London Bridge Hospital, SE1 2PR
Running is the most common sporting activity undertaken by men and women alike in an effort to stay healthy. Unfortunately it is also the cause of many injuries, especially to amateur athletes. Accurately diagnosing running injuries is practically a speciality within itself.
The consultants at our sports injury clinics are highly experienced in treating typical running injuries such as:
Runners Knee or Iliotibial Band Syndrome (ITBS)
Although less common than anterior knee pain, lateral knee pain is frequently seen in sports that require repetitive knee flexion and extension, such as distance running and cycling. Iliotibial band (ITB) syndrome is the most common cause. It’s a condition resulting from excessive compression/irritation between the ITB and the lateral femoral epicondyle of the knee. Most frequent in distance runners, the condition can occur with any activity requiring repetitive knee flexion and extension.
This is a general, non-specific term used to describe a chronic exercise induced (usually running) shin pain. The important point is to diagnose the cause of the shin splints. For example, one of the more common causes is Periostitis, which is an inflammation / stress response of the bone lining (periosteum) caused by muscular traction forces. Periostitis of the front and inner aspect of the lower shin is specifically termed Medial Tibial Stress Syndrome. Anterior compartment syndrome may be another cause.
Anterior Compartment Syndrome
Exertional compartment syndrome is a reversible condition leading to a reduced blood flow in muscles because of tight fascial compartments both in the lower and upper limbs. Most commonly seen in the anterior shin compartment and is often present on both sides. It presents as recurrent episodes of leg discomfort experienced at a given distance or intensity of running. Although a characteristic history is highly suggestive of exertional compartment syndrome, no physical examination finding can firmly establish the diagnosis. Diagnosis based solely on clinical presentation can lead to misdiagnosis and inappropriate therapy or delay of proper therapy. An exercise provocation test is usually carried out, and documentation of elevated compartment pressure in one or more of the compartments of the leg confirms the diagnosis.
Achilles Tendinitis ( Tendinopathy )
Injuries of the Achilles tendon include peritendinitis, tendinosis, and partial or complete ruptures. They are forms of inflammation/degradation of the tendon best referred to as Achilles tendinopathy. Peritendinitis of the Achilles is one of the most common overuse syndromes seen in sports injury clinics. Although the true incidence of peritendinitis and tendinosis in athletes is not known, in one study Achilles tendon pain accounted for 6.5% to 11% of the complaints of runners who were examined for lower extremity problems. It also occurs in a variety of other sports such as soccer, football, tennis, volleyball, basketball, and badminton.
Plantar fasciitis is a common overuse condition of the plantar fascia, which is a strong ligament- like structure under the foot. Pain typically occurs at its attachment to the inner aspect of the heel bone (calcaneum ). The pain can be mild to severe and occurs ( with stiffness ) more often in the morning. Excessive pronation is a risk factor for plantar fasciitis. X rays may demonstrate a heel spur, which is thought to be a result of chronic inflammation/degeneration and calcification. Stretching of the calf, insoles, and local therapeutic agents are commonly given. Local extracorporeal shock wave therapy has also been used with some success.
Lateral ankle sprain represents one of the most common injuries in the athletic population. Inversion stretching or tearing of the lateral ankle ligaments can lead to recurrent pain and weakness if not managed promptly. It has been noted that a history of previous lateral ankle sprain is the most commonly cited risk factor for ankle sprain.
Patellofemoral Pain (PFP) Syndrome
This condition refers to pain in and around the knee cap. Patellar tendinopathy is a common and significant condition which may present as a low grade constant ache just below the knee cap. It is believed to result from repeated loading of the knee extensor muscles and tendon in sports involving some form of jumping. Investigations such as MRI and CT scans are often needed to distinguish between knee cap problems and problems localised to the tendon.
A stress fracture is a partial or complete fracture of bone that results from repeated application of a stress lower than that required to fracture the bone in a single loading situation. These tend to occur in specific locations based on particular loading patterns associated with specific activities. A wide range of the population is affected, including both sexes and all ages, in athletes participating in virtually every kind of sports. Recent literature has placed new emphasis on the nature and occurrence of stress injuries in elite athletes, and emphasised the nutritional and hormonal contributions to these conditions.
Snapping Hip Syndrome
The snapping hip syndrome is a condition that can be caused by several different abnormal processes. All patients with snapping hip syndrome have a reproducible audible or palpable “snap” during particular movements of the hip joint. The causes have been broadly categorised into external snapping hip syndrome, internal snapping hip syndrome, and intra-articular snapping hip syndrome. Both internal and external snapping hip syndrome usually occur in patients who are in their early 20s and late teens. Of the three categories, external snapping hip is the most common and is most often caused by thickening of the iliotibial band or gluteus maximus snapping over the greater trochanter. The thickening is believed to be caused by microtrauma to the tendons. Patients with external snapping hip will also have inflammation within the trochanteric bursa. Internal snapping hip is most often caused by the iliopsoas tendon snapping over the iliopectineal eminence of the pelvis or over the femoral head. Ballet dancers are particularly susceptible. Intra-articular causes of snapping hip include labral (cartilage) tears, loose bodies, or osteochondral injuries. Most patients with intra-articular causes have a history of an injury.
Whether it is your foot, calf or knee that is troubling you, our sports medicine consultants can accurately diagnose your running injury and prescribe the appropriate treatment. Contact us to book an appointment with one of our consultants at our sports injury clinics in London.