Ask a Vail Sports Doc column: Don’t be plagued by trail-running injuries |

Ask a Vail Sports Doc column: Don’t be plagued by trail-running injuries

Trail running can lead to several common issues. Pay attention to your body, use the proper footwear, and watch where you’re running, and you shouldn’t have issues.
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There are several common injuries we see in the office that can occur after a long summer of trail running:

Illiotibial band syndrome — The illiotibial band is a long band of fascia that runs from the outer hip down the outside of the thigh to the outside of the knee on the tibia. Runners tend to have lateral leg pain that normally starts at the knee and moves its way up. The reasons for developing illiotibial band syndrome are numerous, and it’s tough to identify the exact biomechanical cause. Tightness of the illiotibial band, weakness in the hips, overuse, poor running form and, of course, improper footwear can all lead to a raging case of illiotibial band syndrome.

Prevent and alleviate: Foam roll your outer thigh, stretch and gradually increase your running distance.

• Ankle sprains — These are common due to uneven ground of the trail.

Prevent: Do strengthening ankle and balancing exercises, such as one-leg stands on a bosu ball.

Alleviate: RICE: Rest for a week or two, ice, elevation and compression.

• Achilles tendonitis — This often happens due to extensive uphill climbing while trail running. The Achilles tendon is the thick tendon connecting your calf muscles to the heel bone allowing you to walk, run and jump. Achilles tendonitis can present in two ways, insertional versus non-insertional.

Insertional Achilles tendonitis initially presents as pain at the heel where the Achilles tendon connects. As the condition becomes chronic, the tendon can thicken and a bone spur can develop. Non-insertional Achilles tendonitis is when there is micro tearing of the tendon fibers in the middle of the tendon. This can result in thickening and weakening of the tendon. If ignored, Achilles tendonitis can result in a traumatic rupture of the tendon requiring a surgical repair.

Prevent and alleviate: Foam roll the Achilles tendon, calf stretching and ankle band exercises.

• Plantar fasciitis — Heel pain and painful initial first steps in the morning are the first signs of plantar fasciitis. It’s an inflammatory process of the thick, fibrous band of tissue that runs from your heel to your toes. Most common in people with high arches or flat feet, plantar fasciitis can start as a mildly uncomfortable condition and become debilitating painful.

Prevent and alleviate