While athletes risk injury in many forms, several specific injuries occur frequently in the running community: plantar fascitis, Achilles tendonitis and runner’s knee.
Literally speaking, plantar fascitis is an inflammation ("itis") of the plantar (bottom of the foot) fascia. The most common symptom is pain in the bottom of the heel when first arising in the morning or after being seated for a period of time. The pain usually dissipates fairly quickly after moving about, and, in some cases, may return later in the day after prolonged standing. Many people describe the first symptoms as feeling like a "stone bruise" on the bottom of the foot. When left untreated, these symptoms may accelerate until nearly all activity presents acute pain.
The plantar fascia is tough, much like a ligament, and spans the arch of the foot from the heel bone to the ball of the foot. When a foot contacts the ground, the arch "unlocks" so that it can absorb shock and adapt to uneven terrain. As the arch drops, the plantar fascia stretches. If the calf muscle is a little bit tight, it places additional stress on the plantar fascia as the heel comes off of the ground. Micro-trauma occurs and sets the stage for the inflammatory process to begin.
Achilles tendonitis is an inflammation of the Achilles tendon. This large tendon attaches the calf muscle group to the heel and, not surprisingly, is a common site of injury in runners. The first symptoms include a vague, dull, aching in the tendon after running. Also, stiffness and aching in the tendon upon first arising in the morning occur frequently. If ignored, the symptoms usually worsen until running initiates pain, which worsens when sprinting. If left untreated, the symptoms eventually persist at all times, and the individual cannot run due to acute pain. Although the primary cause of Achilles tendonitis is a lack of flexibility in the calf muscle group, stretching these muscles during an acute flare up only makes things worse. This is one time when stretching must be delayed until the acute soreness subsides. If a runner catches symptoms early, a short rest of about 2 weeks often settles things down. Pain that persists for anywhere between 3 and 6 weeks usually requires 6 weeks or more of rest to resolve. Symptoms that persist for 8 or more weeks often bring with them thickening and scarring of the Achilles tendon, making it weaker and at greater risk of rupture in the future.
Really a catch-all term, runner’s knee refers to pain in and around the knee cap. This odd shaped bone the patella is an integral part of the quadriceps muscle on the front of the thigh. The patella rests in a groove on the femur and acts as a fulcrum to improve the angle of pull of the quadriceps muscle, which attaches to the lower leg bone (tibia) through a thick tendon called the “patellar tendon”. Dull aching in and around the patella after running usually indicates runner’s knee. Sometimes, the knee may feel stiff, as well, due to swelling of inflamed tissues. Depending upon the biomechanics of the individual runner, the pain may be localized to one area of the patella or another. When this happens, it is often referred to as “patellar tendonitis”. If the biomechanics of the runner are such that the patella does not sit properly in its femoral groove, the underside of the patella wears down becoming rough over time. This deterioration is known as “chondromalacia patella”. As with most inflammatory processes, if left untreated, the symptoms generally get worse, and, over time, the involved tissue deteriorates and scars.
Although runners have a difficult time avoiding injuries due to the nature of impact and repetition, certain regular practices can aid in maintaining health. The treatment strategies given for each injury will help eliminate most problems.