General Health & Wellness • Jun 01, 2010

Running and Injury Prevention

As parents we are constantly encouraging physical activity in our youth to promote healthy lifestyles and reduce childhood obesity.  Many of us have even carried those habits we learned as children into adulthood and still remain active today.  Running is one of the most accessible and inexpensive activities available to all and has become an ideal first step, rapidly increasing in popularity in the past 20 years.  But like any activity it is not without risks and we as parents and caregivers need to be aware of potential injuries.  Overuse injuries are most common and it is estimated that more than 25% of all runners will have to seek medical attention for injuries suffered during their careers.  The AAP warns against intense training at a young age and there is still a hot debate in sports medicine on whether children should participate in long distance running.  However, no matter the distance or age all runners should be injury-free and self-motivated.

All runners young and old should begin their training with proper nutrition and hydration.  Caloric intake should at least be the recommended daily requirement and should include both carbohydrates and protein.  Children should never eat right before exercise and also maintain a minimum amount of calcium and iron in their daily diet.  Many runners and especially children do not maintain adequate hydration for exercise leading to increased risks of exhaustion, strains, heat cramps, passing out (syncope) or even heat stroke.  Children are even more susceptible to these risks due to their higher production of heat per body surface area and decreased sweating ability.  They should work on being hydrated prior to exercise and replace lost fluids with a sports drink with electrolytes.  Proper clothing such as light breathable fabrics and frequent breaks especially on hot humid days are also recommended.

The most common injury to all runners and especially adolescents are muscle strains.  They are generally graded between 1 and 3.  Even grade 3 strains can heal in 12 weeks or less with proper care.  The risk of strains can be lowered with good stretching techniques before and after all exercise.  All strains should be treated initially with complete rest from activity and ice.  Heat may be used after the first few days.  NSAIDs such as ibuprofen are helpful with pain but may delay healing so should be used sparingly.  Cross-training with swimming, biking or elliptical machines to maintain cardiovascular fitness and maintain surrounding muscle tone may also speed recovery.  As with any injury, return to running should be gradual and pain-free.

Iliotibial band syndrome (ITBS) and patella femoral pain syndrome (PFPS) are both common causes of non-traumatic knee pain in runners. ITBS usually causes pain over the outer knee that occurs especially with longer runs and descending stairs.  It is treated with proper stretching, rest and strengthening of the gluteal muscles.  A visit to the physical therapist is sometimes necessary for massage and proper stretching and running technique.

PFPS causes a dull achy pain above or below the knee and may be worse with climbing stairs or prolonged sitting.  It can be caused by poor kneecap tracking or general overuse and is also treated with rest, stretching and strengthening of the lower quadriceps muscles.  Treatment exercises for both syndromes can be recommended by physical therapists or found on the internet and many times bracing or taping may be helpful for prevention and care.
Other acute ligament and bony injuries are also seen quite often with runners as they increase their distances.  Ankle sprains or fractures, avulsion fractures, or stress fractures are all seen in runners and more common in children and adolescents than in adults.  They should always be evaluated by a physician initially especially with point tenderness and swelling over the lower leg, ankle, or foot.  These injuries will also heal in time, but need to be monitored by a physician before exercise is resumed.

At what age a child may begin running for exercise is still under debate.  But no matter the age, proper technique, precautions and stretching along with good nutrition and hydration guidelines should be followed for a more enjoyable and injury free running career for all.