Sore or Bloody Nipples

Symptoms: Some runners, usually men, get chaffed or bleeding nipples, which can be extremely painful.

Causes: When men run, their nipples are constantly rubbing against their shirt. Over the course of a run (especially a long one), this sensitive area can be rubbed to the point of bleeding. Because women wear tight-fitting sports bras, this shouldn't be an issue for them.

Prevention: Some men learn the hard way how painful it can be, but it's actually very easy to avoid that problem. Generously apply a lubricant like Vaseline or Body Glide to the nipple area before a long run and you should be fine. Some men will also wear products such as Nip Guards or Band-aids to protect the nipples. Also, for longer runs, make sure that you wear a synthetic-material (Dri-Fit, not cotton) shirt closest to your body. Cotton shirts will cause chafing. Women should make sure their sports bras are not cotton. For longer runs, both men and women should also apply Body Glide or Vaseline to any areas where there may be rubbing (inner thighs, under arms) to avoid chafing.

Iliotibial Band Syndrome – ITB

Definition: Pain and inflammation on the outside of the knee, where the iliotibial band (a muscle on the outside of the thigh) becomes tendinous, and results in a friction syndrome by rubbing against the femur (thigh bone) as it runs alongside the knee joint.

Symptoms:

Initially, a dull ache 1-2 kilometres into a run, with pain remaining for the duration of the run. The pain disappears soon after stopping running, later, severe sharp pain which prevents running pain is worse on running downhills, or on cambered surfaces pain may be present when walking up or downstairs.

Local tenderness and inflammation

Causes:

Anything that causes the leg to bend inwards, stretching the ITB against the femur overpronation (feet rotate too far inward on impact) tightness of the ITB muscle lack of stretching of the ITB incorrect or worn shoes excessive hill running (especially downhills) and running on cambered surfaces and overtraining

ITB – Treatment Methods

Self-treatment:

Stop running, especially in the case of severe pain if pain is mild, then reduce training load and intensity, and avoid downhill running and running on cambered surfaces.

Take a course (5 – 7 days) of non-steroidal anti-inflammatory drugs (ibuprofen/voltaren/cataflam/mobic) available from your general practitioner or pharmacist.

Apply ice to the knee (for 10minutes every 2 hours) in order to reduce the inflammation

Self-massage, using arnica oil or an anti-inflammatory gel, to the muscle only (along the outside of the thigh). Do not massage the side of the knee where you feel the pain, as this will only aggravate the friction syndrome stretching of the ITB.

Stand with the right leg crossed in the back of the left leg. Extend the left arm against a wall/pole/chair/other stable object. Lean your weight against the object while pushing your right hip in the opposite direction. Keep your right foot anchored while allowing your left knee to flex. You should feel the stretch in the ITB muscle in the right hip and along the outside of the right thigh. Hold for 30 sec. Relax slowly.

Repeat to opposite side. Repeat stretch 2 – 3 times per day.

Remember to stretch well before running

Return to running gradually

Full recovery is usually between three to six weeks

Medical treatment:

Physiotherapy, if injury doesn’t respond to self-treatment in 2 to 3 weeks

Orthotist or podiatrist for custom-made orthotics to control overpronation

Orthopaedic surgeon – if injury does not respond to physiotherapy treatment, a cortisone injection into the ITB, or surgery to release the ITB may be indicated.

Alternative exercises:

Swimming, pool running, cycling (in low gear) “spinning”

Avoid any exercise that places strain onto the ITB, specifically, avoid stair-climbing

Preventative measures:

Stretching of the ITB, quadriceps, hamstring, and gluteal muscles. Hold each stretch for 30 seconds, relax slowly.

Repeat stretches 2 – 3 times per day. Remember to stretch well before running.

Strengthening of quadriceps, hamstring and calf muscles.

Correct shoes, specifically motion-control shoes and orthotics to correct overpronation

Gradual progression of training programme

Avoid excessive downhill running, and cambered roads (stay on the flattest part of the road)

Incorporate rest into training programme

Achilles tendonitis

Definition: Inflammation of the Achilles tendon.The Achilles is the large tendon connecting the two major calf muscles, gastrocnemius and soleus, to the back of the heel bone. Under too much stress, the tendon tightens and is forced to work too hard. This causes it to become inflamed (that is tendinitis), and, over time, can produce a covering of scar tissue, which is less flexible than the tendon. If the inflamed Achilles continues to be stressed, it can tear or rupture.

