The Why's and Wherefore's of Common Running Injuries

For many, running is a necessary part of a healthy lifestyle. However, as running involves greater forces to our ‘chassis’ than many other types of aerobic activities, most runners eventually familiarize themselves with the causes, prevention and treatment of running injuries. In a study I did some years ago as a recent graduate, with Joseph C. D’Amico, DPM, Professor and Former Chair Division of Orthopedics and Pediatrics at the New York College of Podiatric Medicine, we found that over 80 percent of runners complained of pain. Though our sample population was skewed toward younger runners, in my experience the numbers are higher for older age group runners.

We’re all born with hereditary imperfections. Being bipedal (walking on two legs), brings with it certain weak points. After all, walking on four legs provides superior balance and support, some of which was lost when our ancestors climbed down from the trees, gradually stood on two feet and left for the African plains.

Uterine position may subject the lower extremities to deforming forces. Due to its plastic nature, the lower extremity is shaped by the forces imposed on it. During the latter part of pregnancy, the left limb often crosses over the right and presses against the mother’s spine. This may result in abnormal curvatures to the leg, ankle or foot.

Thus, as a result of heredity or uterine position there are often characteristics of the foot at birth which, to some degree, may be retained in later life These may lead to injuries when subjected to the stresses of running. Depending on the degree of these ‘imperfections’, the stresses and strains placed on the lower extremities in large part determine whether one develops pain or injury.

Now let’s look at how we may stress ourselves during training, taking us beyond the body's ability to adapt.

Common Risk Factors

Overuse or training errors

• The Terrible Too’s: too much, too soon, too often, too fast

• Intensity

• Miles per week, overuse, rapid increase

• Prior running injury

• Incorrect shoe

• Mobility or flexibility issues

• Strength issues

• Surface issues

• Abnormal biomechanics.

Next time I’ll discuss how running injuries are approached.