11 Causes Of Shin Splints In Runners

11-Causes-Of -Shin-Splints-In-Runners

What exactly are shin splits?

Well, apparently there’s no clear consensus among sports scientists of what shin splints actually are. It can be small tears in the muscle that’s pulled off the bone, an inflammation of the periosteum [a thin sheath of tissue that wraps around the tibia, or shin bone], an inflammation of the muscle, or a combination of them.

Collectively they are referred to as MTSS – Medial Tibial Stress Syndrome.

According to the NHS shin splints is the name for pain in the shins, or the front of the lower legs, usually caused by exercise.

In The Runner’s Body, Ross Tucker and Matt Fitzgerald define shin splints a symptom, rather than a diagnosis, of the many potential injuries of the tibia.

According to Runner’s World shin splints make up about 15 percent of running injuries. Although the numbers are from 2011 they still give us an idea of how common these injuries are nonetheless.

Shin splints are among the most common injuries. The tissues are more prone to injury in beginner runners and runners who return to running after a break because the bone and muscles are not yet conditioned. So the unconditioned or de-conditioned runners. We will talk a little bit more about this later in the article.

The most common site for shin splints is the medial area (towards the inside of the shin) – medial shin splints. Overpronation is a common cause of medial shin splints.

Anterior shin splints (toward the outside of the leg) usually result from an imbalance between the calf muscles in the back and the muscles in the front of your leg. The anterior shin splints often affect beginners who either have not yet adjusted to the stresses of running or are not stretching enough.

The anterior shin splints may also be compartment syndrome and nothing to do with the bone, which we will talk about later in the article. Pain around the shin can also be a sign of a stress fracture.

But let’s go through the causes of shin splints to get a better understanding of why they happen and what actually happens.

 

Causes of shin splints in runners

 

1. Progressing or upgrading your training too fast, too soon

A progression of your training programme above the level you are currently at that’s too fast or too much can put your body under too much strain all of a sudden.

Whether you are a runner or not, bone tissue continuously breaks down and is being rebuilt, that’s how bones work. When you begin a running programme this process accelerates due to the repeated impact. Now, that’s a good thing. Impact exercise does build stronger bones, when done properly (this doesn’t apply to people who have health conditions or certain injuries though, one must assess very well whether impact training if for them).

The good news is that the existing bone tissue is broken down and a denser, stronger bone tissue is formed. This is the work of osteoclasts (breaks down bone tissue) and osteoblasts (makes bone tissue).

The bad news is that the bone must first be weakened before it can be strengthened. Runners who do too much, too soon, increasing their mileage too quickly or jumping into long mileage from the beginning, develop small bone fissures that cause pain. If the pain is not managed properly and on time, once the small fissures pass a certain point a stress fracture may result.

In the 2nd article on shin splints I will come back with ways to train through the shin splints (if possible) and/or how to best manage and home treat them so you can get back to training.

 

 Running form

Danny Dreyer, author of Chi Running, attributes “almost all running injuries to the current running paradigm of running, which [he] calls power running”.

Other well knows running coaches and authors share his view, such as Nicholas Romanov author of The Pose Method Of Running, and Danny Abshire author of Natural Running.

You can and should take time off to recover from shin splints, then strengthening and stretching. However, if you’re using the same running form that created the injury in the first place, that muscle will eventually tire, and you’ll end up with the same injury again and again. The way to heal any injury, after you recover of course, is to address the cause(s) that result(s) the symptoms. That cause might be hidden in your running form.

Danny Abshire talks about impact and rotational forces which cause shin splints as well as many other injuries. This too is associated with power running. We will talk about this later in the article.

And since we’re talking about power running, Malcolm Malk, author of the Art Of Running and Alexander Technique practitioner, also advocates a lighter running style, stating that “runners who pound the ground often end up injured”. In the list of do’s and don’ts Malk points out not to push the body up or push off with the feet. This is power running in a nutshell: pushing off and pounding the ground.

Running form may be the cause, but how do we know what aspect of the running form causes shin splints? Don’t worry, I’ve got you covered. The running form aspects that can cause shin splints are:

  1. Landing ahead of the body
  2. Heel striking and over striding
  3. Landing on the toes

 

2. Landing in front or ahead of the knee joint or landing in front of the body

This is a major running technique mistake identified in The POSE Method of Running and mentioned again in Nicholas Romanov’s Running Revolution as well as in other speciality books.

Landing ahead of the body causes the lower leg to land at an angle to the ground instead of perpendicular (which it would if the foot would land under the body or under the hip). Landing at an angle also causes stress fractures and compartment syndrome (which is the tightening of the muscles in the front of the shins).

How do you know it’s compartment syndrome or bone related pain? If it’s bone related you would feel pain when you push on the bone, the shin bone becomes sensitive to touch. If the pain feels more like tightness, which usually comes up while running and when you don’t run you are ok, it’s probably muscle related. This is a general guide so it’s good to check with a therapist or GP to get a diagnosis.

Landing ahead of the body, at an angle to the ground, creates a shearing effect on the shaft of the tibia bone when load is applied. Your joints aren’t designed to accept and hold (the load), but rather to accept and unload, so they get damaged in the process.

When we land ahead of the body we have to wait with the support foot on the ground until the upper body and GCM (general centre of mass) pass over the support leg. You may think it’s fast, but not for your support leg which needs to wait and hold the load until it’s able to unload. When you land straight under the body, your GCM is already over the support leg so there is much less waiting, you can unload almost straight away.

Furthermore, landing ahead of the body, known as active landing, also results in increased impact during landing, compared to landing under the body. This impact produces a shaking effect through the bone and muscles and leads to a separation of the periosteum tissues (a dense fibrous membrane covering the surfaces of bone) from the bone.

