Runners and athletes often suffer lingering pains, but arming yourself with the knowledge to spot and avoid damage in the first place is simple. Simon Moyes, one of the UK’s leading orthopaedic surgeons (www.simonmoyes.com), has treated a number of patients who have suffered injuries sustained from taking part in endurance sports including marathons, triathlons and Iron Man contests. He’s here to give WideWorld readers the low down on the most frequent complaints – and the best ways to counter them.

“The most common injuries include Runner’s Knee (chondromalacia), Achilles Tendonitis, Ilotibial band syndrome, Shin splints and impingement syndrome,” he says. “A large percentage of these injuries occur whilst training as these contestants are putting their bodies through incredible stress and many are using muscles they have not done before. “

Shin splints

This causes pain along the inside of the shin, which can move towards the knee. It is most painful at the beginning of a run but can disappear once the muscles warm up.

Shin splints are caused by inflexible/tight calf muscles, incorrect footwear or excessive running on hard surfaces. Beginners are most susceptible as the leg muscles have not yet stretched.

If you notice these symptoms, reduce training and avoid downhill running.

Apply ice to the shin area for 10 minutes every two hours, to lesson inflammation. Massaging an anti-inflammatory gel into the muscle will also help.

Should you continue to suffer from the condition after 2-3 weeks, see an orthopaedic surgeon who, through an MRI scan will determine if the condition is a stress fracture and what further treatment is needed.

Impingement syndrome

Impingement syndrome is most common in those who take part in endurance events involving swimming including triathlons and Iron Man contests. It is usually the result of over training as tendons in the shoulder are put under immense pressure because of narrowing of the space between the acromin process of the scapula and the head of the humerus.

The most common symptom is pain which worsens with overhead movement. Weakness and restricted movement may also occur.

Treatment is usually conservative and involves rest, physiotherapy and ice packs to help relieve pain. If pain is severe a cortisone injection may be given to the affected area. Should the condition not respond to the above, arthroscopic surgery to remove the impinging structures and widen of  subacromial space may be offered. Damaged rotator cuff tendons may also need to be repaired.

Achilles Tendonitis

Achilles tendonitis is a common problem that causes heel pain and can be a precursor to a rupture of the tendon. The main symptom is a sharp pain along the back of the tendon, usually close to the heel.

This condition is normally caused by tight/tired muscles putting too much pressure on the Achilles including little or no stretching, increasing distance too quickly, over training and inflexible running shoes. If your feet overpronate, you can be more prone to this condition.

If you notice any symptoms, stop running immediately and apply ice for 10 minutes. To reduce inflammation, continue this treatment every two hours. In addition, avoid weight bearing exercise and massage the area with anti inflammatory gel e.g. arnica or ibuprofen up to three times a day. Ibuprofen pills can be taken for up to seven days to relieve pain and reduce inflammation. Full recovery usually takes between six to eight weeks.

If the condition has not improved after two weeks, visit an orthopaedic surgeon who will analyse your condition and decide the appropriate treatment which can range from physiotherapy to injection treatments and occasionally surgery.

Runners Knee – anterior knee pain

There are a number of reasons why this can occur. They include:

• Overpronation – when the foot rotates inwards on contact causing the kneecap to twist.
• Muscle weakness – ill fitting/worn shoes and over training can also cause this problem.

Symptoms include excruciating pain under or on the sides of the kneecap as well as swelling of the knee.

If you start noticing any of the above symptoms, stop running immediately and apply ice to the shin area for 10 minutes. To reduce inflammation, continue to treat the knee every two hours and elevate the foot. Massaging the knee with an anti inflammatory gel will also help. Full recovery usually takes four-six weeks.

If symptoms continue after two weeks, visit an orthopaedic surgeon who will investigate the extent of the damage through an MRI scan and, depending on the extent of the injury, may operate on the knee although physiotherapy is the usual treatment. ??To avoid this condition it is advisable to stretch your muscles before and after running.

Plantar fasciitis

This condition causes pain at the bottom of the heel which tends to be worse first thing in the morning and at the start of a run.  The pain tends to lessen as you walk or alternate your stride whilst running.

It is caused by a number of different ailments including stress, tension and pulling on the plantar fascia. Inflexible calf muscles and tight Achilles tendons can also be an issue as they put more pressure onto the plantar fascia. Overpronation, high arches and incorrect/worn shoes can also aid to the problem.

If you notice any of the symptoms, stop running immediately and apply ice to the affected area. Reduce training and take a course of anti inflammatory drugs i.e. ibuprofen. Massage the affected area with anti inflammatory gel and return to running gradually. Full recovery is usually between six to eight weeks.

If the condition does not improve after 2 – 3 weeks, I would recommend a scan either MRI or ultrasound. A cortisone injection may be needed to relieve pain and/or surgery to release the plantar fascia.

Ilotibial band syndrome

ITB is caused by overpronation as the muscle has less room to stretch. Worn out shoes, hill running and over training can also cause problems.

Symptoms include a dull, painful ache less than one mile into a run. The area is also tender and inflamed and continues to get worse when running downhill.

Once again, should you notice these conditions, it is important you stop running immediately. Apply ice to the knee as well as anti inflammatory gel. You can also take ibuprofen for up to seven days to relieve pain.

If symptoms persist after three weeks, make an appointment to see a physiotherapist who will offer a course of treatment. If the injury does not respond to physiotherapy treatment, you will need to be referred to an orthopaedic surgeon who, depending on the severity of the condition, will treat the pain with a cortisone injection into the ITB or make a decision to operate.

For more information or consultations, speak to Simon Moyes at: www.simonmoyes.com or www.ankle-arthroscopy.co.uk