Runners love to talk about running through the pain. And while a certain amount of tough love is necessary to make it to the finish line, running through real, injury-related pain is often the fastest way to the operating theatre.

“The seeds of major, long-term injuries can be planted years before, in common injuries that runners often ignore.” That’s Dr Camdon Fary, an orthopaedic surgeon who specialises in sports injuries and reconstructive surgery of the hip and knee. “The longer you ignore these issues, the more likely you’ll end up having to see a surgeon as well as a physiotherapist.”

The most common of these injuries are as follows:

“Runner’s Knee” (or Anterior Knee Pain/Patellofemoral Pain Syndrome)

“Runner’s knee” is the most common cause of knee pain that walks into doctors’ clinics. A diagnosis of elimination, it’s declared when an MRI fails to show actual damage, but the patient is still experiencing pain at the front of the knee (anterior knee pain).

Symptoms

• Pain in the front of the knee
• Swelling in the knee
• Knee stiffness

Causes

• Repeated stress to the knee joint (e.g. running)

Treatment

Most doctors will recommend:

• Rest
• Activity modification
• Non-steroidal anti-inflammatory drugs
• Rehabilitation by a physiotherapist

It’s likely your physician will encourage you to try these alternative forms of treatment for at least 12 months before considering more serious options, such as surgery.

Achilles Tendinopathy

Achilles tendinopathy is a series of microtears (tendinosis) that weaken the tendon. Until recently it was incorrectly considered to be an inflammatory process and called Achilles Tendinitis.

Symptoms

• Pain in the Achilles tendon (particularly the day after exercising)
• Morning stiffness in the tendon
• A thickness or lump in the tendon

Causes

Dr Fary calls the injury a “weekend warrior” injury, noting that it’s often the result of:

• Too much activity too soon
• Repetitive action (e.g. jogging or jumping)
• Poor footwear
• Hard training surfaces
• Inadequate warm up, stretching and cool down

Treatment

Achilles Tendinopathy is generally managed through a combination:

• Physiotherapy
• Replacing running shoes with better heel support
• Modifying your training regime.

Shin Splints (Tibial Stress Syndrome)

Shin splints are microtears in muscle and bone tissue in the tibia. They affect between 10-15% of runners and are the source of 60% of leg pain syndrome.

Symptoms

Shin splints rarely go undetected—they usually cause:

• Extreme pain in the shin bone (exclude stress fracture)
• Trouble running (and even walking)

Causes

Shin splints generally come from overtraining. Specifically, they’re caused by:

• Repeated pounding and force on legs
• Overloaded leg muscles and tendons

Treatment

If you’re diagnosed with shin splints, your doctor will recommend:

• Decreasing your running distance, frequency and intensity by at least 50%
• Incorporating low-impact and cross-training exercise
• Stretching and strengthening muscles regularly
• Avoiding concrete, asphalt tracks and hills
• Changing old running shoes

Preventing injuries

To lower your chances of injury, Dr Fary recommends addressing these three things:

Footwear

Poor footwear could be old, worn-out shoes that need replacing (running shoes need replacing at about the 750km marks), or even new shoes with incorrect support. Invest in supportive shoes designed for your unique foot structure.

Core strength

Well balanced core muscle strength is key to any successful physical activity. A strong balanced core gives stability and acts as a buffer against a score of injuries. Dr Fary recommends working with a physiotherapist to assess and maintain balanced core strength especially through periods of pain and injury.

Overtraining

The majority of pain and injuries are the result of simple overtraining. “A general rule is to increase your training distance by a maximum of 10% each week,” says Dr Fary.

For runners, it’s often a combination of factors—such as poor footwear combined with overtraining—that leads to injury. All runners, from the occasional to the professional, are at risk.

Dr Fary warns: “If your pain becomes increasingly severe, and starts to appear when you’re at rest, it’s time to see a specialist for a proper consultation.”

Dr Camdon Fary and St Vincent’s Private Hospital Melbourne

St Vincent’s Private Hospital is a centre of excellence for all orthopaedics, offering a wide range of orthopaedic procedures like joint replacement surgeries, other orthopaedic interventions including sport medicine and injuries, and tumour and reconstructive surgery. Our facilities include on-site consulting rooms, pathology, radiology, sports medicine specialists, state-of-the-art surgical theatres, physiotherapy and other post-operative services.

Dr Camdon is a specialist in minimally invasive surgery and joint replacement. His subspecialty interests include hip and knee arthroscopic surgery, total knee replacement, and hip and knee sports surgery. He is a Fellow of both the Royal Australian College of Surgeons and the Australian Orthopaedic Association (AOA). He consults primarily at:

Specialist Orthopaedic Surgery Clinic
166 Gipps St, East Melbourne VIC 3002
Phone: (03) 9928 6161
Website: www.camdonfary.com.au