Common Running Injuries: Consultant Surgeon Assesses the Damage for London Marathon

Over 300,000 people applied to take part in this year’s London Marathon, and of those 40,000 people will be running the 26 mile stretch across the capital.  Around 58% of those competing, have never run a marathon before but will be valiantly pushing themselves to run for fun, charity or health reasons.

The wide range of abilities and disabilities of runners also determines the chances of injuries during or after the race.  A medical specialist team will be on hand to support the participants in the event of any strain or injury but in the event that those taking part only feel discomfort or anything unusual when they arrive home, we asked Mr Harold Nwaboku, Consultant Orthopaedic Surgeon of Total Orthopaedics at Highgate Private Hospital to give us a breakdown of the most common injuries suffered as a result of such a long distance trek and how to spot these symptoms:-

What is iliotibial band syndrome?

Iliotibial band syndrome is a recognised problem in runners which can surface at this time of preparation for the London Marathon.  The iliotibial band runs from the hip region to the knee and its function includes movement of the knee.  This injury arises from overuse when the band becomes inflamed, which can hamper the training programme of runners.

What are the symptoms and who is susceptible to this injury?

Pain and sometimes swelling on their outer side of the knee.  It can often become very painful and difficult to run, but the pain subsides as soon as you stop. Athletes who do repetitive forward motion exercises for extended periods of time, most commonly including long-distance runners, cyclists, and gym goers who perform repeated squats.

How do you test for this injury?

You can self-test by bending the affected knee whilst standing, you feel pain on the outside when the knee bends.  Touching the outer side of the knee will also elicit the pain, and an ultrasound or MRI will reveal the inflamed site.

What are the treatment options?

Most patients will respond well to rest or change in activities.  Physiotherapy assessment and treatment is also an option which can assist with recovery.  If rest or physiotherapy do not help, an Orthopaedic referral and assessment is the next recommended course of action.  Steroid or Platelet Rich Plasma (PRP) injections can offer pain relief.  Surgery is usually the last resort when all the non-operative options are unsuccessful.

Patella tendinitis (Runner’s Knee)

What is patella tendinitis?

Patella tendinitis is commonly known as ‘runner’s knee’.  It is a common cause of anterior knee pain which occurs at the front and centre of the knee, where the tendon attaches to the bone.  The pain is often constant and can negatively affect the motion and motivation of the individual.

What are the symptoms and who can be susceptible to this injury?

You will experience a dull or sharp pain under the kneecap while running, kneeling and climbing stairs.  Pain can also occur after sitting for long periods of time.  Knee instability is also common, leading to the knee giving way or falling. Individuals involved in running and jumping sports, and the condition is found to be more common in females.

How do you test for this injury?

The act of squatting is a common test, in addition to touching along the patella tendon from where the pain starts and ends.

What are the treatment options?

Assessment of footwear and of the training equipment can aid in preventing patella tendinitis, in addition to maintaining a healthy body weight.  Physiotherapy can help aid recovery as well as activity changes.   The RICE regimen may be recommended to calm inflammation: rest, ice, compression and elevation.  Steroid or Platelet Rich Plasma (PRP) injections can offer pain relief.  Surgery is usually the last resort when all the non-operative options are unsuccessful.

Hip stress fracture

What is a hip stress fracture?

It is a fracture of the top part of the femur (hip bone).  It occurs when there is repeated stress to the bone over time and can occur in high mileage runners and those training for a marathon.  At the start of this condition, there is a small crack, which can lead ultimately to the fracture of the hip if left untreated.  While it is a rare cause of hip pain, it should be ruled out to prevent further injury.

Who can be susceptible to this injury?

Athletes who take up running and jumping sports, who repeatedly put pressure and stress on the hip.  When stress to the bone is applied repetitively, it can cause an overuse injury like a hip stress fracture.  In addition to runners, gymnasts, ballet dancers, and power walkers and marchers can also experience this injury.

How do you test for this injury?

The condition may be suspected after learning of a patient’s history.  Rotation of the hip will be tested and could lead to further investigations like imaging scans being needed.  X-rays may not reveal anything visible for several weeks, so an MRI scan will likely be recommended as it is the most sensitive and specific test for this condition.

What are the treatment options?

Orthopaedic referral and assessment are recommended if a hip fracture is suspected.  Rest and protection from weight bearing, so repetitive activity will need to be stopped.  Bed rest will be recommended in cases of severe pain, but surgery will only be recommended for cases with two complete hip fractures.