4 Common Hiking and Running Injuries and How to Fix Them
The trails are ready and the sun is shining! Time to get in the mountains, train for that half marathon, or just get outside to get some exercise. Before you do, know how to identify, prepare and prevent injuries from occurring this season!
- Runner’s Knee (AKA Patellofemoral Pain Syndrome): The patella is another word for the kneecap, and patellofemoral pain syndrome is the technical term for pain in your knees and is very common when running or hiking. The most common condition of the kneecap that creates this is patellar tendonitis, which is inflammation in the tendon located under the kneecap. This usually occurs when the tendon has been overloaded, inflamed, or stressed. Pain often is felt when running or hiking downhill. Treatment should include strengthening and stretching the quadriceps and hamstring muscles to help support the additional weight placed on the kneecap. With strong quads and thighs, each step that the runner takes gets distributed to the surrounding muscles as opposed to the kneecap itself, much like how a shock absorbers on a car would distribute and dampen impulses from going over bumps. Balance training, like a one legged stance and squat can also be helpful to strengthen the lateral stabilizer muscles around the kneecap. Evaluation of patellar tracking (how well the kneecap moves) may be needed if pain persists. There is no one-size-fits-all to knee pain, and if there has been trauma or sharp pain and weakness it is important to see your physician, PT or chiropractor for further evaluation. Patellar issues, particularly patellar tendonitis is one of the most common knee injuries I see in my office in the hiking season. Usually with a few treatments of Active Release Technique we are able to get folks back on track!
- Shin Splints: This is a common condition for those of us just starting to run again, or those training that add too much mileage too early in training. They are most commonly identified as pain and tenderness along the shin bone and they account for up to 15% of all injuries in runners. Less common in hiking, shin splints can be a reflection of “pounding the pavement” a little too hard! The best fix is rest and ice. In my office, we use cold laser therapy to speed the recovery of the muscles and promote circulation to the area. Josh Sandell, chief clinical officer at Orthology, INC suggests increasing mileage by 10% a week in order to reduce risk for injury.
- Plantar Fasciitis: This condition is difficult to pronounce and can be difficult to treat!!! The plantar fascia is a thick band of tissue on the bottom of your foot that runs from your heel to your toes and its primary function is to absorb the high stresses and strains we place on our feet. Pain in the heel, arch or balls of the feet can be a common presentation of inflammation in this tissue. It can be caused by tightness in the calves or Achilles, poor footwear, or too much mileage too fast. Sandell recommends changing your running/hiking shoes every 300-500 miles to avoid problems with foot wear. A good stretching warm up pre or mid exercise can be effective in preventing this problem, focusing on calf, hamstring and hip flexor stretches. I also really like balance training in my routine (one- legged stance and squat or balancing on the Bosu) to help strengthen the small little stabilizer muscles of the foot and ankle to help support the plantar fascia. Using a frozen water bottle to “roll out” the bottom of the foot can be a helpful treatment. There are also many foam roller techniques for the pelvis and legs that can help to indirectly treat the area.
- Tight Hip Flexors: Sound familiar??? Those darn hip flexors. For a lot of us around here that ski in the winter, this can be a year round battle. This is a common complaint walking into my office. I hear it daily and more commonly during hiking season as this musculature is responsible for carrying us on the uphill and stabilizing us on the downhill. On the preventative end, a good stretch before an exercise can help. I also like a one legged pendulum swing. Using something for balance, swing one leg back and forth, side to side, and if you want to get fancy, in a figure 8. Even better if done with a heavy boot or ankle weight on, this helps to distract the femur head within the hip socket and can help to open the joint before using it. Prevention can also focus on maintaining alignment, as dysfunction in low back, pelvis or lower leg biomechanics can create added stress to the hip flexors. Whether that be with chiropractic, pilates, yoga or soft tissue work- alignment can be key for a lot of things! The best prevention is maintaining a strong core, specifically glut strength. Treatment can include laser therapy, massage, Active Release Technique and physical therapy to stabilize and strengthen the right areas to take the stress off of the hip flexor.
Dr. Balbo is a chiropractor practicing in Telluride and Ridgway. She focuses on sport’s injury, soft tissue work and rehabilitation in addition to chiropractic.