It’s been a long winter season, but spring will be here soon. With the arrival of warmer weather, many people will return to outdoor activities for the first time in months. One of the more common activities for health-conscious adults is jogging. As beneficial as running is for good health, care must be taken after a winter layoff to avoid early season injury. The four most common lower leg injuries in runners are:
- Shin Splints
- Achilles Tendon Injury
- Plantar Fascitiis
- Stress Fracture
Shin Splints
The term “shin splints” (or medial tibial stress syndrome) refers to pain and tenderness along the medial (inside) aspect of the tibia (shin bone). While this ailment isn’t unique to joggers, running is one of the most common causes. Repetitive activity leads to inflammation of the perisoteum, (or lining) of the shin bone, which is quite painful. The muscles in the front of the shin may be involved as well. Treatment of shin splints includes use of the “RICE” regimen (Rest, Ice, Compression, and Elevation), and modifying activity. Runners affected by shin splints should decrease weekly mileage, cross train with other types of cardiovascular exercise, stretch, and consider use of anti-inflammatory medications. If symptoms persist, consult a physician to exclude more serious conditions.
Achilles Tendon Injury
The Achilles Tendon is located in the back of the lower leg, and attaches the plantar flexor muscle group (calf muscles) to the calcaneus (heel bone). Although the tendon is one of the thickest and strongest in the body, it is still vulnerable to injury, due to the excessive force it is subjected to during running. The most common Achilles tendon injury is tendonitis (or non-specific inflammation), caused by overuse. Tendonitis generally results when runners increase weekly mileage too quickly, or suddenly add hill training to the exercise routine. Treatment is generally conservative, using the RICE protocol. Also, anti-inflammatory medication, and shoe orthotics may be employed to decrease pain and help healing.
Plantar Fasciitis
Plantar Fasciits is an overuse injury of the flexor soft tissue (or the sole) of the foot. The condition involves heel pain that generally occurs after, rather than during exercise. Runners are vulnerable, as are women, overweight individuals, and workers that spend long hours on their feet. Treatment is usually non-surgical, with the RICE protocol, anti-inflammatory medication, gentle stretching exercises, and orthotics. In severe, unremitting cases, surgery may be required.
Stress Fracture
Stress fracture is an overuse injury. In runners, stress fractures most commonly occur in the feet, shins or hips. Stress fractures result from fatigue of the bone, generally related to repetitive motion. Intense, repetitive exercise leads to tiny microtrauma to the bone. Over time, without proper rest, the damage becomes cumulative, resulting in a painful, non-displaced fracture of the bone. Treatment is centered on rest. Failure to stop the repetitive activity can lead to a more serious, complete fracture, or chronic lower leg problems.
Prevention
Prevention of these common injuries of the lower leg is a matter of using good judgement when training. Runners need to use a common sense approach, and avoid over-exertion early in the outdoor running season. The following tips should also help:
- Choose your running shoes carefully.
- Consider using orthotics, if you have had foot or leg problems in the past.
- Always warm up and stretch before exercising. Focus stretching routines on the calf, hamstring and quadriceps muscle groups.
- Increase distance and speed gradually, by no more than 10% per week.
For more information, consult the American Academy of Orthopedic Surgery website.
