Common Running Injuries

Running is a great way to stay in shape, manage stress and increase your overall wellbeing, however it’s not without it’s drawbacks. While being a low risk activity, there are a few injuries that commonly affect runners. As running is a repetitive impact activity, most running injuries develop slowly and can be difficult to treat. Here are three of the most common conditions faced by

Runners Knee

Runners knee is a persistent pain on the inside of the knee caused by the dysfunctional movement of the kneecap during movement. The kneecap ideally sits in the centre of the knee and glides
smoothly up and down as the knee bends and straightens, in a process described as tracking. If something causes the kneecap to track abnormally, the surface underneath can become worn, irritated and painful. The pain might be small to start with, however left untreated, runner’s knee can make running too painful to continue.

Shin Splints

Shin splints is a common condition characterised by a recurring pain at the inside of the shin. While the cause of this condition is not always clear, it is usually due to repeated stress where the calf
muscles attach to the tibia (shin bone). Why this becomes painful is likely due to a combination of factors that can be identified by your physiotherapist to help you get back on track as soon as

Achilles Tendonitis

The Achilles tendon is the thick tendon at the back of the ankle that attaches to the calf muscles. The amount of force that this tendon can absorb is impressive and is vital in providing the propulsive force needed for running. If the stresses placed on the tendon exceed its strength, the tendon begins to breakdown and become painful.

The information in this newsletter is not a replacement for proper medical advice. Always see a medical professional for assessment of your individual condition.

ACL Tears

What is an “ACL tear” and how does it occur?

The ACL, or anterior cruciate ligament, is a strong piece of connective tissue which attaches the thigh bone (femur) to your leg bone (tibia). The ACL is referred to as a “crucial” ligament due to the stability it provides to the knee joint. The ACL’s job is to prevent the tibia from sliding forward relative to the femur.

This ligament is injured in athletes more often than other populations, however injury to the ligament may occur in other ways. Injuries tend to occur when landing awkwardly from a jump, twisting the knee, or suddenly stopping from running. The ACL may also be injured during knee hyper-extension, or when hit from the outside. Many times, other tissues surrounding the knee are also damaged, including the medial collateral ligament, meniscus, joint cartilage, and bone marrow.

A musculoskeletal practitioner can formally grade the severity of ACL injuries. A grade I injury occurs when there is minimal damage to the ligament and the joint remains stable on testing. Grade II injuries occur when the ligament is partially torn. The joint becomes loose on testing, but still provides a degree of stability. Grade III constitutes a full tear or rupture of the ligament. There will be no stability provided to the joint on testing.

What are the signs and symptoms of an ACL tear?

Many people will report hearing a “pop” in the knee associated with pain at the time of injury. Within a few minutes to hours of injury, there is likely to be significant joint swelling. Decreased range of movement of the knee is common, and the injured knee is typically unable to take full weight upon standing or walking. It may also feel unstable at times, such as a “giving way” sensation. Poor balance and coordination may also be experienced.


Non-surgical management of the injured ACL is taken when there is a grade I to grade II injury. Surgical management typically occurs for grade III injuries, and occasionally grade II injuries to the ACL. Your doctor or physiotherapist can help you decide whether non-surgical or surgical management is best for you. Regardless of surgical or non-surgical management, your physiotherapist will assist you with improving your knee’s range of movement, lower limb strength, balance, stability and coordination. You will re-learn the tasks of walking, using stairs, and negotiating obstacles. Early in rehabilitation, the RICE protocol (rest, ice, compress, elevation) is used in conjunction with static resistance type exercises to improve muscle contraction in the leg and increase blood flow in the area. Throughout your rehabilitation program, you will progress through a variety of strength and mobility exercises targeted towards your individual needs, with goals of returning to your favourite sport or hobby as soon and as safely as possible.

This information is not a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.

Optimising Injury Healing – Stress

Healing from injury or surgery is an important process. Poor healing of muscle, ligaments, tendons and bones can delay your recovery and your return to the things you like doing. If you have had surgery or have open wounds, poor healing can increase wound infections or complications.

