The Top 6 Running Injuries Seen By Physiotherapists

By: Leanne Loranger, PT

For many Canadians running is the leisure activity of choice. With the warmer weather, many people move their exercise programs outside. Some may even participate in weekend fun runs, fundraising races, and more serious running competitions and marathons. But even if you are running inside, on a treadmill, all that running comes with the risk of injury.

Running injuries often affect the legs, knees and feet.


1. Shin Splints (Tibial Stress Syndrome)
Inflammation of the muscles at the front of the leg, between the knee and the ankle. Shin splints can be the result of several issues. Among runners, shin splints are thought to be caused by overuse, running on hard surfaces or on hills and poor foot and ankle control that leads to over-pronation when running (excessive inward ankle rotation).2


2. Front of the knee (Patello-Femoral Syndrome)
Pain at the front of the knee, often caused by a combination of changes in the cartilage lining on the back of the knee cap (patella), pressure between the knee cap and the thigh bone (femur), or misalignment between the knee cap and the thigh bone.1  

3. Outside of the knee (Iliotibial Band Syndrome)
Pain on the outside of the knee caused by friction between the bones of the knee joint and the thick ligament on the side of the thigh (Iliotibial band). Thought to be made worse by weakness of the hip muscles as well as running downhill and running excessive distances in a week.4

4. Knee joint (Meniscal Injuries)
Although more common with sports that involve twisting motions through the knee (such as football or soccer) than with running alone, meniscal problems can be the result of repeated small injuries that lead to the breakdown of the cartilage lining of the knee joint which in turn causes inflammation.5 Although often not caused by running, meniscal injuries can be made worse by running, especially running excessive distances in a week.


5. Heel pain (Plantar Fasciitis)
Heel pain that is caused by repetitive minor trauma to the thick ligament on the bottom of the foot that supports the foot’s natural arch. Excessive weight, weakness of the small muscles of the foot that support the arch, poor footwear, running and especially a sudden increase in running distance/intensity are all thought to contribute to plantar fasciitis.3

6. Ankles (Achilles Tendinopathy)
Inflammation of the thick tendon at the back of the ankle. The Achilles tendon is the attachment for the muscles that help you to push off when running, walking and climbing stairs. Repeated minor trauma to the tendon that doesn’t heal properly can lead to inflammation, pain and stiffness.6

As you can see, many of these injuries are either thought to be directly caused by or are made worse by overuse, especially unfamiliar overuse (for example when you set out to run a marathon by well, running a marathon rather than gradually working up to that distance). This results in injury and inflammation.

How to prevent running injuries

Take a break!
Often runners are reluctant to seek treatment,7 perhaps because they don’t want to be told to put their training on hold, however that is exactly what needs to happen in order to fully recover from the injury.

Listen to your body.
Some authors have suggested that more experienced runners are less likely to suffer an injury because they are more likely to pay attention to their bodies7 and because they have built up their ability to run over time.

Check your shoes.
There are many schools of thought on the subject of which type of shoe is best for running and remarkably little evidence to support a specific recommendation. Anecdotal evidence does however seem to suggest that if you are struggling with a running injury, it might be time to replace your old running shoes.8

Increase your distance over time.
An increase in the distance run in a week seems to be associated with an increased risk of injury. When increasing your distance, good practice is to do so gradually and to be cautious about how many consecutive days you spend running.7,8

Cross Train
Maintaining flexibility and strength will help to prevent injury by maintaining a balance between muscles used for running and their counteracting muscles. When injured or on off-days some activities to consider include: cycling, swimming, water jogging and cross country skiing as well as weight training. Not all of these activities will be appropriate for every injury, for example cycling may aggravate an Iliotibial Band Syndrome.4 Your physiotherapist will be able to give you specific advice about what activities will allow you to be active without aggravating your injury.

