Dr. Kevin Toss DC, DACBSP
Diplomate American Chiropractic Boards Sports Physicians
Staten Island, NY - 718-966-7000
Clifton, NJ - 973-777-2536
Usual symptoms of this running injury include pain directly under the kneecap. Stair climbing may cause knee pain. Such symptoms are associated with conditions called patellar tendonitis and chondromalacia patella.
The biomechanics of running involve almost every major muscle of the upper and lower limb. For this reason, running is associated with a plethora of injuries. The most common running injuries involve the hip, knee and ankle regions and are collectively known as the “Big 5”.
Heel Pain - Plantar Fascitis
Plantar Fascitis is a condition that can result from excessively tight calf muscles resulting in the pulling or the Achilles tendon from behind the heel. This stresses the attachment site of the tendons on the bottom of the foot causing heel pain. Flattened arches also contribute to the pulling of the tendons on the bottom of the foot to the point of causing a plantar fascial pain syndrome. Custom molded orthotics usually help to alleviate such pain, but prolonged pulling of these tendons on the heel can lead to bone spur formation that causes pain with every step.
With plantar fascitis, the person feels severe pain in the morning after having slept all night with the foot relaxed in a plantar-flexed (pointed down) position. This causes a sensation of ripping or burning in the foot or heel with the first few steps after getting out of bed.
Ilio-Tibial Band Syndrome
The ilio-tibial band is a long tract of fibrous connective tissue that stretches from the pelvic bone to the outer part of the shin. It has little contractibility and thus little flexibility. Because of this, it rarely shortens during movement, however, it tends to slide forward and backward across the knee joint creating friction, inflammation and pain. This is commonly seen in both runners and cyclists as the hip and knee repetitively flex and extend during striding or pedaling. The pain can be anywhere along the outer edge of the thigh musculature to the outside part of the upper shin where the band attaches.
With ITB syndrome, the friction point is at the lateral aspect of the femur. Note the shift in position of the iliotibial band from anterior to posterior as the knee moves into flexion, drawing the iliotibial band across the prominence.
Shin splints is a term used to describe any condition that causes pain in the front of the tibia (shin) while performing activity such as running, walking or biking. It is most commonly the tibialis anterior muscle that becomes extremely tight and inflamed causing symptoms that range from a throbbing ache to severe intense pain in the lower leg. The tendinous attachment of the muscle will actually pull on the covering of the bone, called the periosteum, casuing a serious and painful condition called periostitis. In rare cases, microfractures can form in the lower leg if left untreated.
The Achilles tendon is extremely vulnerable to overuse injury due to running and poor foot mechanics. The tendon sheath becomes inflamed and nodules of scar tissue form within the tendon itself. In the absence of treatment, the tendon starts to degenerate and fray until reaching a threshold at which stress and overload cause eventual rupture of the tendon requiring surgery.