Dr Kannan Kaliyaperumal tells us about 3 common injuries experienced by runners and how to avoid them.
Scenario 1: I am a weekend warrior – I run a few hours every weekend to burn calories. Recently during my run, I developed pain at the front of the knee. The pain was very sharp and severe.
You may be suffering from a condition known as ‘runner’s knee’, otherwise referred to as anterior knee pain. It is a very common symptom among athletes and runners. As a weekend warrior, it is even more important you pay attention to this symptom as your body may not be as well conditioned as that of an active professional athlete.
The most prominent of the knee is the patella, which is commonly known as the kneecap. As we run, our muscles contract and the kneecap glides over the thighbone. If our thigh muscles are weak, the kneecap is unable to glide smoothly. This abnormal gliding then causes knee pain as the patella knocks unusually on the thighbone.
Additionally, the tendons above and below the kneecap could be inflamed from overuse, hence causing knee pain as well.
Another reason why you experience pain in your knees could be because a structure within the knee or a ligament is injured.
The most common structure within the knee that tends to be injured is the meniscus. The meniscus is a type of cushion that protects the cartilage within the knee during impact. When we accidentally twist the knee or land awkwardly while running, it’s possible for the meniscus to be injured.
If the pain persists, it is best to seek a medical opinion from an orthopaedic surgeon. Once a ligament or meniscal knee injury has been ruled out, you can begin with physiotherapy to strengthen the muscles.
Occasionally, if there is structural damage to the knee and when physiotherapy does not work, surgery may be required. Knee surgeries are usually minimally invasive and there is a shorter recovery period.
Scenario 2: I run about 3–5km every 2 days. When I press my fingertips along my shin, I feel a sharp pain. The pain is worse in the morning, especially when I try to lift my foot up to flex my foot.
You probably have shin splits. A shin splint is an inflammation of the muscles, tendons and bone tissue around the inner edge of the leg bone (tibia). They are often associated with running or walking for prolonged periods of time. In general, shin splints develop when the muscle and bone tissue in the leg become overworked.
Standard treatment includes several weeks of rest from the activity that caused the pain. It may be advisable to switch to lower impact activities such as swimming or stationary bike.
You should be free from pain for at least 2 weeks before returning to exercise.
If the pain in the shin persists it is best to seek a medical opinion.
Occasionally a stress fracture occurs in the tibia. A stress fracture is a small crack in the tibia caused by overuse. Your specialist may sometimes order a bone scan or magnetic resonance imaging (MRI) study to pick up on a stress fractures in the tibia.
It is best to prevent the occurrence of a shin splint. Keep in mind the following when exercising
- Always wear the right sports shoes of the right fit
- Slowly build your fitness level by engaging on a structured fitness programme
- Avoid bursts of exercise routines to avoid any overuse injury to the tibia
Scenario 3: My 42-year-old auntie does a lot of running. She experiences pain in her heel – the pain stretches to the Achilles tendon attached to the heel bones, which interferes with her normal activities, particularly when she exercises.
She most likely has Achilles tendon inflammation.
There are 2 types of inflammation – insertional and non-insertional – based on which part of the tendon is inflamed.
Pain occurring in the area where the Achilles tendon attaches to the heel bone is known as insertional Achilles tendonitis. This happens more in the middle to older age group. A small group of patients may also experience pain on the sole of the heel.
In non-insertional Achilles tendonitis, fibres in the middle portion of the tendon have begun to degenerate. This condition commonly affects younger people.
In most cases, non-surgical treatment options will provide pain relief although it may take a few months for symptoms to completely subside. A structured physiotherapy program also helps to condition and strengthen the Achilles tendon.
Surgery should only be considered if the pain does not improve and it becomes difficult to wear shoes or perform simple day-to-day activities.
The specific type of surgery depends on the location of the inflammation, amount of bone spurs and the amount of damage to the tendon. Bone spurs are extra bone growth often as a result of repetitive stress to the tendon. The goal of this operation is to remove any excessive bone growths and repair the damaged part of the Achilles tendon.
It is best to discuss the options with your orthopaedic specialist.
Article contributed by Dr Kannan Kaliyaperumal, orthopaedic surgeon in Mount Elizabeth Novena Hospital