Running injury treatment and prevention

Running injury physiotherapist in Sydney

In the Sydney suburbs of Maroubra, Penshurst & Concord, Switch Physiotherapy’s clinics provide physical therapy treatment to runners suffering from running injuries. The vast majority of people In Australia suffer from some sort of sports injury, especially running injuries, because we live an active, outdoor lifestyle and many people participate in outdoor activities.

A running injury can be caused by different factors including;

• Simply running too much too soon
• Running with poor technique
• Running when your body isn’t quite ready for it.

There are both pains and joys associated with running. Running is a wonderful exercise for getting fit, reducing weight in the body, as well as helping to clear your mind. In addition to working out your body, there may be risk of an injury that can result in a sudden halt in your performance. Having a better understanding of how to store and reuse energy has allowed humans to increase their ability to run and cover significant distances as they have evolved over time. As you run on your feet, did you know that your achilles tendon can store up to 30% of the energy generated by your calf muscles and that it can snap back to help you lift your heel off the ground as you run?

You can gradually increase the distance you run by gradually increasing the time and the workload of the exercise, and gradually the load on your muscles, tendons, and bones increases as well. Increasing the workload too quickly can, however, lead to breakdown of these structures, resulting in an injury.

Some people cannot run due to a lack of mobility, range of motion or strength, but this can usually be changed relatively quickly with the help of trained physiotherapists at Switch, who aid in creating a running injury recovery program and provide education to prevent further injuries. Running injury strength training, a return to running program after a hamstring injury, or even retraining for lower limb injuries are all possible with Switch physiotherapy.

Physios are trained to look at several areas to determine what may have led to your injury, including:

• Your running biomechanics – using movement analysis we can look at your running technique
• The type of footwear you are using
• Assess your training load – what is good, too much, too little
• Examine your joint range, muscle length and overall flexibility
• Test your muscle strength: core control, foot arch control, hip, knee and lower limb control.

In the event that our physiotherapist is able to identify the factors that led to your running injury, then they will work with you to help you get back to running as soon as possible. Depending on the severity of your injury, you may need to rest for some time for it to heal, during which time cross-training can be an effective way of maintaining your fitness. There is no better person than your physiotherapist to advise you on a running injury since he or she has a special interest in this field.

Running injury classifications

Coming back stronger beats coming back sooner. Rushed returns are how injuries linger.

When we treat running injuries we normally group them into these classifications;

Non-traumatic injuries are usually a sign of a ‘chronic problem’. So you may think, “oh my pain started out of the blue for no reason”… although we disagree, there is always a reason. Humans don’t just wake up with an achilles tendon injury or a feeling of hamstring tightness randomly. The body is out of equilibrium somehow. 

“Acute injuries” are typically a chronic problem and you have to find out what the underlying cause is and a physiotherapist can help with this, for example an acute hamstring tear is a chronic lack of eccentric/lengthening of hamstring strength and muscle flexibility) 

Does getting a scan help identify a running injury?

The common comment we hear when our physiotherapist starts a treatment session for a running injury is that ‘My GP sent me for a scan but the report was all clear”

Keep in mind that a scan is basically a static photo of you sitting or laying under a machine. So it won’t detect movement problems like when you are running or lifting weights. So you may be able to see individual bone problems but you can’t really see soft tissue issues. That is why having a deeper analysis with a physical therapist is a wise decision.

What are the most common running injuries a physio treats?

Shin Splints 

• Pain in front of shin 
• Pain on touch of tibia bone 

This will progressively gets worse and the pain might ease with rest although gets much worse with exercise (particularly during and after) and can be a sign of too much running (overload) or the need to have a footwear and running assessment to make sure you have the right technique or movement pattern.

Achilles Tendinopathy 

• Pain in back of ankle 
• Achilles tendon sore to touch 

The pain is similar to shin splints where it will progressively gets worse and ease off with rest. A physical therapist can help with physiotherapy treatment to increase ankle range + mobility and also recommend strength work.

Patella (knee tendinopathy) Muscle Tear (Hamstring or Calf)

• Weakness in the muscle 
• Pain on contraction 
• Sudden onset – feel a “pull/catch or twinge” 

Pain from this doesn’t ease with rest and normally needs treatment by a physical therapist.

Other injuries can be;

• Runners knee (ITB friction syndrome) – pain outside of knee 
• Patella Femoral Pain – pain under knee cap
• Runners hip – clicking hip 
• Plantar Fasciitis – pain under heel 
• Meniscus pain – pain in the joint line of the knee 
• Shin splints 
• Pain in the ankle and foot: plantar fasciopathy, tib post tendinopathy, Achilles tendinopathy, peroneal tendinopathy
• Pain in the knee: patellofemoral pain syndrome, patella tendinopathy, quads tendinopathy, ITB syndrome
•  Pain in the hip/back: hamstring tendinopathy/tear, gluteal tendinopathy, trochanteric bursitis, adductor strain/tendinopathy, hip flexor strain/tendinopathy, lumbar overload

The main causes of these types of running injuries include; 

• Poor functional or structural alignment.
• Poor running technique.
• Incorrect footwear.
• Overstriding or under striding 
• Not sticking to the 10% rule. Too much too soon.
• Poor stability through the entire running chain.
• Running at too high a volume too soon; progressing things too quickly E.g. running 10km after not running for months
• running with poor technique and overloading structures. E.g. running with excessive ‘heel strike’ which can overload the knee 
• muscle weakness and poor control of specific muscle groups. E.g. poor gluteal strength 
• not enough rest between runs

How often should you run & how can you avoid an injury?

