, so you can gauge the strength difference between your left and right leg.
Addressing tight musculature around the area will also be of benefit. The ilio-tibial band (ITB) has a natural tendency to tighten up in runners and cyclists. It can be seen in this picture as the substance in white. It helps stabilize the outside aspect of the leg, and connects to the outer edge of the kneecap. Hence if it is tight, it can pull on the kneecap, causing CMP. In fact professional cyclists and runners, might get this ITB massaged DAILY during peak training periods! If you have CMP, doing some self massage to the ITB will almost certainly help as well!
Lastly, you might want to think about whether your feet are implicated in causing your knee pain. Again over-pronating will not only stretch your plantar fascia in your foot, but also alter certain angles and alignment for your patella, causing CMP.
Good luck to all the avid runners out there!
