Physical Therapy and Common Running Related Injuries

How To Choose How Far and How Fast To Run

During the spring and early summer, many recreational runners are gearing up for longer and longer races leading into the fall marathon season. There are also those people that start running again for basic fitness, after taking the winter months off. What both examples have in common is that mileage and frequency are increasing. 

For those of us that live in West Michigan and other areas with lake effect snow or extreme cold, a bit of warm weather mixed with sun and blue skies elicits feelings of pure happiness and motivation for lots of movement. I can remember back in March of 2012 we had a week of 80 degree weather. I had just purchased a new Trek road bike and new clip-in road shoes, so I rode between 25-35 miles a day every day for a week. That sudden increase of mileage gave me acute achilles tendonitis. Even physical therapists do impulsive things like that when spring fever hits. The same is often true for runners. 

Increasing speed or mileage too fast can have many consequences.  Some common running related overuse injuries are:

  • Patellofemoral pain (Runner’s knee)
  • Medial tibial stress syndrome (shin splints)
  • Iliotibial band syndrome
  • Patellar Tendinopathy (jumper’s knee)
  • Greater trochanteric bursitis
  • Gluteus medius injury
  • Injury to tensor fascia latae
  • Achilles Tendinopathy
  • Plantar Fasciopathy

A common technique in running is the 10% rule. The 10% rule basically is to not increase your weekly mileage or speed by more than 10% at a time. 

In a 2014 study published in the Journal of Orthopedic and Sports Physical Therapy, researchers looked at the validity of the 10% rule. They looked at 873 new runners over the course of 1 year. Of theses 873 runners, 202 had some sort of injury. 

The researchers looked at injury in relation to how quickly running mileage was increased and what injuries occurred. They looked at mileage increases of 10% or less, 10%-30%, and over 30% mileage increase in the two weeks prior to injury.

The outcomes were what you would expect, in that an increase of 30% or greater had the highest injury rate. The injury rates were much lower in the 10% or less group.

The injuries that most commonly occurred in the greater than 30% group were mainly hip and knee issues listed below:

  • Patellofemoral pain (Runner’s knee)
  • Medial tibial stress syndrome (shin splints)
  • Iliotibial band syndrome
  • Patellar Tendinopathy
  • Greater trochanteric bursitis
  • Gluteus medius injury
  • Injury to tensor fascia latae

Some injuries NOT linked to the fast mileage increase were hamstring injuries, achilles tendinopathy, calf injuries, tibial stress fractures, and hip flexor strains. 

Just based on clinical experience, the injuries I see most commonly are iliotibial band issues and patellofemoral pain.  The knee, in my experience, is the path of least resistance for running injuries. (Some of the causes for overuse injuries can be linked to NOT following the 10% rule, which, based on this study, holds true.) Also, every runner I’ve ever treated has some strength, stability, or biomechanical issue that makes injury easier. Running doesn’t cause injury, but having a body not ready for what you’re asking of it does. 

If you’re a new runner or looking to increase mileage in preparation for a longer race, you need to get screened for the issues that could lead to injury. At Holland Physical Therapy we will look at your hips, core, knees, ankles, and feet for anything that could lead to injury. We will give you a specific program for running to make you the best version of you. Call us at 616-355-4284 or visit us at www.Holland-PT.com to get evaluated. The best runner is the runner who can train without injury.


Ford Reinink PT, DPT
Director of Clinical Operations for Holland Physical Therapy
ford.reinink@holland-pt.com

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