Anyone who has ever suffered from a niggling injury or leg pain when running will agree, it can be incredibly frustrating it is can make the simplest things – such as running – impossible.
So, let's explore some of the culprits behind what is causing your leg pain when your run.
The most common cause for knee pain, and something that affects around 40% of all runners, is patellofemoral pain syndrome. Otherwise know as runners knee.
Runner's knee presents itself as a dull ache or throbbing behind the knee cap. Other symptoms are rubbing, grinding or clicking in the knee as well as some mild swelling. In worse cases it can be described as a sharp pain and the knee can be warm to the touch. Runner's knee is caused by the underside of the knee cap rubbing against the femoral groove and is often caused by a muscular imbalance, weak muscles and tight muscles.
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The common term people refer to describing this type of pain is shin splints. This is a ‘blanket term’ referring to more than one lower-limb ailment. When broken down, medical professionals within sport refer to these common injuries to identify shin pain when running;
Calf strain’ is the common terminology used by runners when describing calf pain. Muscle strains are categorised into four classifications defined in the Munich consensus statement
The British athletics association recently published further categorisation into muscle strains through a sub-classification. This is used to identify the specific structures involved.
Gastrocnemius strains are relatively easy to identify as this is the large muscle that runs down the pack of the lower leg. You will feel pain and tightness within the muscle and it will normally be tender to touch. Doing a calf stretch or heel raises will bring on the pain.
Depending on the grade of the strain you may or may not experience pain when walking. You will experience pain when running and it is advised that you avoid this until the pain eases. Try something that is low impact such as the bike for CV fitness.
Use heat or ice to help manage the pain. Read more here
Soleus muscle strain.
The soleus lies under the gastrocnemius muscle and is a flat pancake-like muscle that runs from the Achilles tendon to the back of the knee. They help to point the toes (plantarflex) are mainly made up of slow-twitch fibres, so very important for long-distance running.
Most runners only become aware of their soleus muscle when they pick up an injury. The most common mechanism for the injury is from overuse of the muscle triggered by running more on the balls of their feet. Things like an increase in hill running or a change to a more minimalist footwear are common contributing factors. Pain in the soleus can also occur when compensating for a knee injury as you will try to reduce the shock on the knee avoiding a heel strike.
Foot arch pain when running can occur due to structural issues, overuse, physical stressors or neurological conditions. A common structural or mechanical issue would be flat feet or high arches.
conditions that can cause arch pain when running:
Plantar fasciitis
Plantar fasciitis is the most common cause of arch pain when running. It is caused by inflammation of the plantar fascia ligament that connects the front of your foot to your heel.
Runners will experience pain and stiffness in the heel or the arch of the foot. Typically, it will feel worse first thing in the morning and become more painful with walking, running or standing for prolonged periods of time.
Pain can be alleviated with some gentle stretches or by rolling your foot on a roller or golf ball.
Overpronation
Overpronation describes the mechanics of the foot when you walk or run and can be commonly labelled as ‘flat feet'. Medically this is not technically true. With over-pronation, the outer edge of the heel strikes the ground first. The foot then rolls inwards flattening the arch of the foot which can lead to arch pain when running due to the damage to the muscles, tendons and ligaments.
If you overpronate you may want to start wearing a more supportive running shoe or seek out supportive orthotics to wear in replacement of your current insoles.
In long-distance runners, you can normally identify if you pronate by looking at the sole of an old pair of trainers. If you have excessive wearing of the outside of the heel and the inside part of the midfoot and toe, then it is worth having a physio or podiatrist have a look.
High arches (Cavus foot)
High arches can be your inherited structural mechanics, or from a neurological condition. With either of these contributing factors, you will have had high arches all of your adult life.
With unsupported high arches, you may experience pain when running, walking or standing for long periods of time. Additionally, you may find you are more prone to ankle strain injuries.
You will need to seed advice from a medical professional such as a podiatrist to help find the best mechanical support for the feet. This can be achieved with the right orthotic insoles, often custom made to your mechanics.
This type of pain is very common in runners and can occur from biomechanics or neural conditions.
Big toe joint pain (metatarsophalangeal joint)
This can present as a dull ache that is sore first thing in the morning, after a run or an in the evening. It will feel stiff and sore, in some cases, it may be warm to touch. This is because of arthritic changes to the joint making it inflamed and irritated.
If you overpronate then you will put excessive force through this joint and over time cause it to degenerate. You can alleviate these symptoms by wearing a more supporting running shoe or supportive orthotics. If the pain persists then it is best to seek a medical assessment of the foot.
Morton’s neuroma (plantar digital neuritis)
These occur in-between the toes and are a degenerative change to the plantar digital nerve. This is often accompanied by a bursitis, inflammation of the jelly-like bursae that act as a spacer between the bones and tissue of the foot. Runners will often experience pain when walking and running, a burning, tingling sensation in the toes as well as a small pea-sized lump in the foot.
You should seek an assessment from a medical professional if you suspect that you may have Morton’s neuroma.
Metatarsalgia
This is a common overuse injury to the ball of the foot. The term refers to pain and inflammation of the foot and is often considered to be a symptom of other conditions, not a specific condition itself. You will experience pain when you run, walk or stand for too long, especially if you are barefoot. Runners often describe feeling like there is a pebble in their shoe. It will feel sharp, achy or burning in the ball of the foot and, in some cases, numbness or tingling in the toes.
Metatarsalgia responds well to ice as it will help to reduce pain and inflammation in the area. As well as that a period of rest and some cushioned insoles will alleviate the pressure to the foot.
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