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1. Sciatica
Sciatica is caused by a strain to the
sciatic nerve, along rope like nerve that starts on each side of your lower
back and winds its way down your buttock and the back of your leg to your
foot. Though strains can have many causes, sciatica in the runner
tends to be brought on by the constant jarring of running, combined with
flat feet, high arches, knee problems and leg length discrepancies.
The initial pain is subtle: a dull
ache in your lower back, buttock or the back of your thigh. It may
subside for several hours, but it returns with each run.
To help prevent sciatica, keep your
spine flexible by stretching your lower back muscles as part of your warm-up
and cool down. Strengthen your abdominal muscles because they lend
support to your back.
If you feel you might be developing
sciatica, stop running. To speed recovery, apply moist heat to the
tender area.
2. Runner's Knee
Runner's knee occurs when the kneecap
becomes misaligned and rubs on an underlying surface of cartilage.
Usually the pain is described as a soreness around the kneecap; it is aggravated
by running or by climbing stairs.
In most cases, you can relieve runner's
knee with rest, proper shoes and a good training regimen. When the
pain is gone, you can resume running, but intersperse it with walking.
Stay on level surfaces and avoid hills and stairs. Don't do deep
knee bends. To forestall further injury and strengthen your quadriceps
muscles, which give muscular balance and support to your kneecap, add some
progressive resistance exercises (with your knee extended).
After exercising, ice your knee for
8 to 10 minutes. In the evenings, apply moist heat.
3. Iliotibial Band Syndrome
The iliotibial band is sheet of connective
tissue that runs down the outside of your thigh from your hip to the side
of your knee; it acts as an important stabilizer for your knee.
Iliotibial band syndrome (ITBS) is
a friction injury caused by the iliotibial band rubbing over the outside
of the knee, a normal motion that becomes a problem under the pressures
of hard running. The initial treatment is rest.
ITBS can result from a number of causes:
bowed legs, excessive pronation (turning in of your foot) and leg
length differences. Hard downhill running or excessive speedwork
can precipitate the condition. So can a single hard race of 10-K
or longer. Running exclusively on the same side of the road can bring
on ITBS in the curbside knee.
The best course for recovery is to
stop running immediately. Rest for two weeks. Meanwhile, reduce
inflammation by icing three times a day. Begin a stretching program
to loosen the band.
Before you try running again, check
your shoes to see if there's excessive wear on the outside of the heels.
If there is, buy new ones with ample heel support and rear foot cushioning.
At first, run only on soft surfaces. Avoid hills and speedwork.
If your knee hurts at any point in the run, stop immediately and stretch.
Ice the knee and try running again the next day after more iliotibial band
stretches.
4. Muscle Strains
Hamstring. An Acute strain of the
hamstring muscle is a classic example of a muscle tear. It is often
dramatic-a sudden, searing pain and tightness at the back of your thigh
accompanied by the inability to bear full weight on the affected limb or
to bring it through the normal range of motion.
Two factors usually lead to this injury:
(1) strong quadriceps muscles but weak hamstrings, and (2) lack of flexibility
in the hamstrings. To prevent hamstring strains, use weight training
to strengthen your quadriceps and hamstrings equally. And with each
run include a warm-up and cool-down with stretches for the hamstrings.
If you do strain a hamstring, check
with your doctor before running. Once he gives the okay, start with
short jogs; then, very slowly and cautiously increase the number of jogs,
and the distances you cover each day. Before doing high-speed running,
be sure that the power, strength and endurance o the injured leg is equal
to that of the other leg.
Quadriceps. The quadriceps muscles
lie on the front of the thigh and are the principal stabilizers of the
knee joint. These four muscles are more powerful than the hamstrings
and are less frequently strained, but many be torn by an explosive sprint.
Use the same methods as for preventing and treating hamstring strains.
Calf Strain. A strain of the calf
muscles can strike at any time, especially if you're older than 35.
Occasionally your calf will signal trouble by cramping a few ties, but
most often the strain will occur without warning.
The standard treatment for a calf
strain is to apply ice and a compress and to elevate the injured leg.
Use crutches to rest the muscle. Within the limits of comfort, very
gently stretch your calf and point your toes.
For a first-degree or a mild second-degree
strain, start walking normally - no limping allowed - with heel
lifts in both shoes. A third-degree tear will most likely require
physical therapy.
5. Achilles Injuries
The Achilles tendon is a tough, elastic
cable through which the muscles of our calf transmit force to your foot.