How physiotherapy can help:

  • Provide advice on exercise and stretching.
  • Help address muscle strain and imbalance.
  • Apply anti-inflammatory modalities such as ice or ultrasound.
  • Provide advice for your return to running including recommendations about footwear and other supports.
  • Provide advice for home management of the condition, both during the acute phase and to help prevent future injury.


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Incredible Mom Transformation! Leslie V!

Down 45lbs since July!  
"When I joined Endurance on 8th early 2012 I was on an endless mental/emotional treadmill – thinking of where I wanted to be in terms of my health, my weight and my level of fitness.  I was wishing for change but not making real commitment to it; disappointed when I didn’t make any progress even though I didn’t change any of my behaviors!  I did my first FitCamp with Sam Medina and was very sore for an entire week.  But I went back and that was the start of my journey.  

I’m very grateful for Endurance on 8th for the comprehensive training they offer.  It was the combination of workouts, nutrition tips and tools, accountability and check-ins with coaches, and the goal setting that have helped me to reach my goals…over 40lb weight loss since July (and nearly 70lbs down in total since my heaviest after having my son).  Huge praise and thanks to Dr. Kevin Ashby, Dr. Wendy Carvalho Ashby, Lani Pickering, Irfan Jessa and Lara Schamotta for getting me organized and into ship shape! 
This comprehensive program was the key to my success.  For as long as I can remember I always put things off or gave up half way through...this time there was no stopping me.  I committed to myself and my goals and I DID IT!
Watch out world…I’m just getting started now!"

By Leslie Velazquez

Spring Sugar Cleanse!

It’s time to clean house!!  By house I mean your body with a sugar free cleanse.  We will begin on Monday June 1st and go until June 30th!  This cleanse entails taking out all processed sugars in your diet as well as any substitutes.  We are overloaded with processed sugars in our daily lives so this cleanse will give you a way to learn where the dangers are and how to teach your body to deal without its sugar fix.  Processed sugar can be extremely damaging to your health so it’s time to learn how it feels to be clean of it!  This cleanse is about learning where to look for bad sugars in your foods and finding a balance in your body.  You will feel full of natural energy by the end of this! 


The parameters to the cleanse are as follows:

-Like the page Endurance on 8th Health Centre on Facebook and follow us on Instagram under “Endurance8health." 

-Check into Endurance on 8th Health Centre on Facebook here  or comment on our Instagram posts.  Do this daily to keep yourself accountable and get the support of your friends!  To do this go to your status daily and simply write which day you are on and tag "@Endurance on 8th Heath Centre".  It pops up if you’ve liked the page already.

-Absolutely no processed sugars (look for added sugars on all your foods and only have ones that have zero added). 

- Only natural sugars are allowed.  Fruit and natural sugars are allowed and encouraged.  They will help you with any cravings.  Fructose is the one you are avoiding but also try to choose low glycemic index foods instead of high glucose contents.  

-No substitute sugars are allowed.  All of these have more chemicals and are technically no better than processed sugar for you.  We will allow Stevia but only if you truly need it.  This is the only substitute sugar that has not been studied yet to prove or disprove any dangers. 

-Look out for added sugar in your dairy and remember anything over 4.7g to 100g of product is added sugar.  Anything under that is naturally occurring sugar and is fine. 

-Make sure to have a preparation day before you go cold turkey!  This means that you slowly decrease your sugar intake leading up to Monday June 1st so the withdrawal symptoms don’t hit so hard that you have a relapse or binge. 

-This is NOT a weight-loss challenge.  If you are someone who checks your weight constantly put that scale away!  You may weigh yourself the day before June 1st and not until after June 30th.  Focusing on your weight can be discouraging and this cleanse is all about how great you will feel and the energy it provides! 


Do this for the performance of your healthy body!  


-Written by Lara Schamotta


Golf and Chiropractic Care

Studies show that more than 80 percent of golfers experience back pain or injury at some point while actively playing golf.


