Avoid Running Injuries for the Chicago Marathon and All Your Runs!

The attitudes of many exercisers are that injuries are a normal part of running, and most injuries just appear with time. “Not so,” says Dr. Rachel Glick, a sports and advanced surgery trained podiatrist at the AnkleNFootCenters in Chicago. “Most injuries can be tracked to a certain cause, such as overuse, faulty biomechanics, or lack of flexibility. Commonly injured areas of the lower extremity include the knee, ankle, Achilles tendon, arch and heel, and the forefoot.”    Let’s review:


Most aches and pains are overuse injuries. Each running step requires your foot to absorb three to four times your bodyweight, and the repetitive stress of this shock can lead to breakdown and injury. Follow these training guidelines to preventing overuse injuries:

  • Build mileage slowly. Increase by no more than 10% a week or 20% every two weeks.
  • Follow hard days with easy recovery days. Listen to your body!
  • Do not routinely increase your weekly mileage, plan easy and hard weeks.
  • Crosstrain. Replacing a day of running with swimming, bicycling, in-line skating, or
    stair-climbing will give you an aerobic workout while resting muscles used in running.
  • Your risk of overuse injuries rises dramatically as your mileage goes above 40 to 50 miles
    per week. Maintain this level only if you can do so relativelypain-free.


 The relationship of muscles and joints to how you run is called biomechanics. Faulty biomechanics greatly increase your risk of injury. The most common example is pronation of the joint below the ankle, which can be noticed as a collapsing arch or rolling in of the ankle as your foot lands.

To determine if you have improper biomechanics, look for worn out tread patterns on shoe bottoms or notice if your ankles “roll in”. Tread wear on the inside or outside of your shoes signifies excessive joint motion and with proper assessment of your gait by a sports medicine podiatrist can be accommodated.

Custom prescription orthotics will help-but should be made by someone who really understands sports biomechanics.


“Running has many benefits, but increased flexibility is not one of them. In fact, although running will strengthen your leg muscles, it will also shorten and tighten them” states Dr. Christina Sarantopoulos, another specialty trained podiatrist at the AnkleNFootCenters. “Tight muscles and tendons restrict your range of motion therefore stretching before and after running is an extremely important prevention method. Since we don’t like to stretch for 10 minutes before and after-cross train with a sport that requires stretching-like Yoga”

Other common aches and pains and associated treatments that are provided at AnkleNFootCenters


Pain in the heel or arch of the foot is often a diagnosis of plantar fasciitis.  Inflammation occurs at the heel bone insertion of a fibrous tissue (plantar fascia) that stretches across the bottom of the foot. Pain may be present upon first step in the mornings, standing after periods of rest, or right before or after a run.  Chronic plantar fasciitis may lead to the formation of a bone spur on the heel. Both flat feet and high-arch feet are prone to this injury. Treatment may include a combination of therapies including, rest, stretching, taping, arch supports or custom orthotics molded by a podiatrist, or ultrasound guided medication placement.  At AnkleNFootCenters we offer in-house, advanced physical therapy modalities such as ultrasound and electrical stimulation for the patients’ convenience and benefit. We even have Platelet Rich Plasma (PRP) Treatments and High-Tech Sound Wave therapy—-Previously available only to elite athletes


 One common knee injury is patella-femoral compression syndrome (also known as chrondomalacia patella). This occurs when the knee cap bangs into the femur, the bone behind the kneecap. This can be caused by excessive pronation or muscle weakness around the knee. Rest and icing can reduce temporary pain. If it is caused by pronation, shoe inserts or custom orthotics will adjust the joints in your rearfoot and ankle and hence knee to help reduce flare-ups. If the cause is from weakness around the knee, treatment will aim at strengthening your quadriceps muscle group. Well made biomechanic sports orthotics may help

Iilio-Tibial Band Syndrome (ITBS) is another common cause of pain on the outside of the knee. Discomfort has a slower onset and occurs after running a certain distance. A podiatrist will evaluate for excessive internal rotation of the leg or pronation of the foot joints as a cause. Either condition will cause the ITB to be stretched over a bony prominence of the femur (thigh bone), which leads to irritation and subsequent pain. Treatment includes rest, icing, eliminating over-pronation in the feet, and stretching the ITB.


Tight calf muscles, poor stretching habits, and excessive running on hard surfaces or hills may result in Achilles tendinitis. This is a progressive degeneration and weakness of the tendon, usually just above its attachment to the back of the heel bone. Heel lifts, icing, and anti-inflammatories in conjunction with rest often speed healing. Achilles tendinitis can often be avoided with good stretching habits. Dr Zats, the Chief Clinician & Surgeon at AnkleNFootCenters states “Physical therapy as well as Platelet Rich Plasma (PRP) Treatments and High-Tech Sound Wave therapy are also offered at Ankle N Foot Centers as adjunct treatments. We provide conservative to advanced surgical treatment at our clinics.”


Typically, an overuse injury, shin splints occur when micro-tears happen to tendon insertion sites along the lower leg bones (tibia and fibula). These small tears in the tendon, results in sharp pains of the shins. Causes include, increasing mileage too fast, aggressive runs on hard surfaces or downhill, or even excessive pronation of the foot. More worrisome are stress fractures if left untreated.  Beginner runners or “weekend warriors” are susceptible to shin splints because of the new stress placed on the legs and musculature. Initial treatments consist of rest, icing, strappings and anti-inflammatories. To prevent shin splints, ease into a proper training regiment and strengthen lower leg muscles. A proper diagnosis is essential.


Many problems develop in the forefoot because of improper and excessive weight transfer during the propulsion phase of running, including bunions, hammertoes, black toenails, and metatarsal stress fractures. If swelling is present with pain in the forefoot, suspect a stress fracture and stop running. Seek the opinion of a specialist before resuming running.


Acute injuries often respond quickly if treated early and properly. Remember PRICE therapies as your first line of defense.

P-Protect                                                                                                                                               R: R-Rest
I:  Ice
C: Compression
E: Elevation

Self-treatment has its limits. If you have acute pain which does not respond to home RICE therapies or a chronic injury from a possible underlying condition, please see a sports-medicine specialist. You should not run through it and you should not live with foot pain!

For more answers to your specific injury questions, contact AnkleNFootCenters.com at 312 612-5000 or info@anklenfoot.com


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