USC Marathon Team





    General Problems

Try RICE. It's the old standby-rest, ice, compression and elevation-or RICE for short. Again, rest is all you need to keep most aches and pains from becoming more serious. Along with rest, ice the injured area as soon as possible. I like to keep a paper cup filled with ice in the freezer. At the first sign of an injury, I peel away the paper from the top of the cup and rub it directly on the affected area. I rub until the area gets numb, which usually takes 10 to 15 minutes.

***Below are some things we sent out in November, 2008. Scroll down for the previous stuff.**

    Articles

http://www.runnersworld.com/runnersbody/ , it seems to be a pretty good one-stop spot for diagnosing and treating injuries. I especially like their visual guide that links where the pain is to what the injury probably is:

http://www.runnersworld.com/runnersbody/tool.html


Here the most common injuries.  Many people experience other injuries so you have to do a lot of research to check your symptoms.  Luckily there is a lot of information on the web, especially on forums.

The most important things are not to run too fast and to have the right shoes.  If it is the first time you have run a distance, you should be conservative.  Long runs should be taken easy and the mid-week runs should be used to work on your pace.  The rest on Monday should be taken seriously... as little exercise as possible. 

Shin splints:
(http://www.coolrunning.com/engine/2/2_5/196.shtml)

What is it? Inflammation of muscles around the shins. The front of your shins will hurt while and after running.  Usually a problem in the initial stages of training.
Causes:

- Impact with the pavement causes strain on the tendons attached to the bone.
- A step up in mileage may develop your calf muscles which pulls on the tendons if you don't stretch regularly.

Prevention:

- Good shoes that are designed for your style of running and improve heel-to-toe smoothness.
- Stretches every morning and evening for both your upper and lower calves.
-
http://www.spinalhealth.net/stretching.html
- Strengthen by sitting down and scrunching up a towel or newspaper with your toes.  After that gets easy put weights on the towel.
- Don't necessarily try to alter your style of running.  It may lead to other injuries.  Your style should develop naturally.

Relief:

- Rest if the pain is intense.
- Swap some runs for cardio workouts with less impact.

- Ice as soon as possible after running to reduce swelling/bruising.

Runners Knee (http://www.coolrunning.com/engine/2/2_5/194.shtml):

What is it? The knee cap becomes loose when running long distances and rubs against the tendons leading to swelling.  You feel a pain after running below your kneecap.  Usually a problem towards the end of our training program.
Causes:

- The arches on your feet collapse, so that your knees are moving side to side as you run.
- Muscles on the side of your thighs are becoming week and allowing side to side motion of your knees.

Prevention:

- Good shoes are key.  Go to a professional store.
- Consider running orthotics. plastic that go inside your shoe and better support the arch found at most running stores.
-
http://www.submityourarticle.com/articles/Dr%20Marybeth-Crane-3414/functional-orthotics-42636.php
- Strengthen your thighs by swimming breast stroke or lifting your straightened leg to the side, away from the other leg.

Relief:

- Wrap with towels that you keep in the freezer straight after running.
- Ibuprofen taken after running (with food).  Don't take while running.  This can lead to bleeding of the stomach.

ITB syndrome: (http://en.wikipedia.org/wiki/Iliotibial_band_syndrome)

What is it?

This is the scourge of our team.  It is the most common injury cause of people dropping out.  The Iliotibial Band, which runs down the side of your thigh, rubs against your knee and causes a very painful swelling.  You feel it while running and it doesn't go away.

Causes:

- Similar to runners knee, but more related to overpronation while running.  Running on a sloped surface can make things worse.

Prevention:

- You need to develop your muscles slowly.  Don't push too hard on distances that are first time.  Run slowly.
- Shoes are again very important.
- Stretches every day (
http://www.spinalhealth.net/stretching.html).
- When running a lot of miles a week, avoid sports like tennis and soccer that go a lot from side to side.

Relief:

- Rest is the best solution, but this can leave you way behind in the training. 
- Ice and ibuprofen after running.
- Massage of the thigh can help, but don't massage the knee itself.
- Some people have found knee supports that worked.  I found that they changed my running style and led to other injuries.  Ask in running shops.


Plantar Fasciitis: (http://www.coolrunning.com/engine/2/2_5/191.shtml#plantar)

What is it?