Some runners do have stride mechanisms that expose their legs to higher impact forces and a higher risk of developing tibial stress fractures.

 

What to do?

Consider shortening your stride to reduce the severity of impact.

Instead of placing your foot in front of your body try landing under the body or under the hips, which is the same thing. Shortening the stride will allow you to land under the body/hips.

From my work with runners I noticed that when they try to shorten the stride they shorten it so little that it makes no real difference. They don’t know the feeling of a shorter stride.

The feeling you are looking for is as if you are running on the spot. Exaggerate in your running technique drills, shortening your stride to half your normal length. After a few weeks or exaggerating the drill, relax your stride and it should be just right.

We will talk more in depth about this, and I will share some pictures and videos in the next article on how to manage and home treat shin splints.

 

How to check whether you’re landing ahead of the body if there is no one to watch you

If you have a friend or a coach who can look at you while you run it’s great. But what if you are alone and you don’t know the feeling yet? How do you check?

When you run, and if it’s safe for you to do this, use your peripheral vision and see whether you can see your feet when you run. Don’t bend your head or from the hips, and don’t lean forward, just take a quick peek. If you can easily see your feet, you are landing in front of your body. If you can see just a little bit of your toes you should be just about right.

 

3. Heel striking and over striding

There are three primary causes of many injuries including shin splints but also plantar fasciitis, Achilles tendonitis, iliotibial band (ITB) issues and patellofemoral pain syndrome. Those three primary causes are:

  1. impact forces from braking with a heel striking gait
  2. rotational forces from the same kind of gait
  3. the subsequent excessive force necessary to push off the ground to begin a new stride with that kind of gait

 

What is a gait?

Whether you walk, run or sprint your feet make contact with the ground in certain positions, causing the rest of the body to react and adjust to this movement. Your body continuously seeks out an ideal balance with gravity so it continuously checks and adjusts. How the feet land and their position is essentially the gait.

Whether you stand, walk, run or sprint the feet and brain are constantly talking to each other. The feet send signals to the brain and the brain repositions the rest of the body accordingly so you don’t fall over.

There are 3 types of gaits. We won’t go into a lot of detail now but these are: the walking gait (heel strike), the running gait (midfoot strike) and the sprinting gate (toe strike).

 

Landing and take off

Let’s think of running as formed of two phases: land and push off (or propulsion). The running movement is more complex that that but it helps get the point across if we simplify it to these 2 phases.

We will later learn that push off should be a pull and not a push, but for the sake of understanding the breaking and propulsion actions let’s think of running as landing and pushing off.

The muscles on the front of the leg are considered breaking muscles (tibialis anterior, quadriceps), the ones on the back of the leg are propulsive muscles (hamstrings, calves).

Your tibial muscles are on the front, so when you repetitively and continuously “break” or interrupt your running momentum by landing ahead of the body (over striding), and heel striking (the landing phase) you absorb too much impact. After landing you then use too much muscle power to maintain forward momentum (the propulsion phase).

Rotational forces and breaking impact increase when over striding and heel striking and lead to overuse injuries.

Excessive propulsion can create problems with hamstrings, Achilles tendon, and connective tissue in the lower leg, ankle and foot. When you land ahead of the body and heel strike – breaking you momentum, you automatically need to push off hard to move forward. You basically slow down and re-start with every step. There is no flow, but a constant break and re-start. It’s like a driver who hits the breaks every 10 seconds, break – accelerate – break-accelerate etc, but you do it every second. That’s what’s happening in your body at a smaller scale, whether you feel or not.

These breaking and propulsion motions create high impact, longer stride and vertical push (the bouncing feeling you get when you push off and up). When running like this you are isolating the breaking muscles on landing and isolating propulsive muscles on takeoff.

Impact forces are caused by the hard impact of a heel striking gate, while the excessive rotational forces happen at foot and ankle. As the foot and ankle rotate, the twisting motion continues up the body and results in traction forces on the sheath (periosteum) surrounding the shinbone. This cause inflammation of the sheath, which a type of shin splints as mentioned at the beginning of the article.

 

4. Toe landing

Landing on your heels is heavy, high impact and leads to injuries, but landing on your toes can also lead to injuries. I often see runners who mistake “ball of foot” or “mid foot strike” with running or landing on their toes. It should actually be somewhere in between.

Think about landing on the balls of your feet and then swiftly tap the ground with the heels. This way you don’t bounce around on your toes, nor do you hit the ground with the heels to heavily.

When your body weight is supported by your toes, the shins and calves workload increases.

When you land on your toes you probably also push off your toes in the propulsion phase, which we have already talked about in the previous section.

 

5. Inadequate muscle flexibility and mobility

Inadequate stretching leads to many injuries including anterior knee pain and Achilles tendonitis. This much is already known and everyone agrees stretching is important.

What type of stretching and when to stretch and which are the most effective stretches is a debate, but we all agree we need to stretch. I believe the debate is a debate because no runner is the same, having had the same training history and injuries, so the stretching routines will, of course vary, to a certain degree. The fundamentals are the same though.

It is more or less agreed that, for runners, static stretches at the beginning of the running session are not likely to improve performance. The runner’s muscles need to be ready to “fire up”, to rapidly stretch and contract, so a dynamic stretching routine is best at the beginning of the workout (i.e. butt kicks, high knees, side shuffles) and leave the static stretches (the ones you hold) for the end of the session.

There really is no way around it. Runners need to stretch on a regular basis, like brushing your teeth. And we also need to have the patience for it.

