Member Case Study: Repeating Pattern of Foot Injuries

author : AMSSM

comments : 1

Everytime I up my run mileage I get injured. As I train I seem to inevitably get pulled calves, IT band syndrome then achilles issues. What can I do?

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Member Question from pbooth2912

Everytime I up my run mileage I get injured. I have fallen arches, but hardly overpronate (analyzed on running machine by tri shop, and an Asics shop) but use orthotics to stop plantar fasciitis. As I train I seem to inevitably get pulled calves, IT band syndrome then achilles issues. What can I do to stop this pattern and improve my running?

Answer by Chris Miars, DO
Member AMSSM

The short answer to your question is to see a local sports medicine physician who can evaluate your biomechanics, core strength and muscle balance.   He or she can use the information from your exam to help with discussion of your training regimen in more detail and possibly make recommendations to a sports physical therapy. 

The longer version is that there is a problem with your training plan which is causing you to have multiple injuries or there is something wrong with your body which is causing you to have the repeat injuries by not properly dissipating forces.  Training problems could include too much training volume, adjusting to many training components at one time, or problems with running form.  Regarding the running volume, it is important to make sure that your total weekly volume does not increase by more than 10% a week and that your long run does not increase by more than 10% a week. 

It is also important to drop the volume every 3rd or 4th week of training to allow your body to recover before starting the build cycle again.  In addition to problems with the overall volume, having too much frequency will also set you up for problems.  With your history of repeat injuries with increased running, it may be that you can only run two or three times a week without experiencing injury.  As a triathlete however, that should be plenty of running frequency to allow you to achieve your running goals.  If you are running two times a week, you could have a long slow run and a tempo run.  If you are running three times a week, you can add in a technique/skills run.

Another common mistake in training is adjusting too many training variables at the same time.  The variables involved with training are volume (the total distance or time of training in a week), frequency (the number of training sessions in a week), and intensity (how hard the workout is).  It is important when training that only one of these three values is changed at any given time.  Trying to increase volume and frequency or frequency or intensity, etc. at the same time can place too much strain on the body resulting in injury.  As mentioned above, recovery is also important.  It is important to have recovery days within the week as well as a recovery week within the month and a recovery month or so within the year.

In respect to your anatomy and biomechanics, you mention that you have somewhat fallen arches and have had this evaluated resulting in you wearing arch supports.  Two other areas to evaluate would be hip/core strength as well as flexibility.  It is not uncommon for runners with repetitive injuries to suffer from poor hip strength which results in compensation injuries such as IT band syndrome.  In addition, there are flexibility issues that are common with runners that result in an alteration in running biomechanics that sets them up for repetitive injuries.  There are many resources with basic programs for runners’ core strength as well as runners’ stretches.  I would recommend following one of those programs if you have not already.  If that does not alleviate your symptoms, again this needs to be evaluated by a sports minded physician who can provide some specific direction to address underlying biomechanics.

In conclusion, there are many factors that can contribute to the repetitive running injury when running training increases.  Hopefully the outline of common causes above will provide some insight for you as to a cause of your continued repetitive symptoms.  If not, a visit with a sports medicine physician should be quite helpful for you.

Good luck!

Chris Miars, DO
Southwest Sports Medicine and Orthopaedics

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date: September 16, 2010