Scott Webb (Host): Running injuries are common and, most of the time, a little rest goes a long way, but there are times when you may need to see a provider, especially if you suspect that you have a stress fracture. And I'm joined today by Dr. Andrew Hills. He's a sports medicine specialist with Franciscan Health, and he's here today to tell us about the most common injuries, what we can do to help ourselves, and when it's time to see a provider.

 This is the Franciscan Health DocPod. I'm Scott Webb. Doctor, thanks so much for your time today. We're going to talk about runners and avoiding running injuries and everything related to that. And I know a lot of people use running as a great form of exercise, of course. Some participate in races, marathons, half marathons. I don't, but others do, and they tend to do it pretty regularly. So, what are the most common injuries that runners face?

Dr. Andrew Hills: In sports medicine, we like to kind of break down injuries into acute versus chronic with acute injuries usually having more of like a specific mechanism injury. In running, we see the majority of the injuries to kind of be more the chronic kind of overuse form of injuries.

The most common injury we see actually has a name known as runner's knees. And in the medical world, we call that patellofemoral syndrome, and that's how the kneecap runs the groove as we flex and extend our knee. Other common injuries we see in the running world tend to be what we call shin splints or medial tibial stress syndrome. And then, we also see a lot of Achilles pain or Achilles tendinopathy. And the one that we are concerned the most about and probably is the most significant that all runners are trying to avoid are what's known as stress fractures.

Host: All right. I was just keeping score in my head here. I know we have tennis elbow, we have golfer's elbow, we've got runner's knees. I mean, you know, there's just lot of sports-specific things out there. Wondering, you know, with some of the stuff that you're describing, acute versus chronic, either way, is there anything that runners can do to prevent injuries?

Dr. Andrew Hills: Again, with these injuries, a lot of them tend to be kind of chronic overuse. So, having a good, solid foundation to help prevent these repetitive stresses are key. So with running, the one thing that everyone loves about running is you need minimal equipment. Really,, the one piece of equipment you need is a good running shoe. So, that's where going to your local running store can be beneficial, especially if this is the first time you're getting into running. They can look into your mechanics and determine what is the right shoe for you, if you need more of a neutral versus stability shoe. And having that is key kind of moving forward because you want a more stable shoe. You don't really necessarily want to focus on the brand or the color or what your friend's wearing. For me personally running, I've been running in the same brand and model for the last 15 years. When the shoe wears out, I buy the same model again.

And then, outside of a good shoe, your training plan is huge. Whatever your goal is, starting early and slow is key. Most of these injuries occur due to too much stress to the body. And one of the most common training errors that leads to injury is simply excessive mileage. So if your goal is to complete a half marathon, starting to train for it a month before will cause you to Increase your volume too quickly, which will kind of make you more predisposed to these injuries moving forward.

Host: Yeah, I see what you mean. And wondering if we can treat any of these injuries at home. Or once they start to mount up, whatever it is, knees, shins, whatever it is, do we need to see a medical professional or is there some things that we can do at home first?

Dr. Andrew Hills: Yeah. I would say the majority of our running injuries are something that people can try to treat on their own at home. Really, the only exception to that rule would be stress fractures. However, kind of starting at home is where someone can start just with relative rest. Basically, what that means is if you're having a lot of aches and pains, is maybe for a few days decrease the number of miles or the intensity you're doing, just to see how your symptoms respond. A home treatment program should also emphasize stretching, making sure you have the flexibility, but then also adding in some strengthening exercises. Running occurs in a north-south direction, which tends to result in weaker muscles that are responsible for stabilizing our pelvis and our running mechanics. Therefore, a strengthening routine that includes more east west direction can kind of help recover from some of these overuse injuries and also prevent injuries in the first place.

Host: Yeah, I see what you mean. If you're only doing the sort of north and south running, the stuff that allows you to go side to side and the stability, the east west, if you will, makes sense in terms of a home treatment plan. So then, when should we see a medical professional? How do we know what's the sort of breaking point, if you will, of like, "Okay, this isn't going away. I've tried all the home remedies. Maybe I should speak with a provider"?

Dr. Andrew Hills: Yeah, I think you brought up a great point there. So, starting with that home treatment, symptoms aren't improving or it's been a week or two and they're still not improving or maybe getting worse, that's definitely when you want to see whether it be a sports medicine physician or your primary care doc.

The big thing to kind of recognize is a sign of a potential stress fracture. That's something that you definitely want to see a medical provider right away for. The majority of these running injuries, I mentioned earlier on, they actually have some improvement as you start your exercise regimen that day. Usually, kind of the tissues warm up. However, if you start noticing some pain during that physical activity that increases during that physical activity and the pain does not get better after you stop, or there's tenderness along the bone, that can be a sign of a potential stress fracture and you should stop running and see a medical professional right away.

Host: Yeah, that sounds right. And great advice, not only from an expert today, but also a runner yourself. As we wrap up here, any additional advice for runners on just how to stay healthy in general?

Dr. Andrew Hills: Biggest thing for me with running is mix it up. Don't be afraid to mix it up. Don't focus on the same daily routine. Running is great for exercise and provides a lot of health benefits, but doing the same thing over and over can predispose you to injury and can also be hard on your psyche, too. So, change it up, whether it be changing the environment, maybe adding some trail runs, change up the mileage. So on your shorter mileage days, you can potentially focus more on speed.

It's also important to cross train, just going back to that north south direction, adding in like swimming, tennis, or some other activity can work on those other muscle groups. Decrease some of those same repetitive stresses that occur with running and improve your psyche and symptoms moving forward so you can continue to run kind of in the foreseeable future without injury, hopefully.

Host: Yeah, that sounds great. For me, with running is it just gets boring running the same route, the same way, day after day after day. So, I find that just kind of mixing it up, maybe just head the other way one day, or as you say, hit some trails, do some swimming, play some basketball, whatever it might be. So, good stuff today. Thank you so much and you stay well.

Dr. Andrew Hills: Thank you for having me.

Scott Webb: And for more information, visit franciscanhealth.org/sportsmedicine. And if you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next time.