• Achilles tendon injuries
• Ankle sprains
• Athletes foot
• Blisters
• Ingrown toe nails
  

• Runner's Knee
• Shin Splints
• Stitch
• Stress Fracture

• Stretching and warming up can reduce injury
• If you are new to running or are back after a break, then break yourself in easily. You will not be able to take up were you left of immediately, however hard you push yourself on the first run!!

Achilles tendon injuries

Achilles tendon = the tendon connecting the calf muscles to the heel
Most common running injuries

Tenosynovitis - most common form

• Inflammation of the tendon sheath
• The pain tends to lessen with movement - pain eases as you move around
• If this is the cause, the pain will be in the neck of the tendon with often some swelling or thickening in the area.

Treatment
Must treat symptoms, reduce the aggravation and eliminate the cause

1. Consult your doctor.
2. Apply ice
3. Cold pack at least 3 times daily then put on some anti-inflamatory cream. Deep fricition of the area can help speed recovery - rub hard along the tendon when the tendon is taut for 5 mins each day
4. Rest from running - cycling can be good alternative that does not strain the tendon

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Musculotendinous Junction

If this is the cause, pressure on the neck of the tendon is not sore, but further up on the calf is sore. Similar symptoms to tenosynovitis - more painful early on it the day or the start of training.

Treatment
Be sure that this is the cause of your pain (use the location of pain as a guide) then treat as follows:

1. Consult your doctor.
2. Have the tendon relaxed this time and deep massage the area across the tendon for 5 mins a day.
3. And apply heat for 15 mins
4. Unlikely to recur once the symptoms have cleared.

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Achilles Bursitis ("Pump Bump")

Location of pain - well, best to start with where the pain is not. It will not be painful in the neck of the tendon, or as it becomes muscular. Examine where the tendon joins the heel. If this is tender to pressure but not sore if standing on your tiptoes then the small sac of fluid behind the tendon has probably become inflamed.

• Can be caused by road running and pounding on the heel area.
• Can be caused by irritation by shoes.

Treatment

1. Consult your doctor.
2. DO NOT USE massage or friction - but reduce the pressure on the area.
3. Use ice to reduce inflammation - 3 times daily for 10 mins
4. Rest from training

Remember: trying to run through an Achilles tendon injury may cause a mild case to develop into a chronic one. This will increase the damage and likelihood surgery will be required to remedy it.

Ankle sprains

• Very common injury
• With pain and swelling of the ankle which can feel worse than just a sprain
• More likely to sprain an ankle doing other sports than when out running.
• Sprains are a result of torn ligaments, broken blood vessels and inflammation.

Treatment

1. Consult your doctor.
2. Immediate treatment is crucial - rest, ice and elevation
3. Recovery can take days to weeks - so stay off that ankle until it is recovered

Athletes foot

A common fungus infection

• Favours warm moist environments and particularly between the toes

Prevention

• Change socks frequently
• Wear cotton socks and avoid plastic or sweaty trainers
• Apply foot powder liberally to prevent occurrence.

Treatment
Several creams and foot powders are available without prescription.

Blisters

The layers of skin become detached from one another and the damaged cells fill the gap with a watery fluid.

Treatment

• Consider whether it is worthwhile treating the blister or whether it would be more beneficial to leave it to die down itself. Often a blister can be more painful once the underlying skin has been exposed.
• If needs be, release the fluid with sterilised needle and apply a dressing.
• If the blister has burst, trim the skin round the area and apply dressing.

Ingrown toe nails

• Usually accompanied with infection of the nail fold
• Associated with poorly fitting trainers and badly cut nails

Treatment

1. Consult your doctor.
2. Try to jack up the nail with slivers of silver paper
3. Cut toenails in a square cut
4. A small "V" shaped nick in the middle of the nail may encourage the nail to grow inwards
   May require antibiotics or even a small operation

Periostitis pain

• Muscle pulls away from the bone, weak scar tissue forms which pulls away from the bone even on minimal exercise.
• Pain on the inner border of the shin bone
• Maybe acutely sore to touch

Treatment

1. Consult your doctor.
2. Rest, Ice and taping the leg.
3. Follow with alternate hot and cold soaks before returning to exercise
4. Start re-training on soft, level ground

Runner's Knee - Chrondromalacia patellae

Commonest form of knee pain in runners - an aching around the knee cap. Patella (knee cap) rubs against the joint as the knee is flexed

Causes

• Typically caused by a novice increasing mileage too quickly.

Treatment

1. Consult your doctor.
2. Treat with rest, ice and asprin
3. Strenghten quadriceps muscles - lie on a bed with the knee held straight. Lift leg gradually increasing the weights that are suspended from the ankle (1lb to 8lb). Lift the weights 100 times per day until the pain disappears. At this point restart training but avoid hills.

Shin Splints

Shin splints may indicate a stress fracture lurking, so it is important not to ignore the signs.

• Very common injury in all types of runners
• Painful swelling of the damaged muscles and tendons along the front of the lower leg between the two bones (fibia and tibula).
• Pain is present all the time when running.
• Pain will run along the edge of your shin bone affecting your running but not much trouble the rest of the time. If you have had the symptoms for a period of time and chosen to "run through it" then it is likely your leg will be sore most of the time.

Causes:

• Common cause is over-pronation - check the wear on the bottom of your trainers. There will be greater wear on the inner edge of your shoe. Either buy shoes to correct this or get insoles made up.
• If the beginner steps up their training too quickly

Treatment

1. Consult your doctor.
2. Locate the area of pain on both legs - sit with your knees bent to relax the calf muscle and press your fingers along the side of the leg to feel behind the edge of the shin bone
3. Apply a cold pack for 10 mins, 3 times daily (don't exceed the 10 mins)
4. Then apply anti-inflammatory cream
5. Stop running totally until the symptoms have cleared - although cycling can be undertaken as there is no strain on your legs.

Stitch

• Not really an injury as such but tell that to the runners who experience that sudden sharp pain in the abdomen or at the base of the ribs.
• Unfit runners/athletes can get a stitch or a fit runner who trains too soon after a meal, faulty breathing or due to the sudden onset of strenuous running.

Causes
Many causes have been suggested but it is thought it may be due to a spasm of the diaphragmatic muscles and a lack of oxygen.

Prevention

• Allow sufficient time between eating and drinking and training.
• Strengthen abdominal muscles with trunk curls or step ups.
• Practise correct breathing techniques while training

Stress Fracture

• These are tiny, incomplete breaks or crack in the normal bone.
• Normally caused by repeated pounding or trauma and often in the:
  • metatarsals in the ball of the foot
  • lower leg bones
  • May occur in the upper leg, pelvis and hip areas.
• Can have a stress fracture and not be aware of it - stress fractures can appear slowly and may seem like tendonitis but if pain persists get an x-ray and a second one if need be as the fracture may not show up on the x-ray for the first 2 week or so.
• Pain is usually gradual on onset and increases with running - usually a spot on the bone that is intensely sore upon pressure

Causes

• Increasing training too quickly, improper shoes or weakness in the foot.

Treatment

1. Consult your doctor immediately.
2. Rest, rest, rest!!
3. Don't run until the injury has totally healed.