By: Nathan Wool, M.D., Sports Medicine Physician
UPMC Orthopaedic Care
The start of spring brings warmer temperatures, and the milder weather motivates people to get
outside and exercise. Running is inexpensive and easy to do, either indoors or outdoors. Whether you
are a seasoned runner or a beginner, taking proper precautions before, during and after running will
help you avoid six common overuse injuries that runners frequently experience: shin splints, Achilles
tendinitis, plantar fasciitis, hamstring strains, tendinitis, and IT (iliotibial) band syndrome.
Shin splints are characterized by sharp pain experienced at the front or inside of the tibia (shin bone).
Individuals who have flat feet are more susceptible to shin splints. Typically, shin splints occur when a
runner increases the distance or number of days he or she runs too quickly. The treatment for shin
splints is rest, stretching and slowly returning to activity as the pain subsides. Insoles or orthotics may be
prescribed to offer stability.
Achilles tendinitis is swelling or inflammation of the tendon that runs from the back of the calf to the
heel of the foot. Runners notice sharp pain and stiffness in the morning and during activity. This injury is
the result of repetitive stress on the tendon and can be caused by tight calf muscles or running too far
too soon. Achilles tendinitis should be treated with rest and ice (10 to 20 minutes at a time with 30
minutes between treatments). Stretching and strengthening the lower legs is important to avoid future
injury. Healing of this injury tends to be slow. If pain increases or persists, contact your healthcare
provider to schedule an appointment.
Runners will tell you that plantar fasciitis feels like stepping on a nail with the heel of your foot.
Inflammation of the plantar fascia, the connective tissue that runs along the bottom of the foot from
heel to toes, can result from either tight lower leg muscles or increasing activity too quickly. People with
high arches in their feet are more prone to this injury. Avoid plantar fasciitis by wearing supportive
shoes (no bare feet) or adding orthotics to shoes. Treatment includes icing the area for pain relief.
Exercises to strengthen and stretch the lower leg muscles will also help improve the condition.
When athletes start a running program, hamstring strains and tendinitis can be a common occurrence.
The hamstring can be injured while performing explosive hip flexion, a fast, powerful bending of the hip
joint that can occur when sprinting or jumping. A good stretching routine is key for preventing this
injury. Ensuring good flexibility allows for the muscle to adapt to the new running program. Treatment
for a hamstring issue includes rest, reduction in intensity and duration of exercise, stretching, ice, and
anti-inflammatory medications.
IT band syndrome is an injury to the connective tissue along the outside of the thigh from the top of the
hip to the outside of the knee. This injury occurs when the IT band repetitively rubs against the outside
of the knee causing pain and inflammation. The injury is often a result of repetitively running downhill or
on sloped roadway. Treatment includes reducing exercise, heat and stretching before exercise, icing the
area after activity and anti-inflammatory medication (i.e., ibuprofen) to reduce discomfort.
Strengthening the hip, quadriceps, hamstring and gluteus maximus muscles often alleviates the pain.
Regardless of the injury, don’t push through the pain. Consult a physician if you have pain that doesn’t
improve with rest. If you are just starting out, talk with your primary care physician about whether
running is a good choice. It’s also good to know your numbers for blood pressure, body mass index,
blood sugar and cholesterol to set appropriate goals when developing an exercise plan.
Consult an athletic trainer or strength and conditioning specialist to develop a running plan that meets
your goals and matches your ability. Just like weightlifting, progression is key. It’s recommended to start
a walk/run combination to give your body time to adjust to the stress running places on joints and
muscles. Your cardiovascular system generally adapts more quickly than your musculoskeletal system.
Also, buy a good pair of running shoes from a store that specializes in proper fit. Think of your running
shoes as shock absorbers that reduce the force on your body while you run. Shoes typically have a 400-
500-mile limit. Check the tread periodically to ensure there is enough cushioning to avoid injuries.
Once you get started, keep going! The first two weeks of running will be difficult. Alternate a running
routine with a few days of strength workout to build muscle and bone density, which should help you
stay strong and injury-free.
UPMC offers walk-in care for acute, non-life-threatening orthopaedic injuries you may encounter during
spring exercise at two locations, Harrisburg and Enola. For more information on hours and specific
locations, call 717-988-0700 or visit UPMC.com/InjuryClinic.
For more information about UPMC Orthopaedic Care, visit UPMC.com/CentralPAOrtho.
Nathan Wool, M.D., is an orthopaedic surgeon and sports medicine physician with UPMC Orthopaedic
Care and serves as the team physician for Carlisle and Big Spring High Schools.