To land mid foot you need to be able to land with the foot roughly parallel to the ground. If your calf muscles are so tight that you cannot flex your ankle upwards to land with the foot parallel to the ground, you will either land too far up on your toes and push off hard in sprinting fashion, in the propulsion phase, straining your calf muscles and Achilles tendon, or you will use the opposite side of the leg muscles, the anterior tibialis (tibia muscle), to lift the toes and force the ankle to dorsiflex, causing shin splits.

Tightness in the calf muscles also causes the foot to overpronate which is a cause of several injuries.

 

6. Dorsiflexion

Dorsiflexion is when runners pull their toes towards their shin and the shin muscles contract. Doing this 10, 20, 30 times is fine, but doing it 10 000 times in one run, several times a week can strain the muscles and lead to pain in the lower leg.

Ensure your calf muscles are loose enough to allow you to dorsiflex. Your ankle mobility also needs to allow for dorsiflexion.

 

Testing your ankle mobility:

  1. Place the tested foot about 4 inches (10 am) from a wall.
  2. Make sure your foot is straight with toes pointed forward.
  3. Attempt to get your knee to touch the wall without lifting the heel or letting your knee move in any direction than forward.
  4. If you can touch the wall without the knee buckling in or shifting out and with the heel on the ground you have pretty good ankle mobility.
  5. Test on both ankles and mark with a couple of pieces of tape (one for the left foot, the other for the right) how far from the wall you are so you can test again after you attempt to improve ankle mobility.

 

7. Over-pronation

Over-pronation, when the foot rolls in excessively, is a common cause of shin splints (as well as knee pain). Over-pronation causes the tibia to twist and the muscles in the lower leg to overstretch. This causes inflammation of the soft tissues that attach to the tibia.

The pain is usually felt on the lower inside part of the leg, near the midpoint of the leg – medial shin splint. But the pain is not local, you may feel the pain in other parts of the leg as well.

 

8. Excessive Supination

Supination is the opposite of pronation. Supination is the foor arch is very high and you walk on the outside of the foot more or less. This is a more rigid foot and doesn’t absorb shock very well. It also transfers more of the impact up the leg causing the pain to be felt on the shin, usually on the bottom half of the shin.

 

9. Weak tibialis posterior muscle

The Tibialis Posterior supports the medial arch of the foot. It is responsible for keeping the arch of the foot when you bear weight on the foot.

When the Tibialis Posterior muscle is loaded more than it can handle, the muscle becomes tight and causes pain around the lower medial shin. In this situation we need to stretch as well as strengthen the Tibialis Posterior muscle and I will share with you some exercises to do this in the next article on shin splints.

 

10. Surface

Running too much on hard surfaces, on cambered roads or running in the same direction on the track, which places the stress on the same side and place over and over again, can also cause shin splints.

 

12. Footwear

Worn out shoes lose their support. Search for shoes that support your foot.

If you have flat feet you want shoes that control the foot motion. That is a shoe that has a rigid sole from the base of the toes to the heel, with a solid heel cup. As it acts as a brace for the foot it can help prevent pronation.

If you have a high arch, your foot is already rigid, so you are looking for shock absorption rather than motion control.

You can combine good shoes with a running techinque assessment to find out how you can tweak your form to reduce the impact force even more.

All shoes should have a flexible toe region to prevent overworking the muscles in the calf during activity and causing other types of running injuries.

 

Do any of these causes of shin splints ring the bell? Do you think any of them lead to your injuries, or maybe other reasons? Leave a comment below and let us know.

Look out for the next article on shin splints where I will share exercises and running technique elements help you to manage, treat and, preferably, prevent shin splints.

 

Sources:

  1. Sam Murphy and Sarah Connors “Running Well”
  2. Danny Dreyer with Catherine Dreyer “Chi Running”
  3. Nicholas Romanov “POSE Method Of Running”
  4. Nicholas Romanov with Kurt Brungardt “The Running Revolution”
  5. Ross Rucker and Jonathan Dugas, Runner’s World “The Runner’s Body”
  6. Danny Abshire “Natural Running”
  7. NHS
  8. Runner’s World
  9. Mayo Clinic
  10. Britannica
  11. https://www.runnersworld.com/shin-splints
  12. https://www.chirunning.com/blog/entry/the-whole-story-on-shin-splints
  13. https://entirepodiatry.com.au/information/injuries/shin-splints/
  14. https://www.runningshoesguru.com/2014/05/running-shin-pain-tibialis-posterior-stretching-strengthening/
  15. https://www.issaonline.edu/blog/index.cfm/2012/10/1/could-your-shoes-be-giving-you-shin-splints-

10 Causes of Knee Pain in Runners

10-Causes-of-Knee-Pain-in-Runners

One of the most common injuries in running happens around the knee because of the impact they need to absorb. We put our knees under pressure with every step, when walking, sitting standing and, of course, running. What we do and how it do it, not only when we run but all the time (this is true for everyone not only runners) is essential for healthy knees.

The kinetic chain means that every part of the body is connected to another part of the body, in such a way that a problem in one area of the body may cause problems in another area are of the body. Nothing in the body is isolated and nothing happens in only one part of the body.

If you have an injured little toe be sure that your body is adjusting to that injury as you cannot use the little toe as you normally would. Those small adjustments can lead, in a few weeks, to tight muscles on the opposite side of your body, for example. Tight muscles will eventually affect your alignment and send pressure to joints, ligaments and tendons, which is not normally their job to do.

That is why an injury, no matter how small should be taken care of as soon as possible, so as to not allow the small problem to escalate and become a major problem.

MOVEMENT

Movement “squeezes” synovial fluid – joint “lubricant” – into the joint. This is why it’s important to take the joint through the full range of motion. For example, if you never take your knee into full flexion, the parts of the surface that don’t come into contact can degenerate more quickly.

