Pace Setter : April 2025

Take every season in stride

Take every season in stride: navigating common springtime injuries
Megan James, PT DPT, USATF-L2; Owner, Immersion PT

Spring is officially here in the Capital Region! With the warmer weather, more daylight, and snow-free trails now, it is tempting to jump right back in where you left off in the fall. Some of us have continued training through the winter – either braving the elements outdoors, or braving the monotony of the ‘mill’ and/or stationary bike – while others went into hibernation mode to recharge. Whichever group you fall into, spring is a time of change all around, and that goes for our training, too! Let’s take a look at a few common springtime running-related injuries and what you can do about them.

●    Medial Tibial Stress Syndrome (MTSS), commonly referred to as “shin splints”: This will appear as an ache or pain along the front-inside portion of the tibia (your shin) that comes on with exercise and may linger for several hours afterward. MTSS occurs when the periosteum (outer covering of a bone) is irritated due to “pulling” from the attached muscles; it is often a result of ramping up too quickly, whether in frequency, intensity, volume or all three. Complete rest is generally not recommended as that will set you into a vicious cycle of “rest, activity, pain, rest, activity, pain” and hinder forward progress in your training. MTSS does fall on the continuum of bone stress injuries and should not be ignored, or you risk progression to a stress fracture. MTSS typically calms down with activity modification, addressing weaknesses in the foot and hip muscles, and potentially footwear modifications. One very simple way to strengthen the muscles in your feet is to spend more time walking barefoot! 
●    Plantar fasciopathy, commonly known as “plantar fasciitis”: Many of us are probably (unfortunately) familiar with that stabbing heel or arch pain, typically worse in the first few steps in the morning or after sitting for a long time. It can be brought on by a change in surface (treadmill to road, or road to trail) and/or a fast ramp-up in training. This was previously thought to be an inflammatory condition (hence, the “-itis”), but now is considered more of a degenerative condition in which symptoms can last for several months or a year if not managed properly. Since it is not truly inflammatory, using “anti-inflammatory” strategies to manage it probably won’t get you too far. Stretching and massage may feel good and provide short-term relief, but the plantar fascia is so dense and thick that we are not physically able to alter the tissue length for a lasting effect. PF tends to respond well to high-load strength training, such as performing single leg calf raises with a towel roll placed under the toes. 
 

●    Iliotibial (IT) band syndrome: ITBS presents as pain along the outside of the thigh, usually close to the knee, that is aggravated by repeated knee flexion & extension, as in running and cycling. This may appear more in the spring as we transition from a flat treadmill to the crowned surfaces of the roads & bike paths. Just like the plantar fascia, the IT band is incredibly dense and thick, so the foam rolling and stretching you may have been told to do is, again, only providing short-term relief, at best. Stretching and foam rolling the muscles around the IT band, such as the gluteals, hip flexors, quadriceps & hamstrings can have a positive effect on symptoms and activity tolerance. Side plank (& many variations!) are also helpful in improving hip/pelvic strength and stability. 

 

Hopefully the strategies above will help get you started, but they are not all-inclusive and, obviously, not individualized to you. As with all injuries, it is best to consult with a qualified healthcare professional who can perform a comprehensive assessment that includes questions and examination related to training history, previous injuries & current training goals; footwear; strength, range of motion and mobility limitations; recovery strategies, including nutrition and sleep; movement patterns and walking/running gait analysis. If something is bothering you enough to alter your stride, affect your other daily activities, or does not calm down to “baseline” within 24 hours of activity, it is time to make an appointment!