Symptoms:

Pain or tenderness along the inside of the shin, usually about halfway down the shin. Pain and tenderness may extend to the knee

Pain on palpation of the shin

Pain is most severe at the start of a run, but may disappear during a run, as the muscles loosen up. This is different to a stress fracture, where there is pain during weight bearing activities (walking, stair-climbing)

Causes:

Inflexible calf muscles and tight Achilles tendons – place more stress on to the muscle attachments

Overpronation (feet rotate too far inward on impact) excessive running on hard surfaces, such as concrete pavements

Incorrect or worn shoes

Overtraining, or a rapid increase in training load or intensity Beginner runners are more susceptible to this problem for a variety of reasons, but most commonly due to the fact that the leg muscles have not been stressed in such a way before they started running.

Shin Splint – Treatment Methods

Self-treatment:

Stop running, especially in the case of severe pain, if pain is mild, then reduce training load and intensity, and avoid downhill running and running on cambered surfaces

Take a course (5 – 7 days) of non-steroidal anti-inflammatory drugs(ibuprofen/voltaren/cataflam/mobic) available from your general practitioner or pharmacist

Apply ice to the shin area – for 10 minutes every 2 hours, in order to reduce the inflammation

Self-massage, using arnica oil or an anti-inflammatory gel, to the muscle only (along the inside of the shin).

Stretching of the gastrocnemius and soleus muscles. Hold for 30 secs. Relax slowly. Repeat to opposite side. Repeat stretch 2 – 3 times per day.

Remember to stretch well before running

Return to running gradually

full recovery is usually between two to four weeks

Medical treatment:

Physiotherapy, if injury doesn’t respond to self-treatment in 2 to 3 weeks

Orthotist or podiatrist for custom-made orthotics to control overpronation

Orthopaedic surgeon – if injury does not respond to physiotherapy treatment, a bone scan, diagnostic ultrasound or X-ray may be necessary to check for a stress fracture.

Alternative exercises:

swimming, pool running, cycling (in low gear) “spinning”

avoid any weight-bearing exercises

Preventative measures:

Stretching of the gastrocnemius and soleus muscles. Hold each stretch for 30 seconds, relax slowly.

Repeat stretches 2 – 3 times per day. Remember to stretch well before running.

Strengthening of foot and calf muscles.

1) Place a weight around the foot, and move your foot up and down from the ankle, with no movement in the rest of the leg. Or use a partner to grasp the foot and provide manual resistance.

2) Band exercises. Anchor one end of an exercise band (e.g; inner tubing of bicycle) to a heavy object, such as the leg of a couch. Loop the other end around the foot. Move the foot up, down, and from side to side against the band’s resistance to exercise different muscle groups.

Correct shoes, specifically motion-control shoes and orthotics to correct overpronation

Always apply ice after running

Run on soft surfaces

Avoid overstriding, which places more stress onto the shins

Gradual progression of training programme

Incorporate rest into training programme

Plantar fasciitis

Definition:

An inflammation of the plantar fascia, a thick fibrous band of tissue in the bottom of the foot which runs from the heel to the base of the toes. When placed under too much stress, the plantarfascia stretches too far and tears, resulting in inflammation of the fascia and the surrounding tissues. The tears are soon covered with scar tissue, which is less flexible than the

fascia and only aggravates the problem.

Symptoms:

Pain at the base of the heel pain is most severe in the mornings on getting out of bed, and at the beginning of a run. The pain may fade as you walk or change running stride, in an attempt to alleviate the pain. This provides only temporary relief

Causes:

Stress, tension and pulling on the plantar fascia

Inflexible calf muscles and tight Achilles tendons – place more stress onto the plantar fascia.

Overpronation (feet rotate too far inward on impact)

High arches and rigid feet

Incorrect or worn shoes

Overtraining

Plantar fasciitis – Treatment Methods

Self-treatment:

Stop running, especially in the case of severe pain, if pain is mild, then reduce training load and intensity take a course (5 – 7 days) of non-steroidal anti-inflammatory drugs (ibuprofen/voltaren/cataflam/mobic) available from your general practitioner or pharmacist

Apply ice to the plantar fascia – for 10 minutes every 2 hours, in order to reduce the inflammation. An effective way of icing is to fill a plastic 500 ml Coke bottle with water, and to freeze it. Apply the ice as instructed by rolling the bottle under the foot

Self-massage, using arnica oil or an anti-inflammatory gel, to the plantar fasciastretching of the gastrocnemius and soleus muscles

Return to running gradually

Full recovery is usually between six to eight weeks

Medical treatment:

Physiotherapy, if injury doesn’t respond to self-treatment in 2 to 3 weeks

Orthotist or podiatrist for custom-made orthotics to control overpronation, or to reduce stress on the heel area

X-rays – to check for a heel spur.

Orthopaedic surgeon – if injury does not respond to physiotherapy treatment, a cortisone injection, or surgery to release the plantar fascia may be indicated.