We regularly practice full squats, a movement which besides strengthening stability muscles around and within the joints, it also take the ankles, knees and hips through their full range of motion.

MUSCLES

Muscles do the hard work, they are the workers in the body. The brain sends them information with instructions to contract and produce movement, by pulling on the bones.

Since they are connected to the bones, joints and ligaments, injuries (strains or pulls) or weakness in the muscles can cause the knees, and other joints, to take too much pressure, do more than their part of the job and degenerate faster. They basically say “that’s not my job!!”.

THE NERVOUS SYSTEM

The nervous system is the means by which your body components communicate. It’s the network that allows the brain to community with the muscles to produce movement. It’s also the communication channel for the body to send information of position in space to the brain, which then places the body in the best position to avoid injury.

For example, when you run into a ridge on the ground, your body send a message to the brain, which then sends a message back to the rest of the body to assume the best possible position to avoid injury. That includes the arms and head. When you lose balance your arms go the side straight away, that’s why.

Going back to the nerves, if there is a problem with one of the nerves, for example the dreaded sciatic nerve, the effected nerve can refer pain in another part of the body, and that includes the knee.

In the sciatic nerve example, if you have ever suffered by a trapped or irritated sciatic nerve, known as sciatica, you probably felt the sharp pain going down the back of the leg.

A nerve problem refers pain, it’s not usually localised.

RUNNING INJURIES

Running is more associated with chronic injuries than acute ones. That means that the knee injury happens gradually, through time, and symptoms just show up at a later stage.

It’s a build up of stressing certain areas of the body. The reason running is so hard on the joint, ligaments, tendons and muscles is repetitive impact.

Each time your foot touches the ground impact forces travel upward through your lower leg, knee, thigh, hip, pelvis and spine. It’s like an earthquake, shaking everything.

So our job here at The Merisoiu Technique Institute is to help you calm down that earthquake, reduce pressure on your joint and enable you to run stronger for longer.

CAUSES OF KNEE PAIN WHEN RUNNING

The topic of this article is knee injuries or almost any kind of knee pain (doesn’t necessarily have to be an injury for the knee to hurt).

There can be many, many reasons your knees hurt. In this article we mention some of the most common knee pain causes, but it’s not an exhaustive list. In subsequent articles we will take each one and see what we can do to prevent or treat the injury or, if it’s something serious, whom to talk to solve the problem.

Thus, here’s what may cause your knee pain:

1. Surfaces you run on

Let’s begin with the surface you run on. When you run on the same surfaces over and over again there’s a gradual accumulation of the same forces applied on the same areas of the body time and time again, over thousands of steps.

That is why it’s important to add variety to your running surfaces, concrete, off road, track etc. We will talk a bit more about this later in the article.

2. Your running shoes

The shoes you choose are critical to injury or injury prevention. If your shoes are too tight, or they don’t allow for a natural bend of the foot, or don’t allow for the toes to expand, or don’t give the support you personally need your stability can be compromised.

That compromised stability will cause instability in the knee as well. Remember the body sends signals to the brain, my means of the nerve network, to position the rest of the body (including spine, arms, neck and head) in the most efficient way to avoid injury. If the information is not accurate the brain can’t act in your best interest.

A word of caution, today’s cushioned shoes mask the pain of running heavily and incorrectly. If you don’t believe be test it yourself. Take your shoes off and run 50m. You will notice how heavy you actually run. Don’t worry your body will soon begin to adjust and realign to reduce that impact. There’s an immediate foot-brain-body communication and the whole system will begin to adjust.

However, this doesn’t mean you should run barefoot, it only means you should learn the natural or barefoot running mechanics with the regular shoes one. It can be done, you can run with your shoes with less impact.

3. Your training

Same as with the running surfaces if you do the same routine over and over again you will stress the same areas of the body time and time again. If you also run the same route all the time then this is even more true.

Bring variety into your running training to reduce the risk of overuse injuries as well as to create adaptation and make progress.

It is worth, and actually important, to keep a running journal where, besides writing down distance and pace, you will note any niggles and pains during the sessions. You can then go back and maybe identify what caused the injury.

It may have been new running shoes, new route, change in speed, distance, too much, too soon and so on.

4. Change and speed

Increasing mileage, frequency or intensity by more than 10% per week can overload a body that’s not prepared for the effort, thus increasing the risk of running related injuries and, of course, knee injuries.

Running too fast while not prepared is another cause for injury. This is common when a runner transitions from distance running to interval running too quickly.

Distance running and interval running are two different types of running all together. Each requires different muscles and, actually, a different body. Just look at Mo Farah – a distance runner vs Usain Bold – sprinter.  Two different body types.

5. Running form

Your knees may hurt from continuous impact on landing and push off. That is why the running techniques we teach, with elements extracted from POSE Method, Chi Running and Natural Running, are meant to re-train your body to land softer, lighter and reduce the push-off – we pull, not push.

Since we’re talking about running technique, let’s talk about how you can address your running form to reduce the pressure on your knees as well as other joints throughout your body

 

a) Poor alignment when running

Alignment literally means arrangement in a straight line. That’s how you want to see and positions your body when you run. But most runners bend from the hips and they form this crocked line.

What’s stronger or more stable 20 bricks on top of each other on a line, or 20 bricks with just on brick sticking out?

A heel striker will bend from the hips even more pronounced because of the way the hip tilts to allow for the heel strike. If you kept your pelvis aligned you wouldn’t be able to comfortably heel strike.

 

b) Running gait – foot turnout

If your feet turn out as you run it can cause knee pain at any distance because it causes the knee to rotate inwards with every foot strike.

