With the end of Autumn nearing, comes some last minute outdoor runs before many of us are confined to a treadmill! Unsurprisingly, this is also the time of year that I tend to see an increasing number of clients with running-related injuries, namely Achilles tendinopathy and shin pain. Both presentations can be extremely debilitating, especially if you enjoy weight-bearing exercise such as running.
Let’s start with Achilles injuries, as I have already treated a number of these in the last few weeks. The Achilles tendon is the thickest and strongest tendon in the body and connects the calf muscles (Gastrocnemius and Soleus) to the ankle bone (calcaneus). A tendinopathy refers to an overuse condition which causes pain and localised damage to the tendon. This is commonly seen in the runner who has increased their mileage in a short time, with insufficient rest periods, and often inadequate footwear. A biomechanical assessment, preferably while running, will provide the clinician with valuable information pertaining to contributing factors. From this assessment, a tailored rehabilitation programme can be developed and, if warranted, footwear or orthotic recommendations can be made. As with any injury, early intervention will enable the most successful and long-term recovery but tendons are particularly notorious for slow healing due to the limited blood supply. If you start to feel discomfort or pain in the Achilles tendon region, seek clinical advice before the problem becomes chronic and harder to treat!
Medial Tibial Stress Syndrome/Medial Tibial Traction Periostitis, otherwise known as shin splints, is a painful condition that presents in the lower inside section of the leg. This is due to irritation of the tendons or muscles of the lower leg or the periosteum (a thin tissue that wraps around the shin bone). Pain will often appear at the onset of exercise, settle once warmed up and most clients will have tender shins and excessively tight calf muscles. As with Achilles tendinopathy, biomechanical errors are a common causative factor and can be addressed at the first sign of symptomatic onset. Inflammatory management (rest, ice, anti-inflammatory medication as advised by your pharmacist), taping and manual therapy can assist with symptom relief but is very important to address any underlying factors with either of these two injuries.
If warranted, I will refer onward to a Podiatrist to ensure all aspects of rehabilitation have been taken into consideration. So get out there and enjoy the endorphins and fitness benefits that running can provide but be sure to seek assistance if you run (excuse the pun) into any issues!
– Ali Wilson