Alternative exercises:

Swimming, pool running, cycling (in low gear) “spinning”

Avoid any exercise that places strain onto the plantar fascia

Preventative measures:

Stretching of the gastrocnemius and soleus muscles. Hold each stretchfor 30 seconds, relax slowly. Repeat stretches two – three times per day.

Remember to stretch well before running stretching of the plantar fascia. Sit on the floor with one knee bent and theankle flexed towards you. Pull the toes back towards the ankle. Hold for 30 seconds. Relax slowly. Repeat to opposite foot. Repeat 2 – 3 times per day.

Remember to stretch well before running strengthening of the muscles of the foot.

1) Pick up marbles or golf balls with your toes.

2) Pull a towel towards you with your toes. Grab some of the towel with your toes and pull, then release, grab, and pull some more to loosen the plantar fascia, place a golf ball under the foot, and roll the foot over the ball. Start with the ball at the base of the big toe, and roll the foot forwards over the ball, then back again. Move the ball to the base of toe and repeat. Repeat for each toe. Always exert enough pressure so that you feel a little tenderness. correct shoes, specifically motion-control shoes and orthotics to correct overpronation

• • always apply ice after running

  • gradually progression of training programme

  • incorporate rest into training programme

Runner’s knee – chondromalacia

Definition: A softening or wearing away and cracking of the cartilage under the kneecap, resulting in pain and inflammation. The cartilage becomes like sandpaper because the kneecap is not riding smoothly over the knee.

Symptoms:

Pain beneath or on the sides of the kneecap crepitus (grinding noise), as the rough cartilage rubs against cartilage when the knee is flexed.

Pain is most severe after hill running

Swelling of the knee

Causes:

overpronation (feet rotate too far inward on impact) - can cause the kneecap to twist sideways fatigued or weak quadriceps muscle. The quadriceps muscle assists in the proper tracking of the kneecap.

Weakness, especially of the inside part of the quadriceps, can prevent the kneecap from tracking smoothly

muscle imbalance – between weak quadriceps and tight hamstring and iliotibial band (ITB)

Muscles can also affect proper tracking hill running (especially down hills) and running on cambered surfaces

Incorrect or worn shoes

Overtraining

Treatment Methods

Self-treatment:

Stop running

Take a course (5 – 7 days) of non-steroidal anti-inflammatory drugs(ibuprofen/voltaren/cataflam/mobic)

available from your general practitioner or pharmacist

Apply ice to the knee area – for 10 minutes every 2 hours, in order to reduce the inflammation

Avoid weight-bearing activities and keep foot elevated where possible

Self-massage – using arnica oil or anti-inflammatory gel, on the sore spots around the knee

stretch 2 – 3 times per day.

Strengthen the quadriceps muscle only when pain-free.

Exercises include:

1) Place pillow under knee, tighten quadriceps, push knee down into pillow and lift foot up. 20 times

2) Repeat exercise as above with foot turned out in order to strengthen the inside of the quadriceps muscle. Repeat 20.

3) Squats. Perform with back against wall. Bend knees slowly to between 45 – 60. Ensure that knee travels over line between big and second toes. Hold for a count of 5 seconds. Relax slowly. 20 times

4) Step-downs. Stand on step or box. Tighten quadriceps and lower opposite leg slowly to the ground.Ensure that knee travels over line and between big and second toes.Then raise the leg up onto the step, relax. Repeat 20. Increase the number of repetitions in increments of 5 every two days, all the way up to 60 reps.

Stretching – of the quadriceps, hamstring, iliotibial band (ITB) and gluteal muscles

Return to running gradually

Full recovery is usually between four to six weeks

Medical treatment:

If injury doesn’t respond to self-treatment in two weeks, see a physiotherapist or orthopaedic surgeon

Orthotist or podiatrist for custom-made orthotics to control overpronation

Orthopaedic surgeon – surgery to scrape away rough edges of cartilage may alleviate some pain.

Cortisone injections are ineffective

Alternative exercises:

Swimming, pool running, cycling (in low gear) “spinning”

Avoid any exercise that places strain onto the knee

Preventative measures:

Stretching of the quadriceps, hamstring, iliotibial band (ITB) and gluteal muscles. Hold each stretch for 30 seconds, relax slowly.

Repeat stretches 2 – 3 times per day. Remember to stretch well before running, strengthening of quadriceps, hamstring and calf muscles correct shoes, specifically motion-control shoes and orthotics to correct

overpronation

Avoid excessive downhill running, and cambered roads (stay on the flattest part of the road) .

Gradual progression of training programme

Incorporate rest into training programme