Injuries to it come from sudden tearing or microtearing (tendinitis).
Sudden tearing that leads to partial or even total rupture is triggered
by an isolated incident, and it often requires surgical attention.
Microtearing, signaled by gradually
building pain, can progress to partial and even total rupture if there
is not healing. Symptoms include pain and stiffness that are at their
worst when you awaken. The pain diminishes as you warm up, and it
may even disappear when you run. When you cool off, though, the pain
returns. The next day you're even stiffer.
Most injuries to the Achilles tendon
come from improper footwear, gout, inadequate flexibility or severe, uncorrected
pronation. The key to recovery from microtearing is rest and modified
exercise with gentle stretching. Follow this procedure for a week
to 10 days. When you resume running, build up your mileage gradually,
train on alternating days, avoid hill running and make sure you have proper
shoes.
If your injury has led to partial
or total rupture, cease running and see your physician. Follow his
advice for recovery and rehabilitation.
6. Ankle Sprains
Ordinary sprains - stretching or partial
or complete tears of the ligaments surrounding the ankle - often occur
in runners who run on soft or uneven surfaces.
The first thing to do if you sprain
an ankle, however slight the sprain, is to stop running. If the pain
disappears completely after several hundred yards of walking, it's usually
safe to resume running. If the pain does not subside, forget the
rest of your workout.
Apply ice to the affected area as
soon as possible and elevate your ankle. Place ice packs on the swollen
are for 20 to 30 minutes every 4 to 6 hours. If the pain persists,
continue the ice treatments for two to three days. When the ankle
is not wrapped in ice, use an elastic bandage to give the weekend ligaments
some support.
A serious sprain may require the use
of crutches or a cane to aid in walking. If swelling persists longer
than two to three days, have an X ray taken to rule out the possibility
of a fracture.
7. Shinsplints
This term can refer to any of three
types of pain in the lower leg: anterior shinsplints, stress fracture of
the tibia and posterior shinsplints.
Anterior shinsplints, characterized
by pain on the outside of your lower leg, usually result from injury to
your shin muscles. A frequent cause is the extreme difference in
strength between shin and calf muscles. You can help prevent this
injury by strengthening your shin muscles. Here's one way to do it:
Fill a bucket with water and wrap a hand towel around the handle.
Then sit on a tabletop and dangle your legs over the side. Next,
place the bucket handle over the the tongue of your shoe and slowly bend
your ankle to raise and lower the bucket 10 times. Rest; then do
two more sets of 10.
If you are injured, stop running;
switch temporarily to another activity. When you return to running,
build your mileage gradually.
A stress fracture of the tibia is
the probable injury if touching the hard bone on the inside of your lower
leg causes pain. Usually these fracture occur when you suddenly place
repeated jarring demands on your legs. The treatment for a stress
fracture is the same as that for anterior shinsplints. It will take
from six weeks to several months to heal.
Posterior shinsplints, dame to the
muscles on the inside (medial) portion of the lower leg, cause pain in
the soft tissue behind the bone. Most come from over pronation.
Should you feel this kind of pain while running, stop. Resume running
only when you can do so without pain. Switch to bicycling or swimming
and strengthen your muscles with exercises. Consider using arch supports
to keep from overpronating.
8. Plantar Fascia.
The plantar fascia is a band of tough
connective tissue that runs from the base of your toes to your heel bone
and supports the bottom of your foot. Planter fasiitis occurs when
this band tears near the bottom of the heel. This injury is most
common in runners who overpronote or who have high arches or flat feet.
Initial treatment includes taping your foot and applying ice.
Pain from plantar fasciitis starts
in your heel and then radiates into the midsection of your foot.
Usually the pain is sever in the morning and as you start to run, but it
becomes more tolerable as you walk or run. But an hour or so after
you stop running, the pain returns. Plantar faciitis worsen
gradually; so early recognition can prevent a serious case.
When you first suspect you have plantar
fasciitis, check your running shoes. If a shoe fits properly and
has a flexible sole, sturdy heel counter, proper Achilles cushion and adequate
toe box and heel lift, it can help absorb the stresses of normal running.
If it doesn't have those features, it can cause injury - so discard it.
To relieve discomfort from plantar
fascilitis, tape your foot before running. After running, use an
ice massage. For additional relief, consider using a customized orthotic.
If, despite treatment, your pain becomes severe, stop running and switch
to another sport until you can determine the cause.
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