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Common Running Injuries
By Shawn Williams

August 17, 2002 - Achilles tendonitis and plantar fasciitis are two different injuries that are very commonly experienced by runners. Achilles tendonitis occurs when there is an inflammation of the Achilles tendon, which is a tendon that connects the muscles of the calf to the heel. Plantar fasciitis is an inflammation of the plantar fascia, which is a type of connective tissue (CT) band that covers the muscles of the bottom of the foot. The plantar fascia supports the arch of the foot by acting as a bowstring that connects the ball of the foot to the heel. During running, both the Achilles tendon and plantar fascia become taut during the different phases of the running cycle. Due to the repetitive nature of running, the plantar fascia and/or the Achilles tendon may undergo excessive stress causing micro-tears in the CT, thus resulting in inflammation. These tears can eventually be covered with scar tissue, which will only aggravate the problem.

Overstraining has a negative impact on the systems that are overstressed; therefore, change or increase in activities is usually what causes most running injuries. Possible causes include 1) Poor Biomechanics (ie. excessive pronation), 2) Sudden increases in intensity of training (ie. too many hill or too much speed too soon), 3) Defective support from running shoes, and 4) Insufficient flexibility or strength (ie. tight calf muscles).

In order to properly diagnosis running injuries, the doctor should take a medical history and ask about the symptoms, while examining the foot. The classic sign of plantar fasciitis is heel pain with the first few steps in the morning. However, the doctor can eliminate many of differentials if the patient complains of pinpoint pain /tenderness when touching the sole or heel. In conjunction with the physical exam, other testing may include an X-ray or bone scan of the foot to help rule out stress fractures of bone spurs.

Indications of Achilles tendonitis are dull or sharp pain, redness, and heat anywhere along the back of the tendon, with limited ankle flexibility. On physical exam, a doctor will look for tenderness along the tendon and for pain in the area of the tendon when the patient stands on their toes. As with plantar fasciitis, imaging studies can also be helpful. X-rays can help diagnose arthritis and an MRI will demonstrate inflammation in the tendon.

Chiropractors can attack these problems from many different angles via gait analysis and treatment. A good pair of orthotics may help, but before that, a specific exercise prescription designed to increase stability and enhance proprioception may be beneficial. Stretching the calf muscles and icing the area of involvement may accelerate the healing process. Swimming is a good alternative to keep the athlete moving and in good spirits. One of the key aspects of returning from any injury is making sure the athlete does not return to their normal amount and intensity of training too quickly.