By Jack Redden, APA Physiotherapist @ Total Physiotherapy

With the city to surf just around the corner and many people well into their training, or some still contemplating starting, we have outlined some common lower limb injuries to be wary of and what to look out for in your training.

Achilles tendionopathy 

This condition occurs through degenerative change to the Achilles tendon which connects the calf muscles to the heel bones. It is integral in transferring force when running. Studies have shown the Achilles tendon can bear more that 2x our body weight when running and is therefore the largest and strongest tendon in the body. This also leads to it being a common site for injury in runners. Injury can occur at the “midpoint” of the tendon (just above the heel) or “insertional”, where pain is located on the heel bone. Pain will often occur at the start of a run, improves a little as the tendon ‘warms up’ and then increases as you increase speed, distance or tackle hills or stairs. This is a tricky condition to manage and can take weeks or months to settle if not managed correctly. Foot biomechanics, running loads as well as strength and muscle length deficits must be addressed in order to return to pain free running. 

Shin splints

Shin splints or medial tibial stress syndrome refers to pain occurring with increased running loads. Pain will be present along the inside of the shinbone and represents around 5-6% of all running related injuries. Pain is caused by stress to the bone as a result of the repeated forces applied to it from the muscles and tendons attaching to the bone. Repetitive ground reaction forces from your foot striking the ground when running also causes stress to the bone. This condition will often be sore to touch/press and will usually be sore towards the end of a run. If left untreated Shin splints may develop into a stress fracture, requiring a significant amount of rest and no running. In terms of treatment and management, the muscles which attach onto and support the tibia must be strengthened to allow better shock absorption and running loads must be modified and adapted to allow the bone stress to settle whilst still allowing the bone to strengthen. To best manage this condition you will need to work closely with a Physio experienced in managing running injuries.

Plantar fasciitis

Plantar fasciitis is a condition which relates to the connective tissue which runs from your heel bone to your toes. Pain is common in the mornings and often worse following increased activity the day before. Those with a low arch or a high arch are more at risk due to excess strain on the attachment on the heel bone. Taping can be very effective with this condition in order to support the plantar fascia and allow short term pain relief. Weakness deficits may also be contributing, altering the way you are running and walking which results in more load being placed on the plantar fascia. Proximal tightness of the calf, hamstring and gluteal regions is also commonly associated the plantar fasciitis and must be addressed. 

Patello-Femoral Pain Syndrome

Patello-Femoral Pain Syndrome or runner’s knee is a broad diagnosis used to describe pain around the kneecap (patella). Causes of pain will vary between people and it is therefore important to determine what is causing each individual’s pain and how to appropriately manage this pain.  Your pain may be a result of one or many different factors so a thorough assessment must be undertaken to determine the cause.

If pain is limiting your running, get it looked at, get on top of it and keep running! Good luck with your City to Surf preparations!