Running Injury Explained: The Diagnosis is Not the Problem

May 24, 2019 | Tony Mikla DPT, MSPT, CSCS

In running, we consistently face overuse injuries. These injuries are often diagnosed as patella tendonitis, plantar fasciitis, shin splints, IT band tendonitis, and even low back pain. Contrary to common thought, these common running injuries are really a result of one problem.

That one problem is tissue tolerance.
Overuse injuries are usually painful symptoms that can come up out of the blue, or they can be festering for a long time. What we feel is the tissue complaining due to the forces that are being put on it. The tissues cannot tolerate the forces being placed on them, so they trigger a pain signal, which is a warning sign to the body to stop activity. Because they are asked to do more than they can tolerate, they begin to form irritation and inflammation which we then call tendonitis or overuse injury. The recovery process is often lengthy to allow the tendon to calm down. In assessing the injury at KIME, we consider the source of these problems and the fact that these problems often stem from somewhere else in the kinetic chain. The immediate question should be:

“Am I transferring force through my body efficiently?”
If the force is transferred to the kinetic chain efficiently, we don’t have some tissues taking more load than other tissues. In order for us to address the problem, we need to make sure that energy and force can flow through the body synergistically without being caught up in certain areas or without causing tissues to compensate.

Let’s go through a few tests to see if your body can transfer energy efficiently while running.
The first tests are going to be mobility focused.

ANKLE DORSIFLEXION ASSESSMENT

HIP INTERNAL ROTATION ASSESSMENT

HIP EXTENSION ASSESSMENT

HIP FLEXION ASSESSMENT

The following tests are going to be more strength and stability focused.

INVERTED T HOLD ASSESSMENT (1 MINUTE)

SIDE PLANK ASSESSMENT (1 MINUTE)

If you are unable to complete these tests with the parameters above, then chances are you have an energy leak in your kinetic chain. That means tissues are compensating and you may have pain as a result of that or you may not have pain YET… If you struggle with these tests, then contact us or a movement professional to find ways to improve.

If you’re interested in more information about body mechanics during running, see our blog post titled “Stop Jogging and Start Running”.

Consider that in running overuse injuries, diagnosis is not the problem. The dysfunction is. Identify the dysfunction using movement assessments like the ones above.

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