Osteopathy for Running Injuries
Can Osteopaths contribute to the rehabilitation process of running injuries?
Yes, an osteopath can help with running injuries, we regularly see runners, especially over the marathon training period who need some hands-on help and support. With the increase in running distances aches and strains tend to develop.
The basic running process is a repetitive pounding of pavements exposing your joints and muscles to constant impact. Any off-road running will also expose your muscles and ligaments to lateral movements. Repetitive demands and stress upon the body can often result in injury. At the end of the post, we offer advice on what you can do to prevent running injuries.
What Are The Common Running Injuries
It is estimated that 70% of all recreational and competitive runners will sustain an overuse injury in any given 12-month period.
The most common running Injuries
Knee injuries 42%
Patellofemoral pain syndrome (runner’s knee)
Iliotibial band friction syndrome
Patellar tendinopathy
meniscal injuries
Foot/ankle 17%
Plantar fasciitis
lower leg 13%
Tibial stress syndrome (shin splints)
Achilles Tendonitis
Source (SMA)
To achieve your optimal performance it is important to find the right balance. It is repetitive and demanding so injuries are common. In this blog, we outline some of the most common running injuries and how we can help. This is just one of many conditions that our Osteopaths can help with.
Runners Knee or Anterior Knee Pain
This is a very common running injury. The repetitive, demanding nature of running will cause additional forces through your knee. If there is a muscular imbalance this will cause irritation in the tendons on one side of your knee through knee cap (patella) maltracking.
What Part of the Knee is Damaged in Runners Knee?
You’re patella, caused by prolonged running strain. Symptoms of this injury are dull aching-type pain around the knee cap (maybe swelling). The pain will be worse upon loading the knee so walking up and down stairs, running a short distance (maybe 5 miles) and after a run either that evening or the following morning. You can find more in-depth detail on this in our blog Osteopathy and knee pain.
Can an Osteopath Treat Knee Pain?
Yes, seeing an osteopath can help you establish why you are experiencing pain and assess how your whole body is moving. Your Osteopath should assess your ankles, knees, hips, pelvic levels and spine, identify muscular imbalances and give hands-on treatment and give specific rehab exercises.
Plantar Fasciitis
Plantar Fasciitis can be caused by a sudden increase in running intensity, mileage or really tight leg muscles (calves and hamstrings in particular) that cause additional tension into the plantar fascia. In addition, a change in running surface causes an increase in compressive forces going through the foot and ankle. Moreover, if you have had a history of inversions ankle strains or ligament strains. It is also important to consider your footwear and whether it has not enough or too much cushioning or support.
Can Osteopathy Help with Plantar Fasciitis?
Yes, it would be worthwhile seeing an osteopath for an assessment, advice and specific exercises to optimise the recovery process. Fascia tissue heals relatively slowly in comparison to muscle as it is a different tissue composition. Therefore having a rehab plan to reduce your foot pain would be beneficial for your recovery.
Shin Splints
A dull achy pain down your shins that becomes progressively sharper aggravated by weight.
Shin splints can be caused by muscular imbalances, tightness and technique. If you are new to running and the compressive loading through the feet and ankles this could increase your risk of experiencing pains.
Do Shin Splints Go Away?
No, if you experience shin pains, do some gentle stretching for your shin muscles (tibialis anterior) and calf muscles. Rest and book an appointment with a specialist to get it checked out. Do not ‘push through it’ in this case, as you may damage the shin bones with stress fractures.
How do I Stop Getting Shin Splints?
Get expert advice to address the cause of your problem as it could be a problem with your ankles, knees, hips or posture. An Osteopath can give hands-on treatment to lightly stretch the muscles and articulate the joints and advise you on a rehabilitation plan to aid your recovery.
Achilles Tendonitis
Your Achilles tendon (AT) runs from the back of your heel to your calf muscles. Injury to the area may be caused by poor running technique, increasing your mileage and/or speed too quickly, and poor function of ankle, knee or hip joints. Tight calf and hamstring tensions are also known to aggravate AT.
If you are feeling pain and tenderness to touch along the back of the foot or above the heel (sometimes swelling) are normal symptoms.
What Causes Achilles Tendonitis to Flare Up?
It can be caused by excessive hill running or speed work, both of which stress the Achilles more than other types of running. If this occurs, rest from training initially to allow time for the tendon to recover.
Can Osteopathy help with Achilles Tendonitis?
Yes, an Osteopath will give hands-on therapy to optimise your recovery. We will look at all the possible causes before providing you with a solution to recovery.
Less Common Running Injuries
Hamstring Tendonitis
Typically you feel hamstring injuries straight away whilst exercising. You will feel a sudden pain whilst running in the back of your thigh or a deeper pain in your buttock. It will then be difficult to walk and straightening your knee will be painful. You may experience weaknesses and your hamstring will be tender to touch. Pain will be aggravated by squats, lunging and prolonged sitting.
Is Tendinopathy the Same as Tendonitis?
No, a tendonitis is where your tendon becomes inflamed from movements which overload your tendon suddenly. This causes micro-tears to the tendon (Bass 2012). A Tendinopathy is the degeneration of your tendon through chronic overuse such as repetitive strain injuries. When this happens it is important to rest and allow the body to heal.
How do you Treat Hamstring Strain and Tendonitis?