Healing from a wound or injury requires you to be in good physical condition. Some things can delay healing such as diabetes, smoking and immunological conditions. You may not realize psychological factors also play a part. Stress, which is a normal and natural reaction, is one factor which has been shown to delay healing of wounds/tissue damage.

Unfortunately, chronic stress promotes habits that can negatively impact on health and healing. These habits include smoking, alcohol and drug abuse, reduced level of exercise, poor diet choice and poor sleep.   This sounds like Queenstown!

How stress affects your body:

Many functions in your body are controlled by your autonomic nervous system, there are two parts to this system; the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS).

The SNS kicks in when your body perceives it is in danger (such as jumping out of the way of a wayward car). It is the fight/flight response. The SNS is also activated when we are under physical stress, such as an injury or a heavy exercise session. Emotional or psychological stress can cause the SNS to work for long periods, which is detrimental to regular body function and can cause clinically relevant delays in healing.

The SNS functions are related to ‘survival’. When activated it helps increase blood flow to your muscles (so you can run away), by reducing the blood flow to your internal organs. If the SNS stays activated for long periods (such as stress), it can have detrimental effects on the functions of your organs such as digestion, fertility and growth (healing).

It is normal for both the SNS and PNS to work together daily, the PNS should be dominant while resting/sleeping to encourage the ‘rest and digest’ functions. The SNS should be more dominant when you are more active, to increase blood to muscles and your breathing and heart rates. Between spikes of SNS activity you should return to a more relaxed/PNS state.

Optimising Injury Healing – Effects of Smoking

Smoking – we all know it’s bad for your health and it is the cause of many serious health problems.  Each cigarette contains over 4000 chemicals, 70 of which have been identified as causing cancer.  In fact, every cigarette takes 11 mins off your life expectancy.


But, did you know that smoking slows our body’s healing?  Every lungful of smoke you inhale prolongs your recovery time from an injury.  How?  Well, our lungs should be filled with oxygen rich air (not smoke) that passes from our lungs into our blood which flows around our bodies, keeping our tissues healthy and healing our damaged tissues.  Essentially oxygen is “food” for our bones, muscles, tendons, ligaments.  If you smoke, you truly are starving your injury of food and its ability to heal.  On top of all that, nicotine is a vasoconstrictor, which means it closes the blood vessels and further limits blood flow to the extremities.   It gets worse – smoking also makes our blood thicker, making it harder to travel through the already narrowed blood vessels.   Think of a busy four lane motorway being your blood vessels and the passengers in the car are oxygen (that tissue food).  If you smoke it’s like blocking two of those lanes off.  Imagine how long it will now take to get all those passengers (oxygen) to their destination (your injury).   That is your recovery time from your injury increasing.


Optimising Injury Healing – Sleep

Sleep is one of the most important elements of injury prevention and healing.  Benefits of sleep include:


  • Improved reaction times
  • Decreased injury rates
  • Longer playing careers
  • Improved weight management
  • Decreased injury risk
  • Increased accuracy and sprint times
  • Improved mental acuity
  • Fewer mental errors
  • Improved cognitive function (attention and memory)


How does sleep affect injury healing?


  1. It directly impacts your immune system

A healthy, strong immune system is crucial to all types of healing. Without a strong immune system, you cannot properly create healthy tissue, fight infections and stay on the path to a successful recovery.  When you do not get enough sleep during the wound healing process, your immune system can become depleted, raising your risk of elongating healing time and developing infections.


  1. It slows down tissue growth

Of course, for wounds to heal successfully, healthy tissue growth is key. When does this essential growth happen? While you sleep. The growth and repair of tissue occurs in the third and fourth stages of sleep, which happen after you have completed about 70 percent of your rest. This means that getting a full, uninterrupted night’s sleep is crucial – a few naps here and there will not cut it.


