This is the third article in a series on lower extremity running injuries and treatment. Previous segments have focused on causes and prevention. In this article we will cover two of the more common specific diagnoses.

Pain at tendon or ligament
Most injuries are caused by repetitive stress to tendon or ligamentous structures and have been traditionally been thought of as inflammatory. During the early phase of these injuries an inflammatory response may set in that could properly be called tendonitis or fascitis. Chronic pain at tendon or ligament insertions actually doesn’t demonstrate inflammation on microscopic exam and is more properly called tendinopathy or tendinosis. These nagging injuries require much time and eventually graduated strengthening to heal properly.

Treatment
• Anti-inflammatory medications may help the pain but really have no effect on correction of the underlying problem.
• Cutting back running intensity, duration, and or volume.
• Ice the area of discomfort several times a day and perform gentle stretching.
• Identify the change that preceded the problem. Identify the source, then alter the plan; go back to the old brand of shoes, change direction every few laps when running distance on the track, or vary the running surface.
• Use a swimming pool for running workouts or engage in cross training on a stationary bike while allowing the body time to heal.
• Early intervention, is always more effective and will ultimately help you achieve your goals.

Anterior Knee Pain Syndrome
The patient will typically have problems squatting, climbing or descending stairs and hills, and may get pain and stiffness after periods of rest with knee flexion such as during driving or sitting in a movie theater. Pain in the knee often presents after an unrelated injury that induces additional muscle imbalance or loss of flexibility. The lower extremity is a kinetic chain, “the hip bone is connected to the knee bone is connected to the leg bone, etc.” Problems with hip rotation, tightness around the knee or excessive pronation in the foot can contribute.

Treatment
• A foot orthotic or a shoe designed with more stability will sometimes help knee pain in the overpronator.
• Athletes who overpronate usually have low arches, “flat feet”. Make sure you have balanced flexibility in the trunk down to the ankle.
• Strengthening of the back, hip, and hamstring musculature will often help to correct anterior knee problems.
• Avoid excessive hill running or jumping sports until symptoms improve. Stay off the leg extension machine in the weight room.
More specific diagnoses will be covered in the next article.
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Tri-City Bike Tour

Registration and Check-In – 5:00 am
Start Time – 6:00am at Jess Ranch Community Church

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