A combination of muscular strengthening, light stretching and hands-on therapy. Everybody is different and so their rehab plans should be too. However, typically we suggest to keep moving but try non-weight-bearing activities like cross trainer or swimming for 2 weeks after the injury onset. It may also be good to do muscular strengthening and tendon loading exercises and return to activity slowly. To optimise your recovery we offer hands-on osteopathy, massage and Pilates exercises. Also, nutrition can optimise healing with the synthesis of collagen production. Adopting an anti-inflammatory diet or talking to our nutritionist would be worthwhile. At Wellthy Clinic we want to take proactive steps to prevent a recurrence by questioning why did it happen in the first place? Could your hip mobility be improved? How is your core, hamstrings and glute strength? How is your upper back and ankle mobility?
Does Hamstring Tendonitis Go Away?
Yes, you will recover but it will take time to heal. Recurrence rates are high (30% of people) and your tendonitis could also develop into a tendinosis which has longer healing times so it is important to have an effective rehab plan.
How Long Does a Hamstring Tendonitis Last?
Typically a tendonitis can take anywhere from a few days to 6 weeks to heal depending on the individual. However, it is important not to repeatedly strain the tendon otherwise this could cause a Tendinosis which could take between 6-10 weeks (early stage) or 3-6 months (chronic stage) to heal. A tendonitis is where your tendon becomes inflamed from movements which overload your tendon suddenly. This causes micro-tears to the tendon. A Tendinopathy is the degeneration of your tendon through chronic overuse such as repetitive strain injuries. When this happens it is important to rest and allow the body to heal. Therefore seeing an Osteopath to get diagnosed correctly and formulate an effective rehab plan is important for effective healing, preventing recurrence and stopping progression into a tendinopathy.
Is it OK to Run on a Sprained Ankle?
Not really. We would advise resting (stop running) for the first 2 weeks to allow the body a chance to recover. In our experience, hands-on Osteopathy with ankle and foot articulation and muscle stretching will optimise recovery. In addition to, ankle strengthening rehab exercises, stretching and non-weight-bearing exercises.
Do Ankle Sprains Ever Fully Heal?
Once you have sprained your ankle the injury reoccurrence rate is much higher so it is important to take proactive steps to rehab effectively. At Wellthy Clinic we would give you a structured rehab plan to get you back as quickly as possible but with a stronger foundation to reduce the likelihood of an injury reoccurrence. A more in-depth explanation of foot pain can be found here.
How Do You Know if you have Pulled Your Hip Flexor?
It’s typical with athletes who engage in a lot of forceful flexion movements. You may feel pain whilst you are exercising or afterwards. Hip flexion will be painful and your muscles at the front of your thigh will be tender to the touch.
Can I Exercise with a Hip Flexor Strain?
Yes but initially it may be better to do some light stretching and rest for a week before returning to activity. Having a rehab plan to avoid future recurrence would be advised. Improving your core strength through Pilates and addressing hip mobility through hands-on Osteopathy would be beneficial.
How Do You Treat a Strained Hip Flexor?
A combination of core strengthening and light stretching of your hip flexors and hamstrings is always a good place to start. That said everybody is different so hands-on Osteopathy and Pilates rehab exercises specifically for the individual will lead to the best results and speed up your recovery.
You can recover from all these injuries given a well-structured sports injury rehabilitation plan and time. At Wellthy Clinic we will assess your posture, joint and muscle movements to identify imbalances and leg lengths. Give hands-on therapy to stretch the muscles, articulate joints, and manipulate joints (only if appropriate and with consent).
We will advise on the best warm-ups and cool-downs. Also structured training programs that don’t progress too quickly (time, intensity or distance). Build up your core strength and flexibility. Also, discuss your running technique and get your race ready!
What You Can Do To Prevent Running Injuries
If it is a long time since you have participated in any physical exercise we recommend that you consult with a professional first.
Always warm up before running (increased muscle viscosity reduces the chance of injury)
Start with small distances and gradually build up in speed and distance (no more than 10% a week)
Hydrate before running (hydrate whilst running once you reach greater distances)
Allow 24 to 48 hours of rest between runs at the beginning
Do not run during the hottest parts of the day (this will lead to dehydration) Dehydration results in tighter muscles and an enhanced chance of injury.g
Start by running on smooth even surfaces (you can slowly add different terrain once you have built up strength and technique)
Invest in shoes that are specifically designed for running
Begin to recognise the difference between ache and pain (ache means you have worked the body and muscles well, pain points more towards injuring the body)
Stop running when you feel any sharp pain and seek professional advice
Join a running club, the wealth of experience and advice will be invaluable to your progression as a runner.
Pilates is really beneficial to support and help increase your running performance.
References
Bass (2012) Tendinopathy: Why the Difference Between Tendinitis and Tendinosis Matters International Journal Therapy Massage Bodywork 5 (1) 14-17 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312643/
Goom et al (2016) Proximal Hamstring Tendonpathies: Clinical Aspects of Assessment and Management Journal of Orthopeadic and Sports Physical Therapy. 46 (6) 1-32 https://www.researchgate.net/publication/301343168_Proximal_Hamstring_Tendinopathy_Clinical_Aspects_of_Assessment_and_Management
Mason et al 2007 Rehabilitation for injuries Cochrane review https://pubmed.ncbi.nlm.nih.gov/17253514/
Matthew Glithero
Matthew Glithero is an Osteopath (MOsT) & Pilates instructor with a background in Sports Science (BSc).