  1. It can trigger and exacerbate coronary issues 

Sleep deprivation can have an adverse effect on the heart health. Because coronary function affects your overall well-being, this is yet another reason to prioritize your rest. Health Line noted that heart disease can be a root cause of poor circulation, which can delay or interfere with the healing process.


  1. It can compromise healthy eating habits 

When you are constantly tired, your body is seeking ways to create more energy. This can lead to cravings for sugary, fatty foods that are not good for your body, and that may further delay the healing process.  People who do not get enough sleep are also more likely to consume bigger portions, which can lead to unwanted weight gain.


How many hours a night do I need?


  • School age children (6 – 13 years): 9 – 11 hours
  • Teenagers (14 – 17 years): 8 – 10 hours
  • Adults (18 – 64 years): 7 – 9 hours
  • Older adults (65+ years): 7 – 8 years

Sleep tips:

How much sleep do YOU need?

  • Are you productive, healthy and happy on seven hours of sleep?
  • Or does it take you nine hours of quality ZZZs to get you into high gear?
  • Do you have health issues such as being overweight?
  • Are you at risk for any disease?
  • Are you experiencing sleep problems?
  • Do you depend on caffeine to get you through the day?
  • Do you feel sleepy when driving?

Did you know?

The amount of sleep you need on a regular basis for optimal performance is called your basal sleep need.

The accumulated sleep that’s lost from poor sleep habits, sickness, waking up in the night and other causes is known as your sleep debt.

An imbalance of the two leads to an unresolved sleep debt, which can lead to increased sleepiness and less alertness.  One or two good nights of sleep may not be enough to settle your unresolved sleep debt, so it is important to get consistent nights of decent sleep in order to make up for this.

Optimising Injury Healing – Hydration

Keep yourself hydrated for optimal recovery from your injury.

We are essentially 60-70% water and this water is vital for everything from boosting your brain power; improving your skin; to assisting in your body’s defence when injured.

When dealing with an injury, hydration is an essential part of the healing process. In a dehydrated state, our body will pull water from our skin and muscles to protect our organs.

Without proper hydration, your skin and muscles will not receive the proper oxygen and nutrients it needs in order to heal.  There are three stages of tissue repair; inflammation, proliferation and remodelling following injury. In each stage, water is a primary catalyst to help move from one stage to the next. Water is used as a vessel to supply the required chemicals, nutrients and oxygen required for healing.

Dehydration can lead to:

Cramps – your body needs both water and electrolytes (sodium, potassium, magnesium, calcium, and chloride) to support normal muscle contractions. When you sweat heavily during workouts, you lose both, which causes cramps.

Cartilage wear – water and electrolytes are essential in delivering nutrients that help cartilage repair itself when it’s injured. If you stop drinking water, the wear and tear on your cartilage (especially your knees) outpaces the body’s ability to generate new cells. Injuries like cartilage tears and meniscus tears can result.

Friction in the joints – cartilage is made of collagen, proteins, cells, synovial fluid, and water — up to 80% water. This water and synovial fluid cushions your bones when they bear weight or pressure. The meniscus, for example, pads your knee joint and allows the leg bones to move smoothly past one another without grinding. Dehydration can deprive your cartilage of the water it needs to maintain this cushion, which can lead to achy or “creaking” joints and osteoarthritis (OA).

We all need to stay hydrated to stay healthy. But if you’re active or athletic, hydration is even more important because you’re losing water to sweat. If you hope to avoid injury, replacing water and electrolytes needs to be a pillar of your sports training routine.


If you exercise vigorously you should drink a glass of water before starting, and then have half a glass every 15 minutes. This will prevent dehydration and improve performance.


The best drink for avoiding dehydration is water. Water is a sugar-free, calorie-free nutrient and is optimal for good health. If you don’t like the taste of tap or bottled water, you can make your own “spa water” at home by adding lemon, cucumber, or mint for flavour. You can also flavour water with slices of fresh fruit like apples, orange, or grapefruit.