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Born to run or cursed to hurt?

Updated: May 1

Born to run - The running debate

Does anyone else feel like running is an oddly controversial topic? Ask ten people and get ten different opinions on running. Some believe it is bad for you, some believe only a select few can do it injury free, some believe everyone can and should do it and we are ‘Born to Run’; ask ten medical professionals and you will get a similar range or responses. Shoes: motion control, neutral, zero drop, none? How about mileage, intensity, weight training, weight training before or after or different day?


People can get awfully bogged down in the what ifs regarding running. So we are here to illuminate some facts about running and offer some helpful suggestions to help you run pain free and with joy.


The first step in solving a problem is identifying it, so today we see what the research says are the commonest injuries affecting runners.


A 2012 research database search pooled the evidence including 3500 runners, with separate analysis for ultra-runners. All of the commonest injuries were in the legs and 80% of injuries were considered overuse injuries.


Enter the weeds...


The main general running related musculoskeletal injuries were:

  • Medial tibial stress syndrome-essentially shin splints- (incidence ranging from 13.6-20% and prevalence of 9.5%*)

  • Achilles tendinopathy (incidence 9.1-10.9%, prevalence 6.2-9.5%)

  • Plantar fasciitis (incidence 4.5-10%, prevalence 5.2-17.5%).

  • In ultra-runners; Achilles tendinopathy (prevalence 2.0-18.5%) and patellofemoral syndrome (prevalence 7.4-15.6%) were the highest injury rates.

  • Also mentioned are lower extremity tendinopathies in general, including those mentioned above as well as patellar and hamstring tendinopathies.

(1)



A 2017 review found similar results. First off, stating that up to 50% of regular runners report having more than one injury each year. Most injuries due to overuse. Their list of most frequent injuries are:

  • Patellofemoral pain syndrome

  • tibial stress syndrome (shin splints)

  • Achilles tendinopathy

  • iliotibial band friction syndrome (IT Bane syndrome or “Runner’s knee”)

  • plantar fasciitis

  • stress fractures of the metatarsals and tibia.


The knee is the most injuries joint at all distances. Hamstring injuries are the one common running injury that happens in an acute fashion.


Most specific to long distance and marathon runners is that the foot and ankle is the most common area of injury. Excess body weight and number of kilometers run per week are high risk factors but other factors such as shoes, stretching, and biomechanics were not clear to those authors. They recommend a detailed physical examination for identification and correction of injuries. (2)


Hopefully, you recognize that running does not have to lead to injury… Let us repeat, “You can run without pain and without injuries”. So in the following article we will explore more risk factors and what has been shown to decrease the risk of the injuries above.


* Incidence: the number or proportion of people who develop a condition during a particular time period; new cases that occurred during a given time period.


*Prevalence: the number or proportion of people who have a condition at or during a particular time period; all cases present during a given time period.


1) Lopes AD, Hespanhol Júnior LC, Yeung SS, Costa LO. What are the main running-related musculoskeletal injuries? A Systematic Review. Sports Med. 2012 Oct 1;42(10):891-905. doi: 10.1007/BF03262301. PMID: 22827721; PMCID: PMC4269925.

2) Tschopp M, Brunner F. Erkrankungen und Überlastungsschäden an der unteren Extremität bei Langstreckenläufern [Diseases and overuse injuries of the lower extremities in long distance runners]. Z Rheumatol. 2017 Jun;76(5):443-450. German. doi: 10.1007/s00393-017-0276-6. PMID: 28236094.

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Zenith Takes PT to the Next Level — Running Pain-Free

I started experiencing a persistent pain in my right hip after returning to running after several years. I am active and participate in sports and the pain was keeping me from my routine runs, races and my overall fitness. Mike evaluated me and got to the root of the issue. He is innovative in his approach and integrates elements of massage into the work. He is fun to work with, communicates regularly and uses humor as we approach some difficult movements that push me out of my comfort zone. After each visit, I receive a set of exercises to complete at home between sessions. As I got stronger, the pain decreased and I was able to return to my routine. We targeted goals, and he continues to tailor each session and prescribe a set of exercises to meet the unique characteristics of my body type and performance needs. I highly recommend Zenith; they take PT to the next level.

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From Misdiagnosed Adductor Pain to Running Strong Again

I can’t say enough good things about Zenith. After over a year of lingering adductor pain that seemed to come out of nowhere, I finally found answers and treatment here. As a semi-professional runner, lingering pain isn’t something I can afford. It throws off my form and affects every part of my training, including lifting. So I went to a doctor who thought it was iliopsoas tightness and they sent me to a PT who thought it was an adductor strain and made it worse. Then I came to Zenith and started working with Jesse. He took the time to understand the full story and offered a completely different perspective: this wasn’t a strain or tightness but actually a nerve issue. That insight alone was a game changer. He worked on the problem during our first session, gave me daily stretches, and even made simple lifestyle suggestions that I hadn’t considered (like actually using my standing desk throughout the day). The progress was slow and steady. After the first follow-up, I still had some discomfort, but the plan felt like it was finally targeting the root cause. Jesse introduced strength training specific to the problem area, which I was initially nervous about. After my first lift, my muscles were sore in and around the adductor area, but the pain didn’t worsen. That was the turning point for me. After just four sessions and a few months of consistent stretching and strengthening, I’m nearly 100% better and still improving. I’m back to running and lifting with more strength, confidence, and most importantly almost no pain.” “If you’re dealing with a nagging issue like me or an injury then I would highly recommend Zenith. It’s an investment, but for me I saw it as a long-term investment in my body’s future, and I’m glad I did because it was absolutely worth it.

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