THE CONFUSING WORLD OF RUNNING INJURY TERMINOLOGY

Running injuries are very common but rarely serious. Some of the terminology used can be confusing and contradictory. It’s important to be assessed by a physiotherapist for a correct diagnosis and management. Let’s look at some common terms.

Shin splints

Simply put, this is pain down the legs which seems to be linked to running. This is an umbrella term and does not tell us very much (and I am not sure where the splints part comes from!).

So, it’s not a diagnosis and can mean at least four different things. Let a physio make the diagnosis!

The common version is diffuse pain on the inner tibia (shin bone) and in medical parlance is known as Medial Tibial Stress Syndrome (MTSS) and is very common in those new to running.

Those with more lateral pain may have a strain on the outer muscle (tibialis anterior).

Of more concern would be signs of a stress fracture of the tibia or fibula – sharp and specific pain, possibly also with night pain and bruising/swelling and linked to sudden increase in running, insufficient diet and menopause.

Lastly, there could be compartment syndrome for those runners who do very high mileage resulting in blood flow being occluded to muscles in the leg.

Or it can even be referred from the spine!

Achilles Tendinopathy

I still often see this referred to as “tendinitis”. But “itis” means inflammation and we now know that tendons do not react in an inflammatory way (unlike ligaments).

Tendinopathy means damage to the tendon (in running this usually through overuse and through degeneration as we age). The tendon can appear thickened and have nodules and may appear puffy (from being hydrophilic). See also below.

Plantar Fasciitis

Again, this term means inflammation of the plantar fascia, but we now know this is also not inflammatory. The newer, more correct term is plantar fasciopathy as it’s thought micro tears from overuse/degeneration are causing the pain. Another term has also emerged, plantar heel pain, as other structures around the heel other than plantar fascia can cause pain so a correct diagnosis is essential.