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Tackling the Top Running Injuries

Dr. John Gross offers straightforward advice to help treat and prevent the most common women’s running injuries.

Based on your experience, what are the most common running-related injuries women face? Are there injuries women are more prone to than men?

The most common running injuries in women aren’t so different than those found in men. The only difference is the incidences of them are somewhat higher in women. The top three running injuries in women are knee tendonitis, otherwise known as runner’s knee, iliotibial band (IT band) syndrome and shin splints, which, if untreated, will progress to stress fractures.

Quite often, runners who experience runner’s knee will have a weak vastus medialis oblique (VMO) muscle, which helps to keep the patellartendon in line. A weak VMO muscle will cause the patellar tendon to deviate one way or the other, resulting in inflammation of the knee.

IT band syndrome is inflammation of the tendon that connects your femur (thigh bone) to your tibia (lower leg bone). This inflammation can make it very painful to go up or down stairs and stand up after sitting for prolonged periods of time, often called the “theater sign.” Women’s hips are shaped differently than men—they are inherently wider at the hip joint. That angle where the hip meets the top of your kneecap is called the Q angle. With each stride you take, a wider Q angle puts stress on your IT band, causing inflammation in the knee.

The third most common running injury is shin splints, which are micro-cracks along the inner portion of the large bone in the lower leg. Shin splints are associated with overtraining or not resting enough. If untreated, they can become full-on stress fractures, which are true breaks in the bone due to overtraining. Shin splints cause intense pain across the front of your leg below your knee while running.

How can you treat these injuries if you happen to get them?

Treating these injuries can be very frustrating because, as a runner, you want to get out and do what you love. But you have to be honest with yourself. If you’re experiencing pain, you need to give the injury a chance to heal. When you have any symptoms mentioned above you should stop running and start RICE, which stands for Rest, Ice, Compression and Elevation.

For beginner runners, it is imperative to do RICE under the guidance of a physician or sports medicine physician. More experienced runners can do this on their own, as they are more able to recognize injuries.

I would also recommend some kind of anti-inflammatory medicine, such as Advil, Motrin or Naproxen. If it’s not getting better in a reasonable amount of time, say three to five days, the injury needs to be evaluated. All three of these injuries can require surgery on rare occasion. However, most times they can be treated simply by allowing your body to heal itself.

How can you prevent these injuries from occurring?

If a runner suffers from runner’s knee, I recommend exercises to strengthen her VMO, which includes simple knee extension and hip abduction exercises (squeezing a ball between your knees) two to three times a week. These are very simple exercises that runners might want to incorporate into their workout regimen to keep their VMO strong. While a lot of runners don’t like to do resistance training, this is a type of cross-training routine that will keep them injury free.

To help prevent IT band syndrome, I recommend side bend and hip flexor exercises, which strengthen the lateral abdominal muscles and IT band. To do side bend stretches, stand straight and bend to one side as far as you can. Return back to the starting position. I recommend two sets of 15 repetitions for each side. To do hip flexor exercises, step forward and kneel on your right knee, turning your torso to the right to put stress on the IT band. Hold for five to seven seconds. Repeat three times on each side.

The best prevention of shin splints is to wear properly fitted running shoes and run on softer surfaces such as asphalt (not concrete). In addition, be smart about mileage and try not to do too much at one time.

Is there anything else a female runner can do to stay injury-free?

To avoid all of these injuries, I recommend the following three tips.

The first is to warm up to stretch, not stretch to warm up. You should run for three to five minutes or do some power walking to warm up your musculature and then stretch. This is a change in thinking from what we are accustomed to, but studies show that you can decrease your rate of injury by warming up before you stretch.

The second tip is to plan for rest. I think a lot of runners, especially beginners, don’t incorporate rest into their workout regimen. I think women runners, in particular, are very goal-driven and often believe they have to work out every day in order to reach their goals. But the best way to prevent injury is to incorporate rest.

The last tip is to hydrate. I think a lot of runners don’t know how much to hydrate. As a rule of thumb, for an average runner, you should rehydrate with 17 ounces of water for every pound that’s lost and drink throughout the day until your urine is a light yellow or clear color. I recommend measuring your pre- and post-run weight. These are all proactive steps to help prevent injuries in the first place.

Dr. John Gross practices family medicine in Saint Petersburg, Fla., with a specialization in sports medicine. He was also the medical director for the inaugural Women’s Half Marathon and 5k.

*As told to Breanne George