Are you frustrated by constantly dealing with the same running injuries over and over again? The pain goes away with rest or treatment, but then it comes back as soon as you try to increase your mileage. You’re not alone! Austin is a great city to be a runner, and as a result, we see a large number of runners at our physical therapy clinic. It’s not uncommon for a new patient to tell us that their injury pops up every time they try to increase the distance of their runs past a certain point. For example, “I can do 3-mile runs every day and feel fine, but as soon as I try to push past the 5-mile distance, my calf starts hurting again.” Sound familiar?
If you’re currently dealing with any pain during or after your runs, we can help you figure out the causes and create a plan for getting rid of it with no cost to you … request your free consultation here, and put an end to those limits on your mileage.
Research has shown that up to 80% of runners will experience some injury during their running years. When you run, you experience 2-3 times the force of your own body weight with every step! Over the course of a run, you experience an extreme amount of force through your joints and soft tissues, which can lead to repetitive strain injury if those forces are not well balanced and minimized by muscular-stabilization of the joints.
Resolving running injuries
The key to resolving a running injury once and for all is to identify and resolve ALL of the underlying causes of the problem. In today’s unfortunate healthcare world, clinicians are often forced to see many more patients per day than they should. If a patient has knee pain, they only have time to look at the knee … but as you’ll see below, this will often lead to missing the real causes, and therefore fails to address what leads to you getting the same running injuries over and over again.
Knee pain from running
The most-common running injuries tend to be at the knee. The knee is a simple hinge joint wedged between your hip and your foot, and the reality is that your knee is usually not to blame!! Knee pain is usually either a result of poor hip muscle control or over-pronation issues.
The old saying, ‘as the foot goes, so does the knee’ is very true. Pronation is a natural motion of the foot that occurs when your foot contacts the ground and rolls in, causing your arch to get lower. Pronation is not inherently a bad thing. In fact, we need to pronate through our feet. It is how we properly transfer forces through our body.
But when we overpronate—when your arch collapses too much, placing increased stress on all the joints above—we put our other joints at risk for injury … including our feet. And when that happens, you’ll keep getting the same injuries repetitively from running.
How to know if you overpronate
So how can you tell if you pronate too much? Is it possible to know if your shoes provide the support you need?
Try this: Get the bottom of your feet damp, and then step on a piece of paper. If your footprint has no gaps/indentation in it, you most likely have flat feet and need more support than you could get from most shoes.
[Aside: if you read Born to Run and think everyone should be running around barefoot, we have about 100 past patients that were injured by running in minimalist shoes who would tell you differently. Barefoot running can be appropriate for some runners, but certainly not all of them.]
If you have flat feet, overpronation can often result. The arch of your foot is NOT meant to be a weight-bearing surface. When that starts to happen, problems follow. The knee collapses, and the hip begins to rotate inward. If you repeat this motion enough, an injury is not far off.
What can you do to resolve overpronation?
So what can you do if you overpronate and are at risk of injury (or already hurting)? A good pair of supportive shoes is a great place to start. Since every foot, body type, and running style is different; we can’t suggest specific shoes in this article. So our best advice is to make sure your choose your running shoes with the assistance and guidance of a professional who has a lot of experience working with runners and shoe selection.
But what if even the most-supportive shoe is not enough by itself to adequately position and support your foot? What other options do you have?
Here, we would suggest two things. The first involves making sure the muscles in your feet are strong enough to do their job and support the feet as much as possible. See the videos below for some quick exercises you can do to strengthen your feet.
Though strength is very important, when you’re full body weight is coming down on one foot during your running stride, there’s only so much the muscles in your feet can do. For those who severely overpronate and collapse through the arch, even strong feet and supportive shoes may not be enough to avoid running injuries at the foot, ankle, knee, hip, or low back.
The market is filled with a lot of options of what to put under your feet. Most over-the-counter shoe inserts and arch supports do not provide the support needed by someone who has significantly flat feet. In this situation, Custom Orthotics are your best bet. They are an assistive device that is placed in your shoe to provide the exact level of support you need and to help distribute forces more evenly through the foot and up the leg. We have seen people with debilitating foot, knee, hip, and back pain get amazing relief and return to running once they started using custom orthotics.
At Carter Physiotherapy, we are experts in evaluating the foot and in the creation of custom orthotics. If you have any foot, knee, hip, or back pain when you run, it may have something (or everything) to do with your feet. If you’d like to have a free assessment of your feet to learn whether you would have less running pain with custom orthotics, call us at (512) 693-8849.
The critical role of the hips and pelvis
The hip, or coxofemoral joint, is a classic ball-and-socket joint that attaches to your pelvis. It is inherently a very stable joint due to its depth, but hip muscle weakness is incredibly common among runners.
One of the distinct signs we look for as bio-mechanical experts is a hip drop, or “Trendelenburg sign,” during stance phase (when the foot is on the ground).
What that means is that when you are on one leg while running, we are looking if that opposite hip drops (see image below). If it drops significantly compared to the other side we know that hip weakness is present. Hip weakness can contribute to back, hip, knee, and foot pain. That’s how important it is!
How can you tell if you have this type of hip weakness and what can you do about it?
See the video below to find out if you’re at risk for injury due to hip weakness, and learn 3 quick exercises you can do fix the problem.
At Carter Physiotherapy, we have set up a Running Analysis & Optimization lab to evaluate our runners’ strides to get to the root cause of their pain and provide corrective exercises that not only eliminate the pain but also keep it from coming back. We use the latest technology with high-speed cameras and gait analysis software to look at every aspect of your running form.
Another key area we assess at Carter Physiotherapy is the connection of the hip at the pelvis. Making sure your pelvis is level and balanced is critical to keeping you pain free and running well. We address this area in a variety of ways such as soft tissue mobilization & massage, joint mobilization, corrective exercises, muscle energy techniques, clinical kinesiology, and even trigger-point needling.
We are experts at balancing the pelvis to make sure that your hip muscles are firing well. We then prescribe corrective exercises to help address the specific issues we found to help you hold the work we have done. This allows you to build your strength for a more solid foundation.
Are running injuries keeping you from the sport you love? Call or text us at 512-693-8849 to arrange a free consult with one of our running expert physical therapists.