Inflammation of the tendon that runs along the sole of your foot.  The pain will be most noticeable in the morning when you get out of bed.

Causes:

- Not distributing your weight evenly on your feet when you run.  This can be related to...
- Shoes that don't deal with your pronation.
- Tight calves that increase your pronation.  When you walk in bare feet, it is noticeable that your heels flick up at the end of your stride if this is the case.

Prevention:

- Again, good shoes.  Orthotics are something you should consider if you have strong pronation.

- Stretches related to calf muscles.

Relief:

- Ice and rest.
- Cut back on the hill work.  Maybe walk up and down hills and concentrate on flat surfaces.


***********************************************************************************

Collected from various sources, including
Runner's World,
American Academy of Orthopaedic Surgeons,
Nicholas Institute of Sports Medicine and Athletic Trauma etc.

    Shin Splints

Athletes often complain about "shin splints" at the beginning of a sports season. They're describing a pain in the front of the lower leg between the knee and ankle. In their hurry to get in shape, athletes can overtrain without properly conditioning their muscles. The result can be injury to the tendons, muscles or bones in the lower leg. Obviously, good shoes are the first key to avoiding these types of injuries. After that, physical therapy and good running practice comes into play. My cross country coach was big on holistic methods, namely, strength conditioning. That is, toe taps and calf raises. NISMAT Shinsplint page

    Knee Problems

This is a big problem for a lot of people once we hit 12-26 miles. I've had good luck with patella straps, but they only address the symptom. Again, physical therapy may be a good solution (after shoes): Runner's world knee page: "Once you've smoothed out the meeting of foot and ground, move north to the leg muscles. "The most consistent result in all our studies is that injured runners are weak," Messier says. "Runners think they don't need to do anything because they run all the time, but that's endurance, not strength. They need a good strength-training program for the legs."

Okay, so maybe you have hamstrings like nobody's business. But there's a good chance your quadriceps muscles are too weak, especially the teardrop-shaped muscle in the inside of the group, just above the knee, called the vastus medialis oblique, or the VMO. That could be bad news, because the VMO helps hold the kneecap in its groove. In one study of people with anterior knee pain, targeted exercise quickly decreased pain by 50 percent. "It works within 2 weeks," Messier says. "It's amazing.""

Also, don't do mean things to your knees. If you ride a bike, raise the seat and shift down so there
is less force at the joint. Don't squat down. Don't kneel down. Don't do anything that puts any
unnecessary pressure on your knees.

Know your knees' needs. That was hard to type.


    Pain Killers

Could we talk about injuries without talking about painkillers? No!
Hint: Don't carry loose pills during the race. If you pour water on your head
the pills will dissolve. Ooopsa!

In general, acetaminophen is your least-controversial bet.

"#8 - Don't take Aspirin, Ibuprophen, or naproxen sodium. One of the main injuries
during marathons is kidney failure, which is often due to one of these three
substances in the body combined with a strenuous effort that takes place over
several hours. " from http://www.coolrunning.com.au/expert/train-001.shtml

"DON'T take NSAIDs like Advil(R) or Aleve(R) before or during endurance events because, according to a few published reports, these over-the-counter pain relievers seem to increase the risk for hyponatremia." from http://www.jnj.com/news/jnj_news/20031030_105713.htm

But, then, maybe not: "Good reasons exist to avoid NSAIDs "on the run." One is the risk of
stomach irritation and bleeding. Another is that they can mask pain
reflecting potentially serious injury. But concerns about NSAIDs and
kidney function seem overblown. Two or three NSAID pills during a
marathon will not likely harm the kidneys."
http://www.gssiweb.com/reflib/refs/284/jan2001_2.cfm

Remember that the pain is your body trying to tell you something. Back off!



    Nipple Rash



I have provided a helpful figure to the left of the most painful problem of nipple rash.

Cause: too much rubbing over delicate nipples for too many miles.

Solution?

Answer a) Run without a shirt. Problems with Solution "a": You may be female. Also, skin cancer.
Answer b) Bandaids, applied before the problem starts. That is, when you start. After you start,
you'll be too sweaty to get the adhesive to stick.


    Protect Thy Toenails


Problem: ill fitting shoes
Solution: nail polish

Erin has graciously agreed to allow her toenails to illustrate this important point: