5 Running niggles not to ignore.

1. Iliotibial (IT) band pain.

Why should we worry about IT band pain? Mainly because foam rollering is rarely enough! Lots of runners really get into a pickle if they push on hard with an IT band problem. Putting up with a relentlessly predictable pain which comes on every time you reach six miles, is pointless when there is plenty you can do about it.

You may need gait retraining, or the opportunity to change some wonky biomechanics. For example, you might have a stiff hip, poorly utilised glutes, or you might even need some more appropriate foot wear. Many people have a gait which isn’t widely spaced enough, so people ‘scissor’ across at the mid line. If it’s a really florid IT band problem, you might end up needing a ‘rescue injection’ just before that marathon (which still might not guarantee you’ll get round comfortably) . The moral of the story is, get help early on with an experienced, running Physiotherapist or Osteopath, who can help you make these changes.

2. Groin Pain.

There is no such thing as a “Groin Strain” and despite what we might be told, its actually not that common to have a true hip flexor problem. Whilst you might be tight in your hip flexors, more often pain at the front of the hip is due to hip impingement (a.k.a. ‘FAI’), or overload of the pubic bone area (sometimes called ‘Osteitis Pubis’). Most serious, however, is a stress fracture involving the neck of the femur. It can have disastrous consequences if not managed properly.  You might have the beginnings of a stress fracture if:

You can feel pain in the groin every time your foot strikes the ground 

You have ‘random’ pain which ‘comes and goes’ and seems to move around  

If you are “aware” of your niggle at night time.

It’s really important that you get checked out early, and you may need an MRI scan to do this. X-rays are not sufficient to detect stress fractures.

Pain in your fore-foot area

3. Pain in your fore-foot area.

Metatarsal stress fractures are common in runners, but pain in the ball area of the foot might also be a neuroma. This feels like a lancing or knife-like pain, between the heads of the metatarsal bones. It occurs when a nerve gets pinched – particularly if the arch of the front of your foot is flattening out.
Always seek a proper diagnosis with this symptom; running with a fracture soon grinds you to a halt and you won’t be able to compete, or worse still, you’ll limp half way round the course and be a ‘DNF’ (Did Not Finish). Neuromas can sometimes be made better with an injection, some good podiatry and again gate re-education. All may not be lost and seeking advice early is the best bet.

4. Heel pain.

Sometimes plantar fasciitis isn’t plantar fasciitis! Sometimes pain in the area of your heal can be calcaneal stress fracture. Plantar fasciitis needs a proper biomechanical work up. For example, do you have a stiff ankle, which reduces its ability to re-distribute ground reaction forces, which overloads the plantar fascia. Do you have weak soleus calf muscles, or a tight calf complex, or maybe you simple need some different footwear? Shockwave therapy can be helpful in some resistant cases and great Physiotherapy or Osteopathy work will help you to resolve this more swiftly than you imagine, so don’t push on through the pain.

5. Shin splints.

Particularly if these are severe you might actually be harbouring a tibial stress fracture rather than just overload of the junction between the soft tissue and the bone. We see many patients post-marathon who actually have run (in agony) with a tibial stress fracture, whilst believing that they had simply a ‘bad case’ of shin splints. DON’T be tempted to run through this, as it can end in very, very length rehabilitation process, even surgery, to fix the bone. Get proper Physio and Osteo advice for this.
If you are still in doubt with any of these problems, seek specialist attention (e.g. with a Sports Physician) early on.

less pain more fun

 

All of these conditions, if given quick attention, can typically be resolved swiftly and conclusively.
So don’t grit your teeth and jog-on with pain. Get it sorted!

 

If you’re concerned about pain when training, click here to make contact with me, or phone

0208 004 7733 to book in for a consultation. #Lessinjurymoreplay!

Dr Cath x

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About the Author:

css@sportdoclondon.co.uk'
Dr Cath Spencer-Smith is a Consultant Physician in Sport and Exercise Medicine and Director of Sportdoc London. Cath is passionate about the diagnosis and management of all musculoskeletal conditions, and has expertise in getting to the bottom of persistent problems, such as hip and groin pain. She works with Olympians, through to the occasional exerciser.

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