In one study of 154 professional golfers, 55% reported a history of low back pain. This pain was of an adequate level to miss at least one tour event, or to play at an unsatisfactory level. Dr. Tom La Fountain is a chiropractor who travels with the PGA tour and regularly provides chiropractic to the pros. Dr. La Fountain reports that up to 85 percent of the injuries on the PGA Tour and Senior Tour relate to the spine, and about 70 to 75 percent of those golfers receive regular chiropractic care. Golfers such as Tiger Woods, Mike Weir, Vijay Singh, and David Duvall have trusted chiropractic for years to help keep them at the top of their game.

“Being a Chiropractic patient has really helped me immensely…lifting weights and seeing a Chiropractor on a regular basis has made me a better golfer. I’ve been going to Chiropractors for as long as I can remember. It’s as important to my training as practicing my swing.”
Tiger Woods

It’s no wonder golfers suffer a lot of back pain. Picture the contortions a golfer’s spine goes through during each and every shot. First, the spine is twisted really far in one direction for the backswing; then, after hesitating for a second, the golfer’s back must suddenly change direction, forcefully twist and bend through the downswing, swinging a driver or three iron at speeds of up to 100 mph, absorb the impact of the golf club hitting an inanimate object, and then continue twisting for the follow-through. This maneuver is then repeated about 70 times (or 180, as the case may be) per game. Once the golfer finally makes his or her way to the green, the golfer is then bent over lining up and standing awkwardly over the ball while trying to sink a putt.

Studies have shown that the chiropractic adjustment can improve the range of motion of spinal joints. No big surprise here. Further, the adjustment can also help to correct improper muscle firing patterns established from previous injuries. What this means to the avid golfer is likely more accuracy, increased muscle efficiency, greater power, and ultimately better performance with less chance of injury. According to Tiger, “Golfers who consistently get it up and down around the green have two things in common: great technique and good posture.” (Golf Digest, February 2001)

Such movement would be hard on even the fittest athlete. That problem is compounded when you consider most golfers are strictly weekend players, mixing this intense activity with long periods of idleness that leave their muscles weak, tight and prone to injury. (This can occur even if the golfer is active in other sports, as the demands on muscles often differ for different activities.) Then, each time the weekend golfer returns to the links and forces these weak or tight muscles into action, it can put excessive stress on the spine and spinal joints resulting in poor spinal joint mechanics. This can decrease power, as well as speed, hand-eye coordination and consistency.

The golf swing isn’t the only aspect of playing the sport that causes golf back pain. There is a lot of walking in golf, even if you take a cart. You have to walk up hills, down hills, and all over the uneven surfaces of the average course. In addition at other times you have to swing and torque your body while positioning yourself on unstable surfaces like hills, tree roots, or sand. Perhaps the worst part of golf for your back though is the simple act of standing. There is a lot of standing around in golf, and just like in everyday life when someone stands they usually shift weight to one side of their body. This tends to tighten muscles on one side while relaxing muscles on the other side.

When a player experiences back pain during a round of golf, their scores suffer and their enjoyment is taken away from the game. There is a higher rate of injury amongst those players with poor flexibility, trunk control, postural control, and improper muscle firing patterns. In addition, back, neck, shoulder and elbow pain will sabotage any golf swing and ruin the golf experience. It shouldn’t be that way and it doesn’t have to. Regular chiropractic treatment can help alleviate golf back pain and injuries and get your game to where it is supposed to be.

Chiropractors can also make nutritional and exercise recommendations such as a specifically designed program of trunk strengthening that emphasizes balance and coordination to help golfers prevent back problems and maintain good spinal health. There are healthy ways to reduce inflammation, so that golfers can avoid over-the-counter painkillers such as ASA or nonsteroidal anti-inflammatory drugs (NSAIDs), which can be harsh on the stomach and can even cause gastrointestinal ulceration. Instead, some foods and natural supplements can provide anti-inflammatory action, while improving overall health. A good example of such a nutritional product is “Natures Relief” manufactured by Adeeva and it is available at the clinic. Ask Kari for more details.