Consequently this will overwork the ligaments and tendons in the knee and lead to knee problems and pain.

See a more detailed explanation of a few knee injuries and conditions at point 4 below.

 

c) Heavy heel striking and landing ahead of the body (overstriding)

Pronounced heel strikers are more likely to develop patellofemoral pain syndrome, because impact forces are transferred more aggressively from the foot to the knee with this type of running.

Impact may can cause knee pain and heel strikers experience greater impact shock. However it can also be caused by excessive rotational forces, which come with a heel strike. A heel strike allows for the foot to rotate in either direction until the foot lands and grounds.

When you heel strike you are also probably landing in front of your body, it’s usually the case since you can’t comfortably heel strike if you land under your body/hips. When you land ahead of your body you are essentially breaking your forward momentum, you’re going against gravity, and you pay for it in the long run (no pun intended).

If your foot stops, as it does when you land in front of the body, and the body keeps moving, your knee becomes the transfer point for all the force. It takes more than its share.

Landing ahead of your body with a locked knee or ahead of your body with an over bent knee, both variations put a lot of stress on the knee join, tendons, ligaments and cartilage.

Also landing wide (with a wide space between your feet, wider than the hip width) ahead of the body with a locked knee and ankle can cause ITB (iliotibial band) pain.

You are landing outside your natural hip width (feet are too wide apart when landing), which causes the legs to bow out so you can move forward. This causes too much lateral movement and your hips need to compensate and adjust which stresses the IT band.

To reduce the impact on your knee join all you have to do is to pick up your feet and land under the body by leaning your body from the ankles, or run with your upper body in front of your foot strike (same thing said a different way).

 

d) Downhill running technique

Most think going downhill is actually better or easier than uphill. Think again. While running uphill your muscles burn, which means they take the load – remember muscles are the workers of the body – downhill muscles relax, and your knees take the load.

There is up to 10 times your body weight with each step when running downhill (Source: Danny Dreyer with Catherine Dreyer “Chi Running”)

6. Structures around the knee

Besides running form, shoes and surfaces you run on, another reason you suffer from knee pain may have something to do with the structures around the knees (i.e ligaments, tendons, cartilage, muscles)

 

a) Patellofemoral pain syndrome (PFPS) or anterior knee pain (where it’s usually felt) is a classic and common chronic injury in runners. It accounts for roughly 20% of all running injuries (Source: Ross Rucker and Jonathan Dugas, Runner’s World “The Runner’s Body”)

The cause of anterior knee pain when or after you run can come from structures which are connected to the knee joint, such as muscles, tendons or ligaments.

If any of the structures around the knee pull incorrectly, or exert too much or too little force, the knee cap can be pulled out of alignment or out of line and it doesn’t roll smoothly as it should.

Misalignment can be caused by strength imbalance of the muscles on the inside (adductors) and outside (abductors) of the thigh, for example the gluteus medius which is a stabiliser muscle.

If the knee rolls in as a result of weak inner and outer thigh muscles, the gluteus medius (gluteus minimus can also be included here) and a muscle called vastus medialis obliquus, can’t do their job properly, so the tensor fasciae latae (TLF) takes over.

But if the TFL has to do more than the job it’s supposed to do it can pull on the illiotibial band (ITB), increasing the lateral pull of the knee cap, again pulling the knee out of the alignment.

A lot to take it isn’t it? The body is not formed of separate pieces, it’s a whole unit. Anything that happens anywhere in the body will have a ripple effect throughout the rest of the body.

If you just run for a bus from time to time you don’t need to know these things, although you should, as general knowledge. Most people know more about how their car functions than how their body works. Which is weird, since they’re driving their body 24/7.

However, if you are a runner and you want to continue running for many years to come, it is essential to understand the basics of running mechanics so you understand how to design your training, when to pull back and when to push on. There’s a difference between productive and destructive pain.

Sometimes the best strategy is to rest and be able to run in 2 weeks, than to push on and be off training for 3 months because of the escalating injuries.

Going back to patellofemonral pain syndrome or anteriot knee pain, to  solve this problem you must find out what is causing your knee to roll in, it could be:

  • Overpronation of the foot
  • Inward rotation of the hips
  • Tight calf muscles
  • Weak abductors
  • Tights adductors
  • Weak gluteus medius (that’s part of the abductors actually)
  • Other tight structures around, below or above the knee (see quadriceps at point 7)
  • Other causes

 

b) Iliotibial Band (ITB) Syndrome

The ITB runs down the outside of the leg and is a thickening of the normal fascia that surrounds the thigh.

To give you a short definition, fascia is a thin membrane that connects or attaches every structure, muscle, internal organs.

ITB attaches to the Tensor Fasciae Latae (TFL) at the front of the hip and to part of the gluteus maximus at the back of the hip.

The TFL goes down to the outside edge of the tibia and to the head of the fibula (the 2 bones forming your shin). It also attaches to the patella (knee cap). If there is any tightness or any problem with the TFL your knee will also be affected.

ITB syndrome is the second most common injury in runners. ITBS is usually felt as a localised pain on the outside of the knee when the leg is bent. It’s usually worse going up and down the stairs and running downhill.

ITB pain can be caused by biomechanical alignment problems such as:

  • Bow legs
  • Overpronation
  • Leg length different

ITB pain can also be caused by training, such as running on the camber of the road on the same side of the road for too long, or on a track when you don’t change direction and run the same way all the time. These 2 cases load one leg more than the other.

Another cause of ITBS can be weak hip stabilisers which increase tension on the IT band upon landing .

Patellofemoral pain syndrome (anterior knee pain) is common in runners with ITBS as the internal rotation of the thigh comes with the weak hip stabilisers.

