The most common injury of the lower leg in runners is medial tibial stress syndrome (Shin soreness or commonly called shin splints) and stress fractures followed closely by variety of other soft tissue strains including  achilles tendinopathy ,plantar fasciitis and calf strains.

There are many reasons for these developing, the two most obvious are overloading (whether it's an increase in training or different training surfaces) and developing biomechanical issues. It's never that easy to find out exactly the cause of all injuries but there's usually something which will be picked up in the subjective history when you see a medical professional.

Foot mechanics are highly complex but generally the research suggests that people who excessively supinate are prone to lateral knee injury (ITB friction syndrome) and hip injury and also can be prone to stress fractures as there is a higher impact force with this type of foot. However the body is great at compensating so when these systems fail, you then you may get symptoms. So don't despair if you have this type of foot!

 With excessive pronation it's a different picture.  The main injuries are likely to be anterior knee pain and the dreaded medial tibial stress syndrome, Achilles problems and other soft tissue injuries.

There is a clear biomechanical relationship within the kinetic chain of the lower limb between the pelvic control and increased force transmission in the leg. Pronatory forces increase within the foot when there is especially poor lateral pelvic control which in turn allows a longer foot contact time .This causes an increase in the internal rotation of the stance leg and hence greater foot pronation. How your body controls this can determine if you are susceptible to an injury.

However prevention is not as simple as doing 'glute exercises'as the pelvis is influenced by more than one muscle in a multitude of planes. Plus if there is a soft tissue or joint restriction lower down in the chain, these will have to be addressed as well.

Running is a dynamic activity so I am always bemused at athletes doing static exercises only. The research does suggest that there is little carry over into the upright activity. All is not lost though as sometimes if the runner can't 'connect' with that muscle then you may be asked to go away and find it!!!! By doing a series of activities prescribed by your practitioner aiming to 'waking it up' and also giving it a little conditioning, in order later to actively engage it within the  necessary motor pathway.

 Foot pain is complex and everyone is an individual so what works for one may not for another, so a good evaluation is mandatory and hence should take time.

 My clients are always surprised when I ask to see their spine and whole leg as I work from above down and evaluate all of the factors relevant. It may be a simple soft tissue presentation due to a traumatic incident but funnily enough those aren't very common in my practice!

 So the message is if you are getting the same repetitive niggle after a certain loading go and get it checked out as you can often prevent it from restricting your running. Athletes being who they are think 'ah! I'll run it off'. When it persists

' LISTEN' to your body, its trying to warn you, if you don't then you have to take the consequences which can be quite costly.

Next Time

1. Plantar fasciitis
2. Motor control programming.