Rehabilitation exercises promote speedier recovery and warm-up exercises can be beneficial before each game. Certain exercises will also help golfers strengthen abdominal muscles to reduce strain on the back muscles. The pros on the PGA Tour know what it takes to play great golf. They also know that being in top physical form reduces injuries and improves performance, which translates into more earnings. The January 2001 issue of Golf Magazine ran an article called Survival of the Fittest in which they contend that physical fitness has become a top priority for many PGA Tour pros. “The PGA Tour has become a sweat shop: Golfers who aren’t physically fit probably can forget about frequent trips to the winner’s circle. Fitness is not only fashionable, it’s an important piece of the professional golf puzzle.”  More detail about what you can do will be found in Part 2 – next week’s article.

Regular chiropractic care is not just for golfers but for all of us for the treatment AND prevention of injuries. If you value your leisure time activities, consider scheduling a check up appointment to see if chiropractic care can be of benefit to you!

By Dr. Gordon Gertz


Top 5 Physiotherapy Myths


By Jean-Michel Cormier


FALSE- I get a good chuckle when a patient tells me “I believe in physiotherapy” like they were telling me that they believe in the tooth fairy. What they probably mean is that they believe in the abilities of the previous therapists they’ve consulted and had positive experiences.

There are several thousands of scientific papers supporting the use of physiotherapy. In fact, several Universities now offer doctoral programs in physical therapy entirely dedicated to providing evidence on the use of current practices and assuring the continued development of the profession.


FALSE- In no context should you ever feel this way when consulting a physiotherapist. Unfortunately, despite our professional associations’ efforts to assure quality with national board exams, variability in quality levels between therapists is still a reality. These individuals give a bad reputation to our profession and should be ashamed. You should have AT LEAST 15 minutes of one on one time with your therapist where that time should be productive, focused on education, management strategies, likely some hands on treatment and you should by no means feel that you’re wasting your time. Respect yourself, there are tons of good and caring therapists out there, don’t support the bad ones.


FALSE- Physiotherapists treat a wide range of injuries going from acute to chronic. Obviously, the interaction with your therapist should vary depending on your current needs. With chronic injuries sometimes comes baggage where poor postural habits, muscle imbalances and/or beliefs related to your problem may require more attention. If the case, your therapist should help you understand the source of your problem and a thorough conversation should be had regarding all aspects of your rehabilitation (what to do, what to avoid, how to do it, etc.).

Not all injuries will heal the same and some may take longer than others. Some may even require surgery or additional medical intervention. Your therapist should closely and regularly monitor your progress taking responsibility in directing you towards the best and most efficient intervention available for your specific needs.


FALSE- I believe this one comes from the general public being misinformed about the wide range of healthcare practitioners out there (physiotherapists, osteopaths, chiropractors, massage therapists, etc.). As a general tendency, I see people relate chiropractors and osteopaths to “bone” or “spinal” problems, massage therapists to “muscle” problems and physiotherapists to the rest!

Not only are physiotherapists specialized in diagnosing and treating all musculoskeletal pathologies in any area of the body, some also follow advanced courses in vestibular rehabilitation, mental imagery for chronic pain, pelvic floor rehab for urinary incontinence, etc.

A good therapist will have no issues referring you to another professional may your problem be beyond his/her expertise and/or require further medical attention.


FALSE- One of the main factor that distinguishes physiotherapists from other healthcare practitioners, with respect to others, is their extensive training in exercise prescription. Physiotherapists firmly believe in acting as a coach and assisting you in attaining an independent position in managing your symptoms.

Your therapist should also encourage a healthy lifestyle. Excessive body weight, poor nutrition habits, a sedentary lifestyle, unhealthy habits such as smoking and excessive alcohol consumption are all things that can significantly hinder your body’s ability to heal. Make yourself a HUGE favor by adopting a healthy lifestyle in the New Year and see your chronic pain become history!

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