Common Tendinitis Injuries in Runners: Symptoms, Causes, and Management Strategies
Tendinitis, more correctly known as tendinopathy, is a degenerative process of a tendon mostly caused by compressive forces that exceed its capacity. This compression is why we most commonly see tendon pain at the point where the tendon attaches to the bone rather than in the middle of the tendon. While the thought of degeneration can be scary, this process occurs at the cellular level and rarely increases the risk for rupture or tears. This blog will delve into the most common types of tendinopathy that affect runners, their symptoms, causes, and strategies for prevention and management.
Achilles Tendinopathy
Proximal Hamstring Tendinopathy
Patellar Tendinopathy
Gluteus Medius Tendinopathy
Iliotibial Band Syndrome (ITBS)
Conclusion
1. Achilles Tendinopathy
Symptoms
Achilles tendinopathy is characterized by pain and stiffness at the base of the Achilles tendon where it meets the heel. Runners often notice pain that worsens with activity and eases during rest periods. The area might also be tender and swollen.
Causes
Achilles tendinopathy typically results from runners increasing their mileage or intensity too quickly. Another contributing factor is increasing uphill running too much.
Prevention and Management
Gradual Progression: Increase your running intensity and distance gradually to allow your body to adapt.
Strengthening: Slow and heavy strengthening of the calf (gastrocnemius and soleus) can add support to the foot and ankle and improve tendon resilience.
Cross-Training: If running at decreased time, intensity, and frequency is not comfortable, incorporate low-impact activities like swimming or cycling.
Physical Therapy: Consult a physical therapist for personalized exercises and treatments.
2. Proximal Hamstring Tendinopathy
Symptoms
Proximal hamstring tendinopathy causes pain at the upper thigh where the hamstring tendons attach to the pelvis at the “sit bones”. The pain can be sharp and aggravated by activities that involve bending or flexing at the hip, increasing tendon-on-bone compression.
Causes
This condition often occurs in runners who engage in high-intensity or long-distance running and progress their training too quickly.
Prevention and Management
Gradual Progression: Increase your running intensity and volume gradually to avoid overloading the tendons.
Isometrics: Held hamstring contractions, like bridges, can significantly and immediately improve pain symptoms.
Strength Training: Once pain is controlled, focus on slow and heavy strengthening of your glutes, hamstrings, and hip muscles.
Increase Step Cadence: Increasing step cadence by 5-10% can significantly reduce force at the knee.
Cross-Training: Incorporate low-impact activities like swimming or cycling.
Physical Therapy: Consult a physical therapist for a personalized exercise regimen and manual therapy techniques.
3. Patellar Tendinopathy
Symptoms
Patellar tendinopathy causes pain at the bottom point of the kneecap or the top point of the shin, where the tendon touches the bone. The pain is usually more intense during activities that involve jumping or running and can worsen when going up or down stairs.
Causes
This condition is often caused by high repetitive stress on the patellar tendon. Sudden increases in running volume, duration, or intensity, an overstriding running form, and weak quadriceps muscles can contribute to patellar tendinopathy.
Prevention and Management
Gradual Progression: Increase your running intensity and volume gradually.
Isometrics: Held contractions of the quads can significantly and immediately improve pain symptoms.
Strength Training: Focus on slow and heavy strengthening of your quadriceps, hamstrings, and hip muscles.
Increase Step Cadence: Increasing step cadence by 5-10% can significantly reduce force at the knee.
Cross-Training: Incorporate low-impact activities like swimming or cycling.
Patellar Strap: Wearing a patellar tendon strap can provide additional support and relieve pressure.
Physical Therapy: Consult a physical therapist for a personalized exercise regimen and manual therapy techniques.
4. Glutes Medius Tendinopathy
Symptoms
Gluteus medius tendinopathy presents as pain on the outside of the hip. The gluteus medius helps to keep the pelvis level when standing on one leg. This condition is often caused by weakness, resulting in a hip drop causing tendon compression, and is often misdiagnosed as greater trochanteric bursitis.
Causes
This condition often stems from weakness in the gluteus medius muscle. Sudden increases in training intensity and running on uneven surfaces can also contribute.
Prevention and Management
Gradual Progression: Increase your running intensity and volume gradually.
Isometrics: Held hip abduction contractions, like standing kicks against a wall, can significantly and immediately improve pain symptoms.
Strength Training: Focus on slow and heavy strengthening of your glutes and hip muscles.
Increase Step Cadence: Increasing step cadence by 5-10% can significantly reduce force at the knee.
Cross-Training: Incorporate low-impact activities like swimming or cycling.
Physical Therapy: Consult a physical therapist for a personalized exercise regimen and manual therapy techniques.
5. Iliotibial Band Syndrome (ITBS)
Symptoms
ITBS manifests as pain on the outside of the knee, increasing tendon compression, which may extend up the thigh. Runners often feel a sharp or burning pain that worsens with activity and can be particularly severe when running downhill.
Causes
ITBS occurs when the iliotibial band, a thick band of tissue running from the hip to the knee, becomes tight or inflamed. Contributing factors include weak hip muscles, running on uneven surfaces, and narrow step width.
Prevention and Management
Gradual Progression: Increase your running intensity and volume gradually.
Increase Step Cadence: Increasing step cadence by 5-10% can significantly reduce force at the knee.
Isometrics: Held hip abduction contractions, like standing kicks against a wall, can significantly and immediately improve pain symptoms.
Strength Training: Focus on slow and heavy strengthening of your glutes and hip muscles.
Cross-Training: Incorporate low-impact activities like swimming or cycling.
Physical Therapy: Consult a physical therapist for a personalized exercise regimen and manual therapy techniques.
General Tips for Preventing Tendinopathy
Gradual Progression: Increase your running frequency, duration, and intensity gradually to avoid overloading the tendons. Tendons have a natural capacity, and exceeding that puts you at significant risk for tendinopathy.
Strength Training: Strong tendons are happy tendons. Performing heavy, slow resistance can improve the thickness and resilience of tendons.
Take it Easy: There are two types of tendinopathies: reactive and regenerative. Reactive tendinopathies resolve quickly and are easy to manage, lasting just a few weeks. If a tendinopathy is ignored, it can degenerate enough to need full regeneration, which can last 6 months to several years. If you feel one coming on, decrease your training and consult a running physical therapist to guide you through this injury.
Conclusion
Tendinopathy can be a frustrating setback for runners, but with proper prevention and management strategies, you can minimize the risk and keep running strong. Remember to progress gradually, incorporate strength exercises, and listen to your body. If you do experience tendinopathy, schedule a consultation call below to develop a tailored treatment plan and get back on the road safely. Happy running!
Disclaimer: The information provided in this blog is intended for educational purposes only and should not be considered as medical advice. The content is based on general knowledge and personal experience related to running and patellofemoral pain syndrome (PFPS). It is not a substitute for professional medical evaluation, diagnosis, or treatment. Always consult with a qualified healthcare professional before making any changes to your exercise routine or if you have concerns about your health. The author and publisher of this blog disclaim any liability for any adverse effects or consequences resulting from the use of the information provided.