By Glenn Cranham – 5S Sports Rehabilitator
Up to 80% of regular runners will develop an overuse injury due to their activity. The most common injuries are Plantar Fasciitis, Achilles Tendinopathy, Medial Tibial Stress Syndrome, Patellofemoral Pain Syndrome and Iliotibial Band Syndrome. All of which can lead to compensatory movements and dysfunction.
Plantar Fasciitis is a disorder that results in pain in the heel and sole of the foot, often worse with the first few steps in the morning. It can seriously restrict the flexibility of the calf and the functional range of the ankle, which can force the knee to drop inward to compensate.
Achilles Tendinopathy is a general term to indicate inflammation and/or degeneration of the Achilles tendon. Symptoms can vary from an ache or pain and swelling to the local area, or a burning that surrounds the whole ankle. This can lead to impaired range of the ankle joint, reduced calf function, poor control of the knee and altered hamstring recruitment.
Medial Tibial Stress Syndrome (MTSS) can manifest as a dull ache through to an intense pain down the inside of the shin bone that gets worse with activity. This can lead to altered gait patterns with the affected person often appearing to run on the outside of the foot. This in turn can lead to problems in the knee and hip.
Patellofemoral Pain Syndrome (PFPS) is a mild to severe pain at the front of the knee that may feel as if it’s just behind the kneecap. It gets worse with activity but may well feel like a dull ache with long periods of sitting. This can lead to a painful and altered gait pattern, with the subject offloading from the affected leg to the unaffected side. Which can lead to dysfunction in the hip and lower back pain.
Iliotibial Band Syndrome (ITBS) is a lateral knee pain that has a gradual onset that progresses through to an intense stabbing pain with activity. As with MTSS this will often lead to running on the outside of the foot, altered hip recruitment and lower back pain.
Interestingly there is one element that groups all these injuries together. It has been shown that a foot which drops into excessive pronation is a significant risk factor in their development.
In order to combat this risk, we can use orthotic insoles that are designed to improve the functioning of the foot and ankle as we load through it during functional movements. They work by realigning the bones and/or giving support, thereby maintaining optimal alignment and reducing excessive forces.
Biomechanical studies have shown that orthotics reduce the speed and degree of pronation that occurs through the foot and ankle during walking and running, even in healthy runners. This in turn reduces the stresses placed through the associated musculature, which can lead to the aforementioned overuse injuries.
Further research shows that as well as prevention, orthotics are effective in the treatment of these injuries. With several studies showing improvement in both performance, and a reduction in pain levels during a number of functional tests that involved single leg balance, strength and running whilst wearing orthotics. There is even evidence of flat footed runners showing a reduction in heart rate and energy consumption when wearing corrective insoles.
If you feel you might benefit from orthotics for prevention, treatment or improved performance, book into see one of our Sports Rehabilitators for a Free 10 minute consultation – Macclesfield.