Running is a sport that has grown in popularity in our country in recent years. More and more people start recreational running every year. However, 50-85% of runners suffer from some kind of injury, which causes them to temporarily abstain from their favorite sport.
The most common running injuries are patellofemoral pain, Achilles tendinopathy, proximal hamstring tendinopathy, iliotibial band syndrome, fatigue fractures, and plantar fasciopathy.
The causes of running injuries have to do with the athlete’s idiosyncrasy and genetic predisposition, psychosocial factors, sleep quality, physical characteristics such as muscle strength and elasticity, joint range of motion, joint biomechanical characteristics and the training load.
Therefore, when a runner starts physiotherapy to return to running after an injury, a detailed assessment should be performed to detect the mechanism that led to the onset of symptoms.
The assessment begins with a thorough history taking:
- History of injury: past and current
- Type of training (frequency, intensity, distance, terrain, etc.)
- Quality of sleep, life stressors
- Diagnostic tests, imaging
- Shoe type, orthoses
The assessment continues with the clinical examination, which includes musculoskeletal examination and qualitative running analysis on the treadmill.
The running analysis can reveal biomechanical errors, which are responsible for many of the running injuries. Some common biomechanical errors are:
- Contralateral pelvic drop (fig. 1), associated with patellar pain, tibial stress fracture, iliotibial band syndrome and gluteal medius tendinopathy
- The crossover gait (Fig. 2), associated with medial knee pain, iliotibial syndrome, plantar fasciopathy, posterior tibial tendinitis and stress fracture in the 4th and 5th metatarsals.
- Overstriding (fig. 3) associated with patellofemoral pain, tendinopathy of the patellar tendon and proximal hamstring tendinopathy.
The runner’s rehabilitation program is based on correcting motor patterns, properly strengthening muscle groups, patient’s education, modifying the training load, and changing footwear or using orthopedic footwear when needed.