Injuries associated with running

I was talking with a few personal trainers and athletic trainers during the past few weeks and the discussion was about the different types of injuries that are caused by participating in sports and activities. It seems each sport has one or two types of injuries that occur more frequently than the usual sprained ankle injury. And some injuries do not happen in sports. I have had flute players and accountants with injuries that required exercises to correct the problem. It just seems that if a person participates in an activity that is repetitive an injury may occur over time. It may start out at a young age with the so-called teenage slouch that will lead to problems as they reach adulthood.

For runners there are several types of injuries that can occur from muscle imbalance in the core area of the body. The main recognition of this imbalance is a sway back. The core area is the abdominal muscle, the low back muscles, the hip flexors and the hamstrings. The initial cause is a forward tilt of the pelvic girdle. The usual imbalance is the hip flexor muscles (ilio-psoas) is strong and causes the pelvis to tilt forward. This forward tilt puts a stretch on the abdominal muscles. The sway back caused by the pelvic tilt in turn causes the low back muscles (sacrospinalis) to shorten. With the pelvis tilting forward the posterior side of the pelvis is slightly higher. This extra height of the pelvis causes the hamstring muscles that attach to the underside of the pelvis to be put on a stretch.

The resulting hip flexion strength and shortening combined with the lower abdominal muscle being stretched can cause an injury. I didn’t notice this imbalance until I started to train for marathons and started to put in long runs. With the pelvic tilt the internal organs were pushed against the lower abdominal muscle attachment on the pelvis. It created a painful lower abdominal muscle stretch and weakness. I had to change my running posture from a sway back to a level pelvic girdle.

The shortened low back muscles and the resulting stretch of the hamstring muscles causes another problem. On a long run the resulting sway from having the vertebra being curved more than normal puts extra pressure on the nerves coming out of the lower lumbar vertebrae.

The extra pressure on the nerves may cause pain in the sciatic nerve that runs down the back of the leg. And if the runner has an occasion to bend forward to lift a weight the low back muscles may be strained. Tight low back muscles are unforgiving when it comes to bending forward at times. You recognize this problem when you see a person, or runner, with their hand pressed against the side of the low back trying to relax the tight muscle.

For a sprinter the pelvic tilt and resulting stretch on the hamstrings will cause a strain or tear of the hamstrings. A tear in the hamstrings can come from two causes. If the hamstring muscle is tight the tear will be down in the belly or middle of the hamstring. If the tear is up high under the buttocks the cause is from a weak lower abdominal, a forward pelvic tilt, and the stretched hamstring. A sprinter will have a much higher knee lift for speed. This is a natural form for a sprint pace. The problem happens when the runner straightens the lower leg out as the leg reaches for the ground. This usually happens in the middle of the race as the hamstring muscle starts to get tired and tight trying to increase speed.

If the hamstring is on a stretch in the beginning the result is often a muscle strain. It is easy to recognize the cause of the injury by where the athlete grabs the back of the leg.

Up high means the tear came from that weak lower abdominal and resulting pelvic tilt. If they grab down in the middle of the leg the probable cause may be from a tight hamstring.

Running as an activity is a relatively safe sport to participate in. For the most part the majority of individuals that run are able to pursue the activity injury free for the length of their career. It is when the runner has a muscle imbalance, poor posture, or poor running form that an injury may occur.

It usually does not happen until the runner starts to increase the distance of the run or increases the speed of the run.

One good point is that with corrections to the source of the problem, whether it is a muscle imbalance or poor posture, the problem can be corrected with proper exercises and running can continue with no further injuries.