Running Injuries | How to Treat Shin Splints, Muscle Strains & More – Runner’s World

There’s no doubt that running is an impact sport with a high risk of injury. For example, during the course of a 4-mile easy run, the average person will take about jarring steps, and each step produces a force that’s equal to about your body weight (and localized forces being as high as even five times).

Those of us with several years of experience understand that these factors make running a relatively risky sport for injury. In fact, estimate that as many as 75 percent of runners will get hurt every single year.

In my own 20-plus years of running, I’ve battled nearly every injury you can imagine from IT band syndrome, shin splints, Achilles tendinopathy, and more. I’ve seen the inside of more physical therapy offices than I care to remember.

Now, after working with thousands of other runners to improve their injury resilience, what stands out are the common treatment methods that are applied to nearly all running injuries. And for those of us who’d like to spend more time out there on the road or trails (and less time in a doctor’s office), it’s important to be able to apply these strategies to your own injuries.

While there’s no substitute for a highly-qualified physical therapist, some running injuries can be self-treated. Here are the basic treatment steps to four of the most common issues.

How to Treat Shin Splints

Shin splints (technically medial tibial stress syndrome or MTSS) are one of the most common injuries among us runners. They are characterized by a tender ache, dull throbbing, or even sharp pain while running or even at rest. The location of the pain is typically along the inner (medial) or outer (anterior) edge of the shinbone (the tibia).

Thankfully, shin splints are rarely serious, and they’re easily treated. Most of the time they can either be trained through or resolved quickly. Use this five-point treatment strategy to address shin splints:

• If the pain is sharp or causes you to change your running form, stop running.
• Manage pain and inflammation by icing the shin 2 to 3 times per day for 2 to 3 days.
• Mobilize the lower leg and foot by massaging the calf, soleus, and underside of the foot.
• Complete a 10- to 20-minute strength workout to increase strength and resiliency.
• Strengthen the shins directly by walking on your heels and other barefoot balance drills.

After 3 to 14 days depending on the severity of your shin splints, you’ll be ready to try a short, easy run. If the pain gets worse or doesn’t subside after about two weeks, see a doctor to rule out compartment syndrome or a stress fracture.

How to Treat a Pulled Muscle

A pulled muscle (or more accurately, a muscle strain) occurs when a muscle is used improperly—either outside its intended range of motion or during a stressful activity such as heavy weightlifting or sprinting. For runners, the most common strains are in the calf, groin, hip flexor, or hamstring. You’ll probably feel the strain as soon as it occurs; it’s accompanied by a sudden onset of pain and a reduction in range of motion and strength.

Since strains typically occur due to an acute trauma rather than repetitive stress (like running), the treatment is usually taking a lot of rest. Since a strain is really an overstretched or torn muscle, you need to allow that damaged tissue to heal. If you have a Grade 1 or less severe strain, you can likely treat it yourself. Anything more severe, and you ought to see a physical therapist.

At the outset, avoid any form of exercise that causes pain and ask your doctor if anti-inflammatory medications are appropriate to reduce swelling. During the first few days, rest completely.

Once pain has subsided, begin relatively easy general strength or core workouts with regular foam rolling. This will bring oxygenated blood to the injured area, improve range of motion, and build strength.

[Blast through a series of HIIT sessions to boost running strength and prevent injury with the IronStrength Workout.]

After a few days or weeks, depending on the severity of your strain, you’ll ready for a short, easy run to test how your strain responds to running.

How to Treat a Twisted Ankle

A sprained or twisted ankle is an acute injury—one that happens at a specific moment in time from a specific stress (such as stepping in a hole, falling off a curb, or losing your footing on rocks on the trail) rather than a repetitive stress injury like shin splints. That means the treatment approach is different. Here are some guidelines:

• If you’re able to keep running after twisting your ankle, do so. Most of these injuries are minor, and if there’s no substantial pain, you should keep running.
• Focus on mobility immediately with ankle circles in both directions, balance board exercises, and barefoot drills.
• If there’s any inflammation or swelling, ice the area for 10 to 15 minutes several times per day for 2 to 3 days.

After 3 to 7 days, you should feel ready for a short, easy run. But if you’re unable to run for a week or there’s a significant amount of swelling or pain, consult a medical professional to rule out a torn ligament or more severe strain.

While not all twisted ankles can be prevented, it’s always best to focus on prevention by doing strengthening the muscles of your feet in ankles with light barefoot running, prioritizing strength with fundamental exercises like squats, and becoming more capable on uneven surfaces like trails.

How to Treat IT Band Syndrome

Illiotibial band syndrome (also known as IT Band Friction Syndrome) affects the IT band, a thick piece of connective tissue that runs parallel to the femur from the outside of your hip to the outside of your knee.

IT band syndrome (ITBS) is diagnosed when pain presents typically at the insertion point of the IT band on the outside of the knee. Many believe that ITBS is caused by excessive friction, though the band itself is so stiff, it barely moves. Instead, a more plausible explanation is compression due to an abnormal movement pattern of the femur.

To treat ITBS, you must address this movement pattern by strengthening the surrounding muscles. The treatment approach is a four-point strategy:

• Take about 7 to 14 days off running when pain begins. While running likely won’t make ITBS worse, it certainly can prolong your recovery.
• Complete a short strength- or runner-specific core workout every day that focuses on strengthening the hips and glutes—I recommend the .
• Spend 5 to 10 minutes foam rolling the glute, hip, quadriceps, and hamstring of the affected leg to improve mobility and range of motion (avoid the IT Band itself as it’s supposed to be tight to do its job properly)
• Use a lacrosse or similar ball to massage trigger points that are particularly sore or painful

After a week or two, you’ll be ready for a short test run to see how your body responds to running. Avoid running on the camber (slope) of the road or track and any long or steep downhills, which may make ITBS pain worse.

If you find yourself still unable to run after several weeks—or the pain increases—you should consult with a doctor.