Running: Preventing and Treating Running Injuries (cont.)

Also known as pain in the middle of arch of the foot, plantar fasciitis is a running injury most frequently caused by an abnormal motion of the foot or too-tight calf muscles. Normally, while walking or during long-distance running, your foot will strike the ground on the heel, then roll forward toward your toes and inward to the arch, Maharam explains. "Your arch should only dip slightly during this motion but if it lowers too much, you have what is known as excessive pronation." What to do? "It is usually corrected with an orthotic and calf stretches" before and after running, Maharam says.

6. Achilles tendonitis

Achilles tendonitis is a running injury that typically occurs from abnormal foot stroke in push-off and too-tight calf muscles. "If you are pronating to the side and pulling at an improper angle, it becomes stressed and inflamed. That's why getting an orthotic to correct the biomechanics of your foot stroke at push-off is key," Maharam says. Also, he suggests doing the same stretch recommended for shin splints.

7. Muscle Pulls

Whether hamstring, quads, or any other muscle, pulls come from not being flexible and/or overexerting specific muscles. "Basically, pulls occur because you haven't stretched or because you are trying to beat your 18-year-old son in a sprint and you are 45," Maharam says. Pulls are basically small muscle tears, and the best way to treat a pull is to do more stretching before and after a run. To prevent hamstring pulls, place one leg on a chair and get your knee straight and bend over. Hold for 15-20 seconds. For an acute injury, ice and anti-inflammatory medication is helpful.

8. Ankle sprains

Ankle sprains occur because runners don't always watch where they are going. "They can step off curb or into pothole," Maharam says. "Pay attention to where you are running or run on a really good, level track where there is less chance of finding a gopher hole." When and if an injury does occur, ibuprofen and ice can help reduce swelling and pain.

9. Dizziness and nausea

"Most runner's drink too much, not too little" water, Maharam says. This can cause overhydration -- also known as diluting -- which lowers sodium levels in the body and stresses the kidneys. Common symptoms of diluting are nausea, vomiting, and dizziness. To avoid these problems, Maharam suggests: "Drink about one-cup (8 oz.) of fluid every 20 minutes while running. This way you will avoid becoming diluted."

10. Blisters

One of the most common sports injuries, blisters on the feet are usually caused by friction combined with excessive moisture. Avoid them by choosing synthetic socks -- such as those by Nike Dryfit -- that wick away moisture," Maharam says.

Remember, Pribut says, that "about 90% of running injuries are due to overtraining, so a very slow buildup is important, and so are rest days." You'll save yourself pain and reach your goals, Pribut says, if you "avoid the 'terrible toos' -- training too much too soon, too often, and too fast."

Originally published Aug. 11, 2003.

Medically updated March 29, 2004.

SOURCES: Lewis G. Maharam, MD, medical director, New York Road Runners Club, New York City Marathon, and NYC Triathlon. Michael Fredericson, MD, team physician, cross country and track team, Stanford University. Sports podiatrist Stephen Pribut, DPM, clinical assistant professor of surgery, George Washington University Medical Center, Washington, D.C.

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