So strengthening the adductors and abductors, as well as the glutes of course, can help both knee pain and IT band pain.

 

c) Patella tendonitis or tendinosis

Tendonitis is an inflammation, while tendinosis is degeneration of the tendon.

This pain is usually at the bottom of the kneecap. Causes of patella tendonitis:

  1. Microtrauma – tiny damage to the tendon fibres
  2. Excessive excrentric overload of the quads – overload while the muscles are lengthening – which can be caused by overpronation again, turning-in of the hips or knees or excessive tightness in the quads.

 

d) Bursitis or Pes Anserinus tendonitis

Problems with this tendon are not as common but they can happen. The cause is usually tight muscles on the inside of the legs, adductors.

Tendonitis happens when the tension on the area is too great, causing inflammation of the tendon and the underlying bursae.

The pes anserinus tendon runs along the inside of the knees and is a combination of the 3 tendons of the sartorius, gracilis and semitendinosus muscles.

The semitendinosus muscle is part of the 3 muscles that form the hamstring. The other two are biceps femoris and semimembranosus.

The actions of the semitendinosus and semimembranosus is extension of the thigh and flexion of the leg, as well as assisting in the internal rotation of the leg at the knee. Problems with these 2 muscles, tightness, trigger points, injury can send pain to the back of the thigh and knee and well as a portion of the calf.

Since we are talking about hamstrings, excessively tightened hamstring muscles can overload the quadriceps, which, in turn, can refer pain to different areas of the knee. Which leads us to…

7. Quadriceps

All four muscles that form the quadriceps attach to the patella (kneecap) through a common tendon via the patellar ligament to the tibia. Well that’s a mouthful.  Just remember the quads attach to the kneecap.

The four quadriceps muscles and pain associated with them:

  1. Rectus femoris – may cause anterior knee pain
  2. Vastus lateralis – pain may be referred to the back of the knee; pain can go all the way up to the hip on the outside of the thigh
  3. Vastus medialis – can refer pain on the front towards the inside of the knee, going up the thigh as well; may cause buckling of the knee
  4. Vastus intermedius – pain over the front of the thigh; no direct knee pain, but it can affect the other muscles which then cause knee pain

Of course the muscle-pain correlation is not isolated. It’s more to give you an idea of which muscle may cause which pain and where you’d feel it. There may be one or more causes of your knee pain, as we’ve seen above.

I added the quadriceps as a separate bullet point because it’s often overlooked by runners as a cause of knee pain.

Many, if not most, runners forget to stretch and massage their thighs and if they suffer from knee pain the cause may not always be a problem like tendonitis or anything structural, it might actually be very tight quadriceps.

That is why stretching is important, among many other reasons. If you do experience any knee pain, you know, at least, you can exclude one of the possible causes.

By the way, you can overload the quadriceps due to excessively tightened hamstring muscles. So stretch those hamstrings and quadriceps.

Sudden overload through misstep or fall can also overload the quads. But this is less of a repetitive running injury, it’s a sort of accident injury. The later can’t always be avoided, no matter how much you train, it’s part of the game.

8. Cartilage problems

The menisci can be damaged or torn by low level twists. There is usually a clicking in the knee, and pain when squatting. The knee may also lock or give way. The pain is usually felt on the inside of the knee with the knee bent.

I have to add I have first-hand experience with the menisci. Since the age of about 12, because of high intensity training in karate during the growth spurt, both my knee menisci damaged (grade 3 damage) to the point where I could barely walk.

Fast forward, natural movement fitness helped re-align, re-adjust and re-educate my body and body mechanics, to the point where today I can run, jump and practice karate without knee pain 95% of the time. The damage is still there, but their pain isn’t, so I dodged the surgery and I’m able to do everything I want without pain.

It all boiled down to perfecting the art of movement. Perfecting is not quite the correct word, there’s no such thing as perfect mechanics, it’s more like fine tuning.

By the way this doesn’t mean you should ignore your doctor. Everything I write in this article and on this website is not meant to replace any medical treatment or specialised advice.

9. Nerve referring pain

This is a very, very complex situation and only an expert can give you any advice here. All I can say is that if you feel pain travelling it may have something to do with the nerves. When a nerve is damaged, trapped or injured in any way it’s not usually localised, it refers pain in another part of the body.

10. Accidents

A twisting injury or a fall can cause damage to the knee’s structure. You should get an immediate diagnosis.

 

All the underlined topics will have their own articles so look out for them.

 

Sources:

  1. Donna Finando and Steven Finando “Trigger Point Therapy”
  2. Sam Murphy and Sarah Connors “Running Well”
  3. Danny Dreyer with Catherine Dreyer “Chi Running”
  4. Nicholas Romanov “POSE Method Of Running”
  5. Nicholas Romanov with Kurt Brungardt “The Running Revolution”
  6. Ross Rucker and Jonathan Dugas, Runner’s World “The Runner’s Body”
  7. Danny Abshire “Natural Running”

Disclaimer: information in this article and on this website is not meant to replace any medical or expect advice; you should always check with your doctor.

RICE Your Running Injuries

RICE-Your-Running-Injuries

For acute running injuries such as ankle sprains or a strained muscle the first 48 hours are very important for recovery and to reduce the risk  of the injury happening again in the future. It is in those first 48 hrs when the inflammatory response occurs and acute injuries respond best to early treatment.

REST

Take pressure off the injured area and use it as little as possible.

ICE

Ice for about 10 min every 3 hours approx. Wrap ice or a bag of frozen vegetables in a towel, never put ice straight on the skin.

