Running aches & pains: The signs & symptoms
 By
Michael Gordon, MD, Milwaukee Orthopaedic Group, Ltd. Orthopedic
Surgery, Sports Medicine Fellowship
Plantar fasciitis, Achilles tendonitis, metatarsal stress fracture,
posterior tibial tendonitis, exertional compartment syndrome, shin
splints, anterior knee pain, iliotibial band syndrome (ITB). What do
they all mean?
How do you know when you or your runners have a serious problem? Part
of running is dealing with the occasional aches and pains that come with
the repetitive pounding on the body. Sore muscles and some mild joint
aching are generally okay and respond well to rest and gentle massage.
But, what about the more constant ache that doesn't seem to respond to
these simple measures?
This article will highlight the signs and symptoms that raise red
flags for the more serious problems that may require medical attention.
Let's get the obvious ones out of the way: chest pain, racing heart
rate, dizziness and shortness of breath are automatic go to a physician
for an evaluation. Now, let's move on to the orthopedic or
musculoskeletal problems that I routinely see in my practice (as well as
the several that I have personally experienced as a runner!).
Bone pain or pain that you can recreate by pushing on a bone
is a very concerning sign for a stress fracture. Commonly, runners will
experience this specific pain over one of the long foot bones at the
base of the toes (metatarsals), the heel bone (calcaneus), and/or shin
bone (tibia). This pain can also be present at night.
Groin pain or deep thigh pain is a warning sign for a
potential femoral stress fracture that can be catastrophic if missed.
This groin pain can be differentiated from a simple groin strain or
muscle ache by pushing on the groin muscles and recreating the symptoms.
If touching the muscles doesn't hurt, then worry about a stress
fracture.
Achilles pain is pain that is present with the palpation of
the Achilles tendon. The Achilles is the most posterior structure of the
ankle and sits just deep to the skin so it's easily palpated. Swelling
and pain over this tendon is a sure sign of Achilles tendonitis that
will require a significant alteration in running and training. Trying to
run through this pain/problem can lead to permanent changes in
the tendon, and ultimately chronic pain.
Medial ankle pain or pain that occurs on the inside part of
your ankle just deep to the tip of the bone. The posterior tibial tendon
runs just distal to the bony prominence on the inside part of your ankle
helping to maintain your arch. And, just like Achilles tendonitis,
attempting to run through this pain can lead to permanent changes
in the tendon and chronic pain.
Numbness and tingling in your foot can be a sign of exertional
compartment syndrome, essentially due to the excessive swelling of your
muscles compressing the nerves serving your foot. People can rarely “run
through” this pain as it becomes quite disabling. This problem generally
leads to surgery to release the compartments and create more space for
the muscles to swell.
There are plenty of other signs and symptoms that are easily linked
to many of the common diagnosis listed above. Even if these aren't
career ending problems, they can most definitely affect your training
and performance. A visit to a sports medicine specialist can help to
expedite your return to running and help you to achieve peak
performance.
Remember to listen to your body. Be smart about training.
Dr. Michael Gordon, of the Milwaukee Orthopaedic Group, Ltd. is an
orthopedic surgeon with a fellowship in sports medicine. For questions,
you can reach Dr. Gordon at 414-276-6000.
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