Most Common Hip & Knee Injuries When Training for the Marathon

If you are training for a marathon this spring, you are likely to be ramping up your distance over the coming weeks. Along with that increase in distance, you may start to experience some pain and could be unsure if you need to get it checked out. Here, our specialist hip and knee consultants explain the most common running injuries and the latest treatment options available.

Iliotibial Band Syndrome

What is iliotibial band syndrome?

Iliotibial band syndrome arises from overuse when the IT band becomes inflamed, and often results in pain that is felt on the outside of the knee, but can occur anywhere along the length of the band, including the side of the pelvis or over side of the hip.  It can become very painful and difficult to run, but the pain subsides as soon as you stop. is also commonly referred to as ‘IT band friction syndrome’. It is a disorder of the muscle / fascial band (connective tissue) that becomes tight as the muscles in the thigh are enlarging due to the increased exercise.

What are the treatment options for iliotibial band syndrome?

Most patients will respond well to non-invasive treatment options for iliotibial band syndrome.  Physiotherapy assessment and treatment can also help this condition. If rest or physiotherapy do not help injections may be another option. Steroid or Platelet Rich Plasma Therapy (PRP) could offer pain relief, and occasionally surgery would be a last resort to consider if all other options were unsuccessful.

Patella tendonitis (Runner’s Knee)

What is Patella tendonitis (Runner’s Knee)?

Patella tendonitis is commonly known as ‘Runner’s Knee’. This is a common cause of knee pain which occurs at the front and centre of the knee where the tendon attaches to the bone. Typically, you will experience a dull or sharp pain under the knee cap while running, kneeling, climbing stairs or after sitting for long periods of time. Knee instability is also common with this condition and can lead to your knee giving way.

How is Patella tendonitis treated?

There are many treatment options available, and in most cases non-surgical treatment options will provide pain relief. Assessment of footwear and training equipment can aid in preventing this, in addition to maintaining a healthy weight. The RICE (Rest, Ice, Compression, Elevation) method, physiotherapy and newer treatment options such Platelet Rich Plasma Therapy (PRP), can also be considered.

Hip Stress Fracture

What is a hip stress fracture?

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

What are the treatment options for a hip stress fracture?

Orthopaedic referral and assessment is 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 when the hip completely breaks or is unstable.

Other Stress fractures

The shin bone (tibia), calf bone (fibula) and long bones in the midfoot (foot metatarsals) are other areas in the body that are prone to a large amount of stress when running and pain can become severe enough to make the person stop running. If you are experiencing pain, seek early review from a specialist. Early treatment can prevent minor fractures from becoming complete fractures – which leads to more prolonged treatment and immobilisation.

Shin splints

Shin splits are also referred to as periostitis or tibial stress syndrome. Symptoms are generally pain along the inner border of the shins and during activity, but often subsides on rest. It is caused by inflammation of the periosteum (the layer immediately adjacent to the bone), which occurs as the muscles try to pull away from their boney attachments. Shin splints are generally self-limiting and can be managed with rehabilitation and/or physiotherapy, but often require an MRI scan to confirm and rule out other causes.

If you are experiencing pain and think you may have an injury, it is best to get it checked out as soon as possible so you can get on the road to recovery – and back to your activity – quicker.

For more information or to book an appointment with a specialist, please contact us.

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