Two common running injuries and how to treat them

We all know that running is great for our bodies and minds but it does come with the potential for injury especially if you are overtraining or using incorrect technique. Get back on the pavement faster with these tips on treating the two most common running injuries.

Two common injuries runners experience are Plantar Fasciitis and Achilles tendon pain. Unfortunately they are often poorly understood and frequently misdiagnosed resulting in unnecessary pain and time off training.

1. Achilles tendon pain

While historically Achilles tendonitis was considered an inflammatory problem, the actual pathology of Achilles tendon pain is far more complex. Achilles tendon problems such as inflammation and acute pain are most commonly reactive, where the load placed through the Achilles is not beyond its capacity to repair and the body is able to recover. 

However where there is extreme load or a reactive tendon is repeatedly stressed while trying to recover, cellular changes within the tendon lead to a gradual breakdown of the tendon structure eventually leading to a weak degenerative tendon. Once your Achilles gets to this stage, your body’s healing response is gradually supressed and the prognosis becomes significantly worse.

What causes Achilles tendon pain?

The Achilles tendon is easily overloaded due to its dual role as a propulsion force generator and a shock absorber. Variations in foot posture and gait can mean that the foot is less efficient at performing either of these functions. Over thousands of steps this increased stress leads to repetitive overload. Any pain in the Achilles particularly where it coincides with increases in training loads, changes in footwear or training surface, or changes in gait should be taken seriously.  

How is Achilles tendon pain treated?

Achilles pain - perhaps more than any other injury - needs to be assessed and diagnosed accurately. While early signs of pain and tightness in the Achilles are often easily dealt with by managing load, the structural changes to the Achilles that characterise tendinopathies are often very hard to manage and require long periods of load modification and treatment. Always seek a professional opinion for management of Achilles pain.

2. Plantar fasciitis 

Do you have pain in your heel or arch? It could be plantar fasciitis. Plantar fasciitis (or plantar fasciopathy) describes injury to strong sling of connective tissue that lies under the medial arch of the foot. It presents as pain in the heel and/or arch.

What causes plantar fasciitis?

The plantar fascia acts like a spring, supporting the medial arch and supplying energy to your feet.  Much like with Achilles tendon pain, the plantar fascia is frequently overloaded by overtraining, incorrect footwear or improper technique. Having high arches can also impact on the foot’s ability to absorb shock. The resulting irritation of the fascia, typically where it connects to the heel bone, creates a painful inflammatory response that is sometimes accompanied by tearing of the tissue structure. Once inflamed, the plantar fascia is easily stressed and aggravated. Standing on hard surfaces in bare feet or after a night’s sleep can easily stress and aggravate an inflamed plantar fascia.

How do I treat plantar fascia?

The key to treating plantar facsia is to remove the load on the arches of your feet through rest and modification including orthotics, taping and correct footwear. In the early stages of treatment, pain management is critical including stretching, ice, and some form of soft tissue therapy. Finally it’s critical to strengthen not only the arch of the foot but also the other load dispersing structures of the lower limbs such as your calves and hips. In stubborn cases when these conservative methods fail, a corticosteroid injection at the discretion of a sports physician is often highly effective.

Pain when running? Contact your local Back In Motion practice to discuss your free initial injury assessment. See also: What are overuse injuries?

Michael Chamberlain - Practice Director and Physiotherapist – Back In Motion Patterson Lakes

Mick joined the practice in 2008 while completing his Bachelor of Physiotherapy with Honours at Monash University, and took on the role of Practice Director in 2012. After graduating with First Class Honours, Mick has gone on to develop his passion for sports physiotherapy and rehabilitation by undertaking a number of post-graduate courses on bio-mechanics and running injuries. Mick played state representative football and baseball as a junior athlete, and remains actively involved in sports through his work with a number of local sporting clubs and organizations, including as the physiotherapist for the VFL Frankston Dolphins.