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Marathon running has become one of the most glamorous and widely participated sporting events in India since the past few years. Long distance running or marathon running, involves running a full marathon (42 km), half marathon (21 km), 10 km, 5 km. People may engage in it for recreation, as a form of physical exercise or for cultural reasons.
It takes strength, speed, endurance and a good aerobic capacity to run such distances in order to avoid injuries. Some estimates say that between 37 to 56 percent of recreational runners, who train and participate in long distance running periodically, sustain an injury every year. Here are some of the most common injuries that plagues runners:
- Iliotibial (IT) band Syndrome
- Shin Splints
- Achilles Tendinitis
- Plantar Fascitis
- Hamstring strains
- Ankle Sprains
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What is IT Band Syndrome?
It is the inflammation of the IT band, which is a thick band of fascia running down from your pelvic bone to the outside of the knee joint. As the knee bends and straightens, while running, this band slides forward and backward over a bony point on the outside of the knee. This repetitive sliding creates excess friction, especially when the knee is bent at an angle of about 30 degrees (seen in long distance runners when the foot strikes the ground), thereby producing pain and inflammation.
Causes
- Improper running technique- especially inward rolling of the hips and knees
- Sudden change in surface (soft to hard, flat to uneven or decline), speed and/or distance
- Weak hip and core muscles
- Flat feet or poor arch control
- Sudden increase in mileage for training
- Improper footwear or worn out shoes
Common symptoms to look out for
Most of our patients at PhysioRehab describe it as a sharp, stinging or burning pain just above the outer part of the knee which starts after running for a particular distance. “I just have to stop running at least for a minute and only then can I continue the remaining run”, says Mr. Mehta. The pain worsens if you continue running or other repetitive activities and subsides with rest. Pain is experienced typically during early knee bending.
To stop or continue?
Once you notice ITB pain, the best way to get rid of it for good is to rest immediately. That means fewer miles, or no running at all. While you're backing off on your mileage, you can cross-train (go swimming, pool running or walking). When cross-training with ITB Syndrome, it's important to pick exercises that don't irritate the area. Stay away from the elliptical machine or exercises which involve constant bending at the knee because it puts more stress on the IT band. As you recover, start doing shorter, faster workout such as strides first, because they tend to irritate the IT band less than long, easy miles.
Treatment
Dr. Anjana Laungani, consultant Physiotherapist and head of PhysioRehab gives her valuable opinion, “IT band syndrome is one of the most common injuries seen in runners. If you want to treat this condition, the root cause or culprit should be addressed and not only the symptoms”.
Although runners usually reach for the foam roller when dealing with ITB syndrome, recent research says that it’s not the IT band’s fault in most cases. The problem is the soft tissue that's pulling on the IT band, not the IT band itself. The foam roller doesn't address the underlying issues like weaknesses in the hip and glute muscle.
“To get to the root of the problem, specific tailormade strengthening exercises are vital for overcoming ITB syndrome”, says Dr. Purti Degwekar, Physiotherapist at PhysioRehab. Rest, icing, ultrasound and kinesiotaping are the primary treatment modalities in acute cases. Strengthening exercises of the glute (hip), knee and calf muscles are done next. A lot of importance is also given to the strengthening of core muscles, which are believed to be the ‘power house’ while running. As the symptoms improve, agility training like jumps and sprints are started.
Faulty foot alignments are corrected by appropriate orthotic insoles
Faulty running style is addressed by the running coach with inputs from the physiotherapist
Appropriate training schedule is planned
Prevention
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Warm-up and stretch: Many injuries occur as a result of inadequate warm up. Before and after you run, stretch your muscles thoroughly - especially your calf, hamstrings, glutes and quadriceps.
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Always decrease your mileage or take a few days off if you feel pain on the outside of your knee. Walk a quarter or half a kilometer before you start running.
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Run in the middle of the road where it's flat. Avoid running on concrete surfaces.
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Wear proper-fitting socks and shoes with good support. If the soles of your running shoes have worn out, replace them. If you have foot problems, such as flat feet or high arches, schedule an evaluation with a podiatrist/ physiotherapist and consider using orthotic shoe inserts.
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Avoid doing any type of exercises which puts strain on IT band, eg. climbing stairs, squats.
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Stay hydrated: Make sure you stay well hydrated on the especially on the days you run.
Article by Dr Anjana Laungani, consultant Physiotherapist & rehab specialist, PHYSIO REHAB.