There is no strict rule or time period for anyone to follow, if you love running then do it as much as you like. Although it is important to understand and listen to your body – bones, tendons and ligaments to know how well they respond to lots of running activity.

A seasoned runner may be able to run consecutive days with minimal rest, but someone starting out may need 24 to 48 hours to recover. If you feel like your muscles are still achy from the last run then it may be a good idea to take an extra amount of time off to let your body recover sufficiently. This may be a sign of the body’s tissues not absorbing that load quick enough or well enough.

Sometimes you can feel a “niggle” before a running injury occurs, these are warning signs that the body is not coping and if you don’t listen to this warning you may injure yourself. So maybe after a long 10km run you feel some tightness and a little catching pain in the back of your achilles. This may be the sign of an achilles tendinopathy injury forming.

Potentially that “niggle” as the tip of the iceberg where you feel 10% of the problem, whilst 90% of it is about to surface if your body isn’t given the rest it needs. It is important to consider getting physiotherapy so that your recovery process is shorter and less painful. Some serious injuries may take 3-6 months to repair.

11 tips for preparing & recovering from running

Like anything the more preparation the better the outcome and running is no different. 

1. Sleep: Clients who sleep for 8 hours or more can decrease risk of injury by 80% and also recover quicker if they get injured. 
2. Diet & hydration: you need the right mix of food and liquids in your diet to keep your body fuelled to give it energy for your running but to also recover. 

3. (Active) Rest: Active recovery refers to going for a light form of physical activity when you’re not running to promote blood flow and help with recovery. So a light walk or stretching or something else that is low intensity.

4. Warm up: Getting your body ready by doing 10 minutes of light activity (paced walk, light jog) and some form of stretching put you in a limber state & ready to run. It can help prevent injury and improve performance because it helps your respiratory and cardiac systems

5. Cool downs: If you gently decrease the intensity of activity it will help the body reset and feel fresher after your run but also assist in the removal of any lactic acid which can help with recovery. 

6. Maintaining healthy body weight: You can manage the load placed on your body’s joints, muscles and tendons. 

7. Physical treatment: have “niggles” treated before they become more sever injuries

8. Change your footwear: running in your favourite shoes you have had for a few years may be keeping your wallet happy but causing damage to your body.

9. Apply the 10% rule: progressing running volume in a progressive and safe manner; following the ‘10% rule’ – only progressing the total amount ran by 10% each week 

10. Strength and control training: do this for key muscle groups involved in running; e.g. glutes, quads, calves etc

11. Running with adequate technique: your body movement patterns can be adjusted to run correctly to reduce or avoid injuries.

How can Switch physio clinics provide treatment for running injuries?

Our dedicated health professional team (physiotherapists and massage therapists) can help you prevent injuries, prevent pain, improve quality of life and achieve your goals. Our physiotherapists can also guide your footwear choices and run a biomechanical running and walking assessment to help fix any little movement problems. 

When a client visits our clinics to get running injury treatment we typically ask these questions;

• Where is the pain?
• When does the pain come on? Before, during and/or after running? 
• How far do you usually run? 
• What terrain do you usually run on? Concrete? Grass? Sand? Trail?
• How long has this been going on for? 
• What footwear do you use to run in? 
• Any other niggles or previous injuries? 
• How long have you been running for/when did you start ? how have you progressed your running regime ? 
• What intensity do you run at ? 
• Do you do any other physical activity ? If so what ? 

How did we treat running injuries in Sydney for our patients?

Our physiotherapy practioners have provided physical therapy to hundreds of clients at our clinics in Sydney for various running injury scenarios.

Tami, 22 years old

Starting running for lifestyle improvement & work / life balance

The situation

Tami decided to take up running as an escape from the pressures of a full time job. Running was a way to clear the mind and get some fresh air. Unfortunately Tami suffered from Shin Splints and was experiencing great pain in both legs.

Treatment from Switch Physiotherapy included;

• Shockwave treatment
• Alignment correction through manual therapy
• Running technique strength training
• Managing a return to running return through a step by step framework.

Outcome:

Tami returned to running after 2 weeks with no pain and was able to learn running principles that should improve running performance and minimise a re-occurrence of the injury.  

Joshua, 23 years old

Grade 2 hamstring tear from Oz-Tag

The situation

Joshua enjoyed playing Oz-Tag and during a sprint he experienced a Grade 2 tear in his right hamstring. This was re-confirmed with an ultrasound.

Treatment from Switch Physiotherapy included;

• Manual therapy to reduce the muscle tension that comes with a muscle tear as well as improving flexibility which is usually lost after a muscle tear. I
• Treatment also consisted of a mobility program to help with flexibility deficits.
• A personalised strengthening/loading program to correct muscle imbalances.
• Work on strength of surrounding muscles such as glutes and calves.

Outcomes;

• Once pain was no longer an issue and Joshua had adequate strength, control and flexibility, we started a running program which starts off at running at 50% maximum capacity building up to 100% sprints. 
• After getting through this, we then began an agility program consisting of movements involved in Oz-Tag and soccer (sports he wanted to get back into).

• Josh is now able to run and sprint pain free, and he is ready to return to training (once restrictions end)

Common questions about headache treatment

Frequently asked questions

What causes most running injuries?

Usually training errors like doing too much too soon, plus strength, footwear and technique factors.

Should I stop running if I am injured?

Often you can keep running with adjusted load. A physiotherapist can guide it.

How do I prevent running injuries?

Build your distance gradually, strengthen the areas that take load, and address niggles early.

How long do running injuries take to heal?

It depends on the injury. Many settle in a few weeks once the cause is managed.