Whether you are training for a marathon or other long-distance race, or you are simply increasing your miles to boost your cardiovascular fitness, injury rehabilitation and recovery are key if you wish to keep running for many years. In a study of over 2,000 running-related injuries, the most common lower leg injuries were medial tibial stress syndrome (4.9%), Achilles tendinopathy (4-8%), and tibial stress fractures (3.3%). What is the best way to prevent injury and recover from these issues?
Medial Tibial Stress Syndrome
Medial tibial stress syndrome, colloquially known as shin splints, results in pain and inflammation along the inner edge of the shinbone. It typically occurs from overuse, biomechanical issues, and muscular weaknesses or imbalances. Recovery strategies for shin splints include rest and cross-training using low-impact activities such as stationary biking, swimming, and underwater running. Once the pain is gone, athletes can slowly accelerate (by between 10% and 15% every three to six weeks). Massage can also help loosen tight calf muscles and work on inflamed connective tissues between the shinbone and the muscles. You can massage yourself using a foam roller or a machine gun. If you use a gun frequently, take note of potential side-effects. Massage devices can cause skin itching, though this is usually temporary. Itching can arise because the vibrations of the gun can cause histamine to be released from cells. If this occurs frequently, it can easily be treated with histamines.
Achilles Tendinopathy
When you run, you load your Achilles tendon with 12.5 times your body weight, and overuse can result in injury. Achilles tendinopathy causes pain, inflammation, and degeneration of the Achilles tendon. It can manifest itself in Achilles tendonitis or Achilles tendinosis. Both can result from overuse or repetitive stress, as well as a sudden increase in training intensity, inappropriate footwear, training errors, age, and gender. They cause intense pain for the runner, and require rest. Ice and heat therapy, physical therapy, and custom heel fits may also provide welcome relief to the tendon. Initially, running should be total avoided. Later in your recovery, light loading may b e helpful to stimulate healing and the remodeling of collagen fibers. The good news is that the majority of people with this condition recover through exercise alone. Among the many exercise types your physiotherapist may recommend, there is strong evidence for the utility of heavy load eccentric exercise. During eccentric exercise, the muscle fibers are activated while they are lengthening, which places a high load on the muscle-tendon unit. This type of training is particularly useful for improving strengthening tendons, improving muscle hypertrophy, and boosting performance.
Tibial Stress Fractures
The tibial shaft is the most common site for lower extremity stress fractures in runners, and accounts for almost half of all stress fractures in athletes as a whole. These fractures can occur when the bone has not had enough time to “remodel” following repetitive loads. In female runners, consuming a low-fat diet, having a low bone mineral density, halving low lean mass in the lower limbs, and menstrual imbalances can all up the risk of this type of fracture. In men, the risk factors are as yet unknown. Tibial stress fractures evidently require considerable rest. However, coupled electric fields and extracorporeal shock wave therapy has been found to boost recovery by enhancing the regenerative process and reducing pain.
As is the case with all injuries, specific treatment programs should be recommended by health professionals. In most cases of injuries related to long-distance running, rest is required. Individual treatments vary depending on the injury, though in all cases, gradual incorporation to previous activity levels is advised.