Physical Therapy for Running Injuries – Part 1

By Helene Mitchell, Physical Therapist Assistant

Each year, approximately 36 million Americans participate in running and each year 46 – 65% of them suffer some form of running injury. The most common site for injury is the knee (42%). Another 40% occur at the knee or below and 20% occur above the knee. The most common running injuries are:

• Patellofemoral pain syndrome (PFPS)
• Iliotibial band friction syndrome
• Plantar fasciitis
• Medial tibial stress syndrome
• Achilles tendinitis
• Stress fractures
• Patellar tendinopathy
• Low back pain

This is the first of a series of blogs addressing each of these running injuries including their causes, symptoms and treatment.

PART I   Patellofemoral Pain Syndrome (PFPS)

PFPS represents 20% of all running injuries and is caused by overuse. It is more common in women than men, especially in the age range of 15 – 35.

• Dull, achy pain & stiffness in front of knee
• Pain with running, squatting, kneeling, going up/down stairs, sitting for long periods of time then getting up
• Swelling around knee cap (patella)
• “Popping” or “grinding” when the knee is fully extended
• In advanced cases, the knee buckles or “gives out”

• Weak muscles of  the gluteals and hip
• Tight hamstrings
• Running on uneven surfaces
• Excessive downhill running
• Excessive foot pronation
• Leg length discrepancy of more than ½ inch
• Trauma or fracture to knee cap (patella)

Conservative Treatment:

Stage I  (less than 2 weeks)
• Temporary rest from running or active rest
• RICE (rest, ice, compression, elevation)
• Modalities ( ultrasound, massage, electrical stim etc.)
• Gentle stretching

Stage II   (2 -6+ weeks)
• Regain flexibility & strength of the impaired muscles
• Lumbar (low back) mobilization & correction of hip rotation
• Balance training
• Postural & core strengthening

Photo Credit: kk+

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