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Reading Chiropractor Toby Roberts-Moore at Reflex Spinal HealthApril is traditionally considered by many to be Marathon running month! Since so many of our guests here at Reflex Spinal Health have been undertaking vigorous training plans for the past few weeks and months, we thought it was an ample opportunity to discuss some of the most common running injuries, how to treat them and how to avoid them. Written by Reading Chiropractor Toby Roberts-Moore.Common Marathon Running Injuries Runner’s Knee – Otherwise known as patellofemoral pain syndrome, is a very common overuse injury in runners, often caused by improper running technique and muscular imbalances. It presents as pain around or underneath the knee cap, and can be exacerbated by going up or down the stairs, running, and squatting. (Smith, B.E. Et al, 2018). Iliotibial Band Syndrome – One of the conditions that comes under the ‘Runner’s knee’ umbrella. The most common cause of pain on the outside of the knee, Iliotibial band syndrome (ITB Syndrome) is an overuse injury of the IT band moving over the outside of the knee. The pain usually presents at the end of exercise, however if left untreated, can cause the symptoms to be present at the beginning also. (Smith, B.E. et al, 2018). Team Reflex's Rob Bryson at London MarathonShin Splints – Often seen during or after exercises that involve repetitive movements (Running!), it presents as pain on the front of the shin or just above the ankle. You are especially at risk of shin splits if you have flat feet or high arches, suddenly increase the frequency and intensity of training, and if you run on hard or uneven surfaces. Achilles Tendinitis – Your Achilles tendon is the largest and strongest tendon in the body, it connects your heel bone to the calf muscle. When the tendon gets repeatedly irritated it can become inflamed, which in turn leads to pain. Up to 6% of the population suffer from Achilles tendon pathology in their lifetime, but this can often be much higher in runners and dancers. (Maffulli, N. et al 2019). Plantar Fasciitis – occurring in 8-10% of regular runners, plantar fasciitis is a condition where there is regular and consistent pain in the fascia on the base of the foot. Plantar fasciitis occurs as a result of repetitive microtraumas to the base of the foot, which causes degeneration in the plantar fascia. It can usually come on first thing in the morning, or when walking after being inactive for a moderate period. (CKS, 2024). Blisters – their significance often overlooked by many, blisters occur as a result of improper fitting shoes and excess sweating and heat; this causes the skin layers to separate and fluid entering the space, forming the blister. Blisters are certainly best avoided with marathon running!Treatment of Running Injuries Digital foot scanning for bespoke foot orthoticsBefore our practitioners decide the best course of action to treat your injuries, we must first take a detailed history of your condition, depicting where your pain is, how long your pain has been present, and potential triggers that may have led to this pain coming on. Once we have all of the information, one of our chiropractors or osteopaths will be able to present the best plan of action for your condition. Detailed below are some of the treatment modalities available for the treatment of sports injuries at Reflex Spinal Health: - Chiropractic or Osteopathic Adjustments and Manipulation – Typically people only think of spinal manipulation, and although this can be very beneficial for runners, when combined with manipulation of the lower limb, it can allow your performance to be heightened even further. - Soft tissue therapy – Hands on therapy focused on improving mobility and easing pain through relief of tension in muscles and joints. Soft tissue release improved oxygen flow, reduces muscle spasms and can also decrease blood pressure. (Gosforth Physio 2020). - K-Laser – A state of the art piece of equipment that reduces inflammation, speeds up the healing process, and reduces scar tissue. It also ensures the reduce of re-occurrence of the injury. (Dundar, U 2015). - Foot Orthotics – The gold standard for management of plantar fasciitis, they’re also hugely important in enhancing sports performance, reducing pain, and improving posture. Foot Orthotics can also help in injury prevention; this is by providing stability, shock absorption, and also ensuring that your biomechanics are perfect whilst exercising, and when not. - Myofacial Dry Needling – A technique that involves inserting very fine needles into muscles and fascia in order to relieve and reduce tension in a muscle.Tips to Prevent Marathon Running Injuries Regular adjustments! Regular Massage! Stretching! Appropriate rest!References: Dundar, U. et al. (2014) ‘Effect of high-intensity laser therapy in the management of myofascial pain syndrome of the trapezius: A double-blind, placebo-controlled study’, Lasers in Medical Science, 30(1), pp. 325–332. doi:10.1007/s10103-014-1671-8. GosforthPhysio (2020) The benefits of soft tissue massage: Gosforth Physio, Gosforth Physio & Wellness. Available at: https://www.gosforthphysio.co.uk/about-us/blog/the-benefits-of-soft-tissue-massage/ (Accessed: 14 March 2024). Maffulli, N. et al. (2019) ‘Achilles insertional tendinopathy: State of the art’, Journal of ISAKOS, 4(1), pp. 48–57. doi:10.1136/jisakos-2017-000144. Plantar Fasciitis (no date) NICE. Available at: https://cks.nice.org.uk/topics/plantar-fasciitis/ (Accessed: 14 March 2024). Smith, B.E. et al. (2018) ‘Incidence and prevalence of patellofemoral pain: A systematic review and meta-analysis’, PLOS ONE, 13(1). doi:10.1371/journal.pone.0190892.