Plantar Fasciitis

The Most Common Injuries in Runners

Lower leg and overuse injuries like plantar fasciitis and shin splints are common in runners. These injuries are often due to overloading tissues by increasing distance, speed, or elevation too quickly, or by changing your primary running surface, or type of shoe. In addition, not allowing appropriate rest after workouts can overload tissues. Training properly and understanding the early signs of injury can help you better enjoy your sport and avoid a more serious problem with significant downtime and recovery.

Symptoms and Risk Factors for Plantar Fasciitis and Shin Splints

Plantar fasciitis is simply pain in the bottom of your feet and can occur in one or both feet near the base of the heel and into the arch. Usually characterized by pain when standing and walking, especially after periods of rest or when doing a lot of activity.

Some risk factors include decreased ankle and big toe range of motion, pronated foot posture, higher BMI, walking on hard surfaces, and changes in training.

Shin splints are divided into two categories:

Medial tibial stress syndrome (MTSS) is what we typically consider shin splints. They cause diffuse pain along the front of the shin bone.

Stress fractures can occur in many different bones, but are most common in the shinbone and characterized by pinpoint pain at one spot. Some high-risk stress fractures include the head of the femur, navicular bone, and anterior tibia. These are high risk due to the possibility of developing a true fracture.

Risk factors for shin splints include increased stress or overload on bones, low calcium and vitamin D, poor diet, and not allowing time for healing. However, if there is a concern of a possible stress fracture, talk to your doctor about possible diagnostic imaging to determine the extent of the injury.

At-home Treatments and When to See a Doctor

Follow these tips if you start to feel symptoms of an injury:

  • Stop running and take some time off. It is much more beneficial to take a few days off than to try and push through an injury.
  • Try to figure out what changed recently that may contribute the injury:
    • Did you change shoes or try a new type of shoes?
    • Have you been pushing your elevation or speed?
    • Have you significantly increased your distance?
  • Use your judgment to determine the pain is minor or something that needs further treatment. Consider these factors:
    • How is your body responding to load, either walking, running or jumping? If you’re having pain during high-impact activities, and especially if you have pain during low-impact activities like walking, consider consulting a medical provider.
    • If you are able to tolerate jumping for 3-5 minutes without any pain, it is usually okay to try running. However, if you have increased pain with jumping, see your medical provider.

    Preventing Injuries

    • Avoid training errors. A good rule of thumb is to increase intensity, speed, distance, and duration by no more than 10% overall each week. For example, if you are increasing distance running, keep your elevation and speed for the week the same. Planning a slower build-up will allow your tissues to adapt and grow stronger to support the increased load.
    • Cross train with both muscle strengthening and control exercises. Some good muscle groups to consider strengthening are calves, glutes, hamstrings, and quads.
      • For plantar fasciitis, try single-leg heel raises with the toes on a towel to help load the plantar fascia.
      • For shin splints, strengthen the muscles around the ankle and lower leg along with control exercises, like balance exercises.
      • Perform strengthening exercises for 3 sets until fatigued (including loss of form) with a goal of 10 – 15 reps for each set, waiting 3-5 minutes between exercises. Strength training should be done in a slow and controlled manner.

      In general, running should not cause pain when you train thoughtfully, increase gradually, and cross train muscle groups. Injuries typically occur when you don’t give your body enough time to adapt to new stresses. Although small injuries can often be managed with rest, it is important to know when to ask for help and seek further treatment to prevent worsening injuries. The Polyclinic Physical Therapy department can help runners develop a robust training program to prevent injuries or recover from them. Learn more here or call us at 206-860-2210.

November 28, 2018 | by Molly Gries PT, DPT, OCS, CertMDT