The Injury Series

One recurring series I have created on Running Writings is the Injury Series: a sequence of long, detailed and rigorously cited articles on scientific treatments for the most common running injuries.  The Injury Series began as a project to review and distribute information on the latest research on effective treatments for the most common running injuries.  As I picked off the "low hanging fruit"—injuries like Achilles tendonitis and patellar tendonitis with good studies backing simple and highly effective treatments—I began to learn how little was known about treating some of the other common running injuries.  I found that searching the internet for information on any common injury, whether it was runner's knee or shin splints, would inevitably lead you to the same old websites with the same outdated or incorrect information.

A lot of what's now accepted as "common knowledge" about running injuries is just plain wrong! Look up "runner's knee," for example, and you'll find plenty of websites claiming that women are at a higher risk because their hips are wider (not true—anatomic differences in hip width do not explain the increased risk of patellofemoral pain syndrome in women).  And plenty of sources still chalk IT band syndrome up to overpronation (in fact, runners with IT band syndrome appear to pronate slightly less than healthy runners).

What's behind this misinformation? My opinion is that it is the result of poor awareness in the medical, athletic training, and running communities of some of the cutting-edge research that's been carried out in the last 10-20 years.  This is where the Injury Series comes in.  These articles give educational summaries of some of the most important research into the causes of and treatments for common running injuries.  Additionally, we are able to peek over the horizon at new treatment possibilities that are informed by our newly-garnered understanding of the mechanics behind injury.

The breadth, detail, and rigor of my injury articles has grown over time, to the point where the oldest articles are not documented enough, so the first few can still be thought of as "works in progress."  While I will eventually rework the older articles, adding footnote-style citations (I didn't have EndNote up and running for the first few months of my blogging) and updating them with some new information, the overarching message will likely change very little, and many runners have still found them exceptionally helpful.  I hope you feel the same way!

Injury Series Articles

What causes metatarsal stress fracture in runners, and how can you prevent it? Research-backed solutions

 Do you have a sharp, aching pain on the top of your foot when you run? If so, it might be a metatarsal stress fracture. The metatarsals are perhaps the most elegant bones in your lower body. The five long, slender bones extend from your midfoot to your toe joints, and despite their small size, ... Read more

The bone stress injury model: a new way to deal with stress fractures and stress reactions in runners

An MRI reveals a tibial stress fracture Traditionally, overuse injuries to the bone in distance runners are divided into two distinct categories: stress reactions and stress fractures.  Runners who develop pain along one of their bones hope desperately that they have the former and not the latter, since the usual prescription for stress fracture recovery ... Read more

Achilles tendonitis in runners: A degenerative overuse injury best treated with eccentric heel drops

Introduction Achilles tendonitis is an extremely common injury, not just in running but in many sports.  The severity of overuse injuries to the Achilles tendon can range from dull soreness that barely impacts your ability to run or play sports to chronic, debilitating pain that can last for months or years.  Fortunately, due to its ... Read more

Injury Series: Tibial stress fractures and stress reactions: The role of bone structure, impact, and calf strength

Tibial stress fractures are related to medial tibial stress syndrome, which you can read about here For an in-depth discussion of return-to-running programs after a stress fracture or stress reaction, see this article This installment of the Injury Series deals with tibial stress fractures, one of the most serious of the common running injuries.  A ... Read more

Injury Series: Uncovering the role of hip strength and mechanics in the cause and treatment of patellofemoral pain syndrome

Today we are tackling the most common running injury of all: patellofemoral pain syndrome, alternatively known as runner’s knee, anterior knee pain, and (sometimes erroneously) chondromalacia or chondromalacia patellae.  As is often the case, there is some controversy about the naming.  “Patellofemoral pain syndrome” or PFPS is the broadest and most common term, but is ... Read more

Injury Series: Biomechanical solutions for iliotibial band syndrome

It's been a while since we've thoroughly reviewed an injury, so today we'll be looking at another one of the "big five" most common running injuries.  We've already seen how treatment for Achilles tendonitis has been revolutionized by specific eccentric exercises to remodel damaged tendon collagen; today's topic is iliotibial band syndrome, sometimes also referred ... Read more

Injury Series: Flat eccentric heel drops for insertional Achilles tendonitis

Introduction Back in August, we saw how a rehab program consisting of eccentric heel drops with a bent and straight knee reversed damage to the Achilles tendon by inducing collagen remodeling.  One thing I didn't make clear enough is that Alfredson's eccentric heel drop protocol, developed in 1998, was designed for midpoint Achilles tendonitis.  In ... Read more

Eccentric decline squats, tendon remodeling, and patellar tendonitis

Note: Patellar tendonitis should not be confused with patellofemoral pain syndrome, or "runner's knee," a different injury in the kneecap area with a different ideal treatment protocol Last time, we saw how an injury rehab protocol consisting of eccentric heel drops can remodel collagen in an injured Achilles tendon.    The intervention was impressive for two ... Read more
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