COMPRESSION

Strap the joint, immobilise it, if you can, to prevent further damage. It will also make sure you rest the area…you can’t use it as you normally would.

ELEVATION

Elevate so the blood flows away from the area.

 

From the RICE, Rest and Ice are crucial.

The sooner you RICE your running injury the faster the healing.

You can read more about running technique and running injuries from the following books.

5 Running Books Every Runner Should Read

5-running-books-runners-should-read

Whether you are a recreational runner going for your regular 5k runs, in preparation for a marathon or ultra or obstacle course racing you should consider knowing a little bit more about the runner’s body, your runner’s body.

Understanding the basics of how your body works at a muscular, skeletal and cardiovascular levels will enable you not only to get more out of your training, but to understand why running injuries happen and what do to if they happen.

Of course a professional, such as a physiotherapist, can look at injuries better and in more detail, prescribing a suitable treatment. And you should check with a professional when you are injured. Nonetheless you should also have an idea of what’s going on.

Some running injuries happen because of repeated movements, if you understand what movements cause your injuries then you can eliminate or change them and, as a results, get rid of the injury and avoid it in the future.

Furthermore one way to reduce the impact on your joints and tension in your muscles is to uncover a form of running that does just that.

Below you have a list of, what I believe, are the top 5 books you should read if you are a runner, regardless of the distance you run. There are many great running books I’ve read but these are 5 of them that left an impression on me. Keep in mind that this list and the descriptions are subjective, you may find you will discover something else in these books, but it will give you an idea of which book to choose.

I also organised them in an order that, I believe, will transition you to the mechanics of running in a way that will make sense even if you know nothing about anatomy.

Once you start running consistently wear and tear takes place. If you can reduce that then you can run faster, for longer and with less risk of injuries. In short you will run smarter and more aware of your runner’s body, which is what we begin with:

1. The Runner’s Body by Ross Tucker and Jonathan Dugas

This book takes you through everything that happens in the runner’s body. From how muscles work and fire, to the skeletal system and common running injuries, to the cardiovascular system, metabolic system – where they talk about nutrition and hydration, how the nervous system works and the runner’s immune system.

I find this book very detailed and educational. But you needn’t worry if you  don’t know much about mechanics and anatomy. They explain everything in easy to understand terms. Just read through it and you will catch the information that is most valuable to you at that particular time.

Click on the image below to check out The Runner’s Body by Ross Tucker and Jonathan Dugas on Amazon:

2. Running With The Whole Body by Jack Heggie

This book introduces us to the Feldenkrais Method applied to running. It’s a very, very interesting and important book in my opinion. It’s a short book but each chapter has a series of detailed exercises meant to “reset” your nervous system.

In short through these exercises you re-wire or re-educate your body’s movement to be more efficient not only when running but also when walking and moving in general.

The big picture I took from the book is the connection between the upper and lower body through the hip. Understanding how the hips works with the shoulders to get you to run lighter but also faster and reduce aches and pain will be an eye opener for you as it is for every one of my clients.

The reason this book is on the 2nd place is because running is a whole body movement, and, unless you understand that – understand it not only mentally but also physically, in your body – you cannot develop an efficient running form, in my humble opinion. So check out Running With The Whole Body by Jack Heggie clicking on the picture below.

3. Natural Running by Danny Abshire

Natural Running by Danny Abshire introduces us to the three gates: walking gate, running gate and sprinting gate. But also how to examine your own running form, educating the reader on on foot imbalances and the evolution of the running shoe as well as how to choose your running shoes.

What sets the Natural Running book apart from the others is the explanation on foot biomechanics and the three gates. I also liked the way Danny Abshire approaches the more common overuse running injuries.

Then he goes on to detail the physics of running and whole body kinematics.

You will also find a chapter on exercises to help you develop the natural running technique and an 8-week transition plan.

This is also a good book if you want to learn how to transition to barefoot running or minimalist running (with “barefoot shoes”)

All in all a great book to introduce you to the world of running mechanics. Check out Natural Running by Danny Abshire by clicking the picture below.

4. POSE Method of Running by Nicholas Romanov

POSE Method takes you through a step by step technical approach to more efficient running mechanics.

It describes exactly how to place your feet on the ground, what your legs should do afterwards, how to hold your trunk and much more. There are plenty of exercises to help you develop this particular running technique.

Although it emphasizes the mechanics of running it also dedicates a few pages to the  “thinking, seeing and feeling” process, basically the internal aspect of running.

It also takes the reader through the most common running injuries, why they happen, from a POSE Method perspective, and how to adjust your running technique to reduce the risk of it happening again or in the first place.

This technique will also enable you to run barefoot or run minimalist.

There are several elements of the POSE Method we incorporate in our own running mechanics here at the Merisoiu Technique Institute. Check out the POSE Method of Running by Nicholas Romanov below:

5. Chi Running by Danny Dreyer

Chi Running has its roots in the art of T’ai Chi, “based on the centuries-old principle from T’ai Chi that ‘less is more’ “.

The focus here is on breathing and relaxation in general, as it is in T’ai Chi, going “limp”, opening the stride behind you and letting your body flow.

It emphasises the idea of listening to your body and on patience and consistent practice.

It also talks more about the upper body movement. So take book #2 and put it next to Chi Running and you will develop a very efficient upper body movement which will help you on your toughest runs, including hill running.

Chi Running method  will “give you a physical understanding of how to put it all together in a unified movement”. Check out Chi Running by Danny Dreyer clicking the link below:

 

Hope you will take the time to read a few, if not all of these books. I assure you it’s time well spent. These books don’t only teach you about running but about movement, and movement is what you do every single day.

By the way the amazon links are affiliate links. 

