Rehab

Lower limb overuse injuries in runners

The injuries that accumulate rather than happen. Runner's knee, ITB syndrome, Achilles and gluteal tendinopathy, plantar fasciitis — the ones you can usually train through for a while, which is exactly why they get entrenched.

Close-up of an ankle and foot assessment at Five Dock

The overuse spectrum

These conditions sit on a continuum. Early on the tissue is irritated and settles quickly with a change of load. Left long enough it becomes less reactive and slower to change, and the rehab gets longer. Which end you are at matters more to your timeframe than which name the injury has.

The load management framework

Find the load the tissue currently tolerates, work just under it, and build from there. That usually means changing volume, surface, hills or pace rather than stopping, and it means adding strength work that gives the tissue somewhere to grow into. Complete rest settles symptoms and rebuilds no capacity, which is why so many of these recur on the return.

When loading is not enough

Some tendinopathies stall despite good loading. Shockwave therapy is worth considering at that point, as an addition to the loading programme rather than a replacement for it.

Common questions

Should I rest completely?

Rarely. Complete rest settles the pain and takes capacity with it, so the same load that caused the problem is waiting when you come back. Reducing and modifying load while building strength gets people back faster and keeps them there.

How long does tendinopathy take?

Longer than most people expect and it depends heavily on how long it has been there. A reactive tendon caught early can settle in weeks. One that has been grumbling for a year is a matter of months. Both respond to loading; the second needs more patience.

Something nagging that will not settle?

The earlier an overuse injury is addressed, the shorter the rehab.

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