Running Injuries


Dr. Rice routinely provides evaluation and treatment for individuals of all ages and levels of fitness including: Olympic athletes, runners, stunt people, professional athletes, football players, tennis pros, marathoners, baseball players, golfers, martial artists and body builders. We help runners and multi-sport athletes stay on top of the most current trends in training, injury prevention and nutrition.

In his Fernandina Beach office, Dr. Rice is a certified Running Doctor and provides chiropractic care for: sports injuries, low back pain, herniated discs, running injuries, neck pain, migraine headaches, joint pain, wrist pain, shoulder pain, hip pain, arch/heel pain, sciatica, shin splints, lower leg injuries, plantar fasciitis, muscle spasms, whiplash, carpal tunnel syndrome, fibromyalgia, iliotibial band syndrome, bunions, and more. Dr. Rice is a volunteer with the Amelia Island Runners Club here in Fernandina Beach.

I’ve finally started to run and now I have pain in parts of my body that never hurt before! Sound familiar? Most people who start running for sport, fitness or recreation face some chance of pain or injury during their training routines. The more active you become, the more you increase your risk of injuries. But . . . you will recover much quicker than your sedentary co-worker. Let’s discuss the most common running injuries and what you can do to prevent and treat them.

Foot & Ankle


Plantar Fasciitis - The plantar fascia is a thick fibrous band of tissue that runs along the bottom of the foot from the heel to the base of the toes. When the plantar fascia becomes inflamed (swollen), it is known a plantar fasciitis.


Symptoms- a deep bruise like pain at the base of the heel. The pain is worse in the morning and at the beginning of the run. Pain may fade as the fascia loosens.


Causes - Occurs when plantar fascia is placed under too much stress, which causes inflammation and tearing of the fascia. Tight Achilles tendons, flat feet that over-pronate, rigid high arches are susceptible to plantar fasciitis. Worn out shoes that allow excessive over-pronation or too stiff of a shoe may lead to plantar fasciitis.


Treatment - Correct shoes and inserts may help alleviate pain. Reduce running during acute periods and use of ice and anti-inflammatory therapies. If condition worsens or persists, ultrasound and soft tissue stripping (Graston Technique) may be helpful as well as custom made orthotics. Heel spurs are commonly found with plantar fasciitis but surgery to remove the spur usually does not help. The spur is not the problem but a reaction to the chronic stress the plantar fascia places on its insertion at the heel.


Prevention - Stretch calf muscles and Achilles tendon. Strengthen by picking up marble or golf balls or by scrunching up a towel with your toes. Stretch plantar fascia with a tennis or golf ball and towel stretches. Make sure you have good shoes that correct any over-pronation problems.


Achilles Tendonitis - caused by inflammation of the Achilles tendon. The Achilles tendon is the large tendon that connects the calf muscles to the heel. Persistent inflammation may lead to rupture.


Symptoms - Dull or sharp pains along the course of the tendon, usually close to the heel. Ankle motion is usually present. Nodules can be felt over tendon and a crackling sound may be heard when the ankle moves.


Causes - Tight or fatigued calf muscles. This causes the Achilles tendon to handle most of the load while running. Excessive speed work, hill running or increasing mileage to quickly can lead to Achilles tendon inflammation. Inflexible running shoes and over pronation may lead to Achilles tendonitis.


Treatment - Rest with ice and anti-inflammatory. If injury does not respond to self care ultrasound over tendon along with myofascial release and deep tendon friction massage may help. If severe, surgery may need to be performed to remove scar tissue from tendon. Resume easy running when toe raises are not painful.


Prevention - Stretch Achilles tendon before and after each run using curbs or arcs. Strengthen and stretch muscles of lower extremity and calf. Control pronation with motion control shoes. Utilize proper rest intervals during training.


Shin Splints - Inflammation of the tendons of the anterior (front) lower leg. This is a very common nagging injury that occurs in new runners or runners coming back from a prolonged period of rest. Symptoms - An aching throbbing tenderness along the front of the shin. Pain is most severe at the start of the run and usually decreases as the run progresses. If it does not decrease running this may indicate a stress fracture in the tibia.


Causes - Fatigued or inflexible calf muscles put to much strain on the tendons, which become strained and torn. Over-pronation and running on hard surfaces will aggravate the problem. Beginners are susceptible.


Treatment - Many runners experience mild shin splints at the beginning of the running season-running through the pain will aid in the body adapting to the new found stress of running. If the problem persists you should not attempt to run through it. Ice and anti-inflammatory and mileage reduction should help. Persistent problems may need ultrasound and anti-inflammatory treatment. Orthotics to control overpronation

may be needed.


Prevention -Stretch and strengthen tendons and muscles in front of leg. DARD’s are useful as well as band exercises. Motion control shoes for over-pronaters.




Patellar Syndromes - Included in this category are chondromalacia patella, patellar tendonitis, and patellar tracking disorder. These are the most common knee injuries experienced by runners. Chondromalacia patella is wearing away of the cartilage beneath the knee cap. Tracking disorders occur when muscle imbalances exert an uneven pull on the kneecap.


Symptoms - Pain beneath or on the side of the knee cap. Swelling around the knee cap may also be present. Pain is increased with running hills. As symptoms get worse, grinding or scraping sensation may be felt under the kneecap.


Causes - Uneven pull of the kneecap by the quadriceps muscles. Weak quads and/or tight hamstrings may aggravate. Running down hill or on heavily cambered roads will also aggravate. Poor rest cycles may lead to patellar conditions since this is an overuse syndrome.


Treatment - Ice and anti-inflammatory with reduction in running. Self massage and glucosamine //chondroitin supplementation to reduce cartilage breakdown. Quad strengthening exercise to address muscle imbalance. An open patella knee sleeve may be used when running resumes. If problem persist arthroscopic surgery may be needed to debris the undersurface of the patella.


Prevention- stretch and strengthen quads. Address any muscle imbalances. Motion control shoes to prevent over-pronation. Avoid downhill running and heavily cambered roads. Incorporate adequate rest cycles.


Iliotibial Band Syndrome - Inflammation and pain on the outside of the leg caused by a ligament that runs along the outside of the thigh (the iliotibial or IT band) appropriate

Symptoms - Dull ache near the outside of the knee that begins a mile or two into your run. Pain at knee may become sharp and cause tenderness and swelling on the lateral aspect of the knee.


Causes- over-pronation, bowlegs, worn out running shoes or banked surface which all cause the leg to bend inward can aggravate the IT band.


Treatment - Reduce mileage, cut back on hill and speed work. Stretch the IT band at least 3 times a day while in recovery. Ice to the knee may aid in reducing symptoms. Persistent cases may need ultrasound and friction massage work. In severe case cortisone injection under the band may be needed.


Prevention- Stretch and strengthen IT band. Avoid heavily cambered roads downhill surfaces. Stretch and strengthen quads and hamstrings.

"This information and website content is not intended to diagnose, guarantee results, or recommend specific treatment or activity. It is designed to educate and inform only. Please consult your physician for a thorough examination leading to a diagnosis and well-planned treatment strategy. See more details on the DISCLAIMER page. Content is reviewed by Dr. James M. Cox I."