We have had a little look at the disciplines of Swimming and Cycling, some common problem areas, and some solutions to these problems.

I will now take a look at running, and discuss some of the mechanisms primarily responsible for the development of these potentially serious problems.

Most of these issues are a result of 2 main factors:

  • Overload / Overuse (For example, To much training volume.
  • Biomechanical inefficiencies (Incorrect or poor running form)
1: Piriformis Syndrome:

The problem arises when the Piriformis becomes excessively tight, from overuse, and begins to irritate the Sciatic nerve.

It then presents as a deep, dull pain right in the ball and socket joit of the Hip, but can also be experienced anywhere from the lower back to the lower leg.

Weakness, stiffness and a general restriction of movement are also common side effects, with the problem potentially escalating to numbness and tingling in the lower limbs.

There are numerous causative factors that can result in Piriformis Syndrome:

1: Exercising on hard surfaces, like concrete
2: Exercising on uneven ground, like running on trails
3: Beginning an exercise program after a long lay-off period, and not following a desirable
periodization progression.
4: Increasing exercise intensity or duration too quickly - not having a properly periodized
5: Running in shoes that are not correct for youe foot type (anti pronation), or do not offer
sufficient shock absorbtion.
6: Increasing exercise intensity or duration too quickly - not adhering to the To much, to soon
principle (progressive overload).
7: Sitting for long periods of time

2: Ilio-Tibial Band Friction Syndrome (ITB Syndrome):

As the name eludes to, the cause of this overuse injury is a result of the ITB "rubbing" on the Lateral Epicondyle of the Femur every time the knee flexes and extends, resulting in friction and inflammation.

It is worth noting that this overuse injury can also afflict cyclists and cross country skiers!

As with Piriformis syndrome, the main culprits for this Syndrome are: poor running biomechanics and issues related to the individuals anatomy (Pronation of the ankle and foot is a major causative factor and poor flexibility), and the old favorite - Overuse and excessive Overload.

As the knee flexes many hundreds of thousands of times every time you go running, if the ITB does not track efficiently over the Epicondyle, friction occurs, resulting in inflammation, a reduction in joint mobility and an increase in pain.

Pain will start to be felt within a few minutes of commencing running, and as the run continues, progressivly worsens till running must be stopped. It almost feels like the "knee locks up". It is especially painful running downhill.

The old R.I.C.E (Rest, Ice, Compression, Elevation) should be utilized immediatly if you feel this injury starting.

  • Reduce training volume
  • Do not run downhill
  • Change your running footwear (look at Anti-Pronation shoes) or consider orthotics.
Patella Femoral pain (Runners knee):

This to is an overuse injury that afflicts many population groups, but as the alternate name (Runners knee) shows, it is somthing that most runners will experience at one time or another in their running careers.

It is the result of the wearing down of the knees cartilage, as a result of poor Patella tracking over the knee joint, resulting in a wearing down of the protective cartilage.

This mal-alignment leads to anormal pressures on and around the knee and ultimately leads to pain around the knee cap during activity, and can eventually get so serious, that pain is felt all the time.

Pain is generally felt on the Medial (inside) area of the knee.

Symptoms can include:

  • A deep, dull and non-localized pain around the knee cap.
  • Sitting for long periods of time aggrevates the problem.
  • Going up and down stairs, and running, jumping and squatting all lead to increased pain.
Structural defects that might cause Patellar Pain include:
  • Internally rotated legs, resulting in poorly tracking Patellars.
  • Excessive Q-Angle
  • Genu Valgum or Valgus

Functional cuases can include:

  • Excessive for pronation
  • Reduced flexibility of the Quadriceps
  • Patellar mal-alignment due to muscular imbalance between the Vastus Lateralis (outside Quad) and the Vastus Medialis (Inside Quad).

In my next post, I will look at some exercises and stretches that can help you reduce the chances of these injuries afflicting you.

James Greenwood is a competitive tri and multisport athlete currently training for Ironman Canada 2009. A level 1 Triathlon Coach, he holds a post graduate degree in Exercise Science, and is a Certified Strength and Conditioning Specialist through the NSCA. James is also currently the resident health and fitness programs expert at MyPypeline.com, and has starred in a number of multisport specific fitness videos.
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