Running Technique – What Not To Do With Your Head When Running

running-technique-what-not-do-with-head

Your head weighs about 4 kg, give or take, with all the accessories (i.e. eyes, ears etc). So bobbing the head around is not a great idea for most people (Paula Radcliffe is a different story, it works for some people).

The point is that what you do with your head sends ripples down the body, all the way to the feet. This means the rest of the body has to adapt to what your head it doing. It’s a chain reaction.

Think about it this way, when you balance on a balance beam, if your head stays over your feet you are balanced. When you head goes left your whole body follows, you lost balance. If you manage to get your head back over your feet you might have a chance of re-gaining your balance.

But it’s more than that, it’s not about that kind of balance, that’s only an example, when you run your body has a different state of balance. When you run you “jump” from one foot to the other, you are on one foot at a time. Your muscles, joints, ligaments all have to activate and do their job to keep everything in one piece and going forwards. There are many elements of movement you have unaware of. And your head it an important part of this chain.

Bottom line, the idea is that your head should be nicely balanced at the top of your spine, with your neck relatively straight, don’t tilt your head backwards or forwards, left or right. Just straight.

Yeah but you need to look ahead!! You might think you need to lift your head to look forward or tilt it forwards (chin to chest) to look down. Actually the eyes are independent of the head, they can look up, forward and down without the help of the head. To a certain angle of course, after that head needs to move as well.

Most runners tilt their head backwards, so they can look ahead I suppose (I used to be one of them until recently), putting strain on the back of the neck and cervical vertebrae. Since this is a chain reaction, the tension and strain goes down through the body, ripple effect. While running there is a lot of vibration going through the body, neck and spine as it is, you don’t want your 4 kg pounding on top of your spine, do you?

That being said your head with never stay put, it has to have some movement of course. It’s a balancing act in fact. If you try to stop it you will only tense and strain your neck even more than if you don’t.

Try this when you walk to begin with:

  • keep chin parallel to the ground
  • back of neck straight
  • look forwards – eyes are independent of your head!

Actually, when you get the hang of it, having a straight neck releases that tension at the back of the neck, tension you are probably not aware of….until you straighten your neck. I know I do run faster and easier when I straighten my neck, it’s an instant shift, but you can’t tell you are tensed until you relax.

SUMMARY

DON’T

  1. Tilt head back
  2. Tilt head forward (chin in chest)
  3. Tilt head to the side
  4. Bob your head

DO

  1. Keep chin parallel to the ground
  2. Keep back of neck straight (there will be a natural curve in the spine of course)
  3. Use eyes independent of the head when possible (probably not on tough trail terrain, make sure you see where you step)
  4. Allow for the natural head movement

If you want to run lighter, faster and stronger get your head in the right place. And if you have any questions just leave a comment below.

In the meantime, keep developing your running skills.

Running Is NOT Only About The Legs

Running-Is-NOT-Only-About-The-Legs

Running is not just a leg movement, it’s a whole body movement and a skill to develop and improve continuously.

Take for example the simple movement of arms and legs. Here are a couple of exercises for you to test the connection between your upper and lower body.

Exercise 1

Walk as you normally would over a 50-100m distance if you can.

Now walk exaggerating the movement of your arms and shoulders only, again 50-100m. Everything else moves normally. What are your legs and hips doing? How do you feel? Are you in control of your movement?

Now walk exaggerating the movement of your legs and hips only. What are your arms and shoulders doing? How do you feel? Are you in total control of your body?

Now walk exaggerating the movement of your arms shoulders as well as your legs and hips. Walk faster, then slower, then faster and notice how your feet are moving and are positioned with each step, notice the level of control you may or may not have and your overall coordination.

Now hold your arms tied to your body and your hands to your thighs. As you walk move your shoulder and whole arm forward. But remember the arms and hands are tied to the legs, so the whole side of the body moves forward, each side at a time

How do you feel? Do you feel your body is moving efficiently? I’m not looking for a specific answer, although you can guess that should happen. I’m interested in your becoming aware of what’s happening to and with your body.

 

Exercise 2

Here’s another example: walk with your arms behind your back.

You will probably notice that your shoulders still want, and struggle to move your arms but the arms aren’t going anywhere. It’s a struggle, you have to put in more energy than usual. If you continue walking like this at your normal walking speed you’d feel tired, more than you’d normally feel.

Notice how much effort the legs have to make to move you forward, how your core muscles do extra work trying, in vain, to move your arms.

Now release your hands and arms and walk normal. How easy is that. It’s just right, natural.

 

Do the 2 exercises above while running as well, you will see a massive difference between when using your arms and shoulders and when you don’t. Replace “walk” with “run” in the instructions.

 

Your body moves the way it moves because it was designed to move like this, this is the most efficient way to move, with the whole body as Jack Heggie says in his book Running With The Whole Body.

Yet many runners hold their arms tight to the sides. You don’t have to strain your arms and shoulders but they do have to move in co-ordination with your legs and hips.

When you move in co-ordination there is a spiralling motion in your spine. Certain muscles contract  storing energy, while opposite muscles stretch and energy is released. You run faster, easier, and, most importantly, you reduce the risk of injuries because your body will begin to move like a well oiled machine, rather than pushing, pulling, struggling and straining.

However that doesn’t mean you have to move your upper body excessively. It’s enough to release tension in your shoulders and allow the arms to move like pendulums back and forth from your shoulders, as if you are hitting someone behind you.

Keep your body moving the correct way, keep your joints as healthy and strong as you can and run for as long as you want.

Explore and develop an effortless and injury-free running style in our fast-track 4 weeks course 1-2-1. You will have videos and material after the course to help you continue to develop your running style. Want to know more? Just contact us here.