Physical Therapy for Runners

by Barbara Foster

As a runner, your body goes through plenty of wear and tear. Miles upon miles of running on pavement can take a toll on the human body. Running is a healthy way to exercise, and for most people who train consistently and properly, it is possible to avoid major injuries for a long time. However, many people sustain running-related injuries for a variety of reasons. It could be helpful to see a physical therapist to overcome these injuries and get back to training. Physical therapy could be a helpful way to strengthen your weaknesses as an runner.

Injury prevention

One of the most important steps in running is injury prevention. If you take steps to avoid and prevent injury, seeing a physical therapist may never cross your mind. The first step in injury prevention is to consider the kind of shoes you are running in. You should be running in shoes specifically made for running. While many people enjoy minimalist shoes that are light weight and allow the foot to move more freely, those who are new to running or run mostly on pavement should avoid minimalist shoes. There are different shoes made for different unique running styles and levels of experience. You can research online or visit a local running specialty store to learn more about these types of shoes.

Choosing a Shoe: The Very Basics

Different Types of Running Shoes Explained

How to Select the Best Pair of Running Shoes

There are ways to prevent injury beyond picking the right shoes. Seek out soft dirt trails to run on. This kind of soft surface could be more gentle on your body than running on roads or a treadmill all the time. Additionally, you may want to consider your form while running. When considering your form, keep in mind that running is all about moving as efficiently as possible. You should lift your feet and land toward the balls of your feet, keep your hands loose and your arms swinging forward and back without crossing in front of your body. Hold your head up and look straight ahead, and keep a relaxed expression on your face. Thinking about these points could help your form and avoid injury in the first place.

Running Barefoot, Forefoot Striking, and Training Tips

Common Running Injuries

There are some injuries that specifically affect runners. However, there is no limit to the kind of injuries you may sustain, whether they are a result of running specifically, or running combined with other activities in your life. These running-specific injuries can be treated by a physical therapist, or with some home remedy therapy.

Piriformis Syndrome: The piriformis muscle is located in the buttocks near the hip joint. Piriformis syndrome is a relatively uncommon injury that occurs when the piriformis muscle compresses the sciatic nerve. You might suffer from this running-related injury if you have pain or numbness starting in the buttocks that is made worse by walking up stairs or sitting for very long periods of time. A good way to treat this kind of injury is with ice or heat. You can lay on your stomach and apply an ice pack to the location of the injury for about 20 minutes. If you prefer heat, you may take the same steps but with a heating pad. Some runners find it helpful to heat before running and ice after running.

The piriformis syndrome

Plantar fasciitis: You may have plantar fasciitis if you have bad heel pain. This injury occurs when a thick band of tissue called the plantar fascia becomes inflamed. The band is located in the bottom of your foot and connects your heel bone and toes. Plantar fasciitis feels like a stabbing pain. It may go away once your foot is loosened up and stretched out. It is more common in runners who are overweight and are wearing shoes that are not supportive enough. Seeing a physical therapist can help with this kind of injury. The physical therapist can teach you different exercises to stretch the injured area and strengthen the foot and lower leg muscles. Additionally, a therapist could show you how to apply athletic tape at the bottom of your foot to help provide more support. They could also help you purchase a night splint, which helps stretch your calf and the arch of your foot while you sleep. A doctor could prescribe orthotics made specifically for you to insert in your shoes. You can take ibuprofen on your own to see if that helps reduce inflammation, as well.

Plantar Fasciitis

Plantar Fasciitis: Treatment Pearls

Save Yourself from Plantar Fasciitis

What is Plantar Fasciitis?

Patellafemoral syndrome: Sometimes, you may hear this injury referred to as runner's knee. This type of injury is located in the front of the knee, in the cartilage under the kneecap. It occurs when this cartilage is worn down or softened. This could happen because someone is running too much and their body is not yet ready for it. It could also happen because the runner is overweight. The pain is worsened by sitting with bent knees, walking down stairs, squatting, and jumping. It may also feel like you have a grinding or popping sensation in your knee when walking or running. Seeing a physical therapist can help with this injury. A therapist will teach you a variety of stretching exercises to increase flexibility and decrease tightness. You may also be given tape or a brace to help stabilize your knee. Taking rest could help with this injury, as well. While on rest, it is important to take it easy and avoid running. If you must exercise, an activity where you are not putting weight or pressure on your kneecap, such as swimming, could be helpful. Taking ibuprofen could help the inflammation caused by patellafemoral syndrome, as well.

Patellofemoral Pain Syndrome

Patellofemoral Disorders

Patellofemoral Pain Syndrome Exercises (PDF)

ITB Syndrome: The ITB in ITB syndrome stands for "Iliotibial band." Sometimes you may hear ITB Syndrome called IT Band Syndrome. This is a common running injury. The IT band is a tendon that runs along the outside of your leg. It runs specifically from your pelvic bone to below your knee. Between the bone and tendon at the side of your knee is a water filled sac. It is called a bursa. When you run and bend your knee over and over, the tendon can become irritated. There can be swelling in the bursa, tendon, or both, which causes the pain. The pain from this injury will feel mild on the outside of your knee. You may notice that the pain goes away once you warm up. If this injury goes untreated, it could feel worse and not go away after you warm up. If you see a physical therapist, they will teach you strengthening and stretching exercises to do. They might also recommend a bandage or knee sleeve, which will keep your IT band warm while you exercise. On your own, you may use a heating pad before exercise to help warm the area up. After exercise, you may take ibuprofen or ice the area to bring swelling down.

Iliotibial band syndrome - aftercare

IT Band Syndrome

Iliotibal Band Syndrome (PDF)

Shin Splints: Shin splints are one of the most common running-related injuries. If you have shin splints, you will feel a sharp pain up and down the front of your shin. Shin splints are generally not serious, but can become worse if left untreated. This injury is common when runners begin to intensify their training or raise their mileage. It is very common for new runners. The muscles, tendon, and tissue in the area become inflamed from the increase in intensity, which causes the pain. It is relatively easy to treat shin splints on your own. You may want to take an easy day to help the shin heal. When you do run, try to stick to softer surfaces, and make sure you are wearing proper running shoes. After you run, ice the area and take ibuprofen to reduce swelling. Some runners find that it helps to wear compression sleeves on their shins or compression socks to help alleviate some of the pain. This could be particularly helpful if the injury is due to excessive running on roads.

Shin Splints

Shin Splints - Cleveland Clinic

Shin Splints (Shin Pain) (PDF)

Say Goodbye to Shin Splints

Achilles tendonitis: This is also a common injury for runners, especially those who have recently increased their mileage. It occurs when the Achilles tendon, the tendon located at the back of your lower leg that connects your calf muscles and heel bone, is overused. If you have Achilles tendonitis, you might feel a mild ache or stiffness where the tendon is, just above your heel. If you meet with a physical therapist, they will teach you stretches and exercises to strengthen the muscles around the Achilles tendon. They could also recommend that you get orthotics. Some steps you can take to help your Achilles tendonitis go away on your own include rest, taking ibuprofen, and making sure your running shoes are not too old. If your shoes are very worn down, it could help to purchase and begin running in a new pair.

Achilles Tendonitis

Achilles Tendonitis - University of Maryland Medical Center

Achilles Tendinitis - New York Times