Three running injuries appear in clinic again and again. Here is what they are, why they happen, and what to do.
Iliotibial band syndrome (runner's knee)
The iliotibial band is a thick sheath of fibrous connective tissue running from the iliac crest (pelvis) to the outer tibia (shin). As the band passes over the lateral femoral condyle (the bony prominence on the outer aspect of the knee), it is prone to friction as the knee is straightened during running. Pain on the outside of the knee, aggravated by downhill running, and tightness down the side of the thigh, are classic symptoms. Treatment begins with rest, cold therapy and stretching of the tight band. Massage and specialist osteopathic treatment are highly beneficial.
Anterior compartment syndrome (shin splints)
The anterior compartment of the lower leg is a group of muscles housed in a connective tissue sheath. When the muscles become too big for the compartment, this painful syndrome occurs. This can be triggered by an impact injury (bleeding, muscle tear) or overuse, both leading to swelling. Symptoms include sharp pain on the outside of the shin, muscle tenderness and pain on lifting the foot. Rest, ice and compression for 20 minutes are the initial response. Sports massage and osteopathic treatment then help to settle the tissue and restore normal mechanics.
Hamstring strain or tear
The hamstrings are a group of three muscles (biceps femoris, semimembranosus, semitendinosus) which bend the knee and extend the hip. A hamstring strain or tear typically occurs during the deceleration phase of running as you straighten the leg and plant the foot. Specialist sports massage and osteopathy support recovery, and progressive return to running is essential.
Return-to-running protocol
A generic protocol that we tailor in clinic:
- Start 48 hours after injury
- 10 minutes of gentle hamstring stretching
- 20-minute running sessions twice a day
- Begin with short-stride jogging
- Gradually increase stride length and pace within the session as pain allows
- Interval runs over 100 metres with acceleration, maintenance and deceleration phases
- If you feel the slightest pain in the hamstring, stop immediately and ice the area. The programme can be attempted again in just over 12 hours.
- Finish with gentle hamstring stretching and 10 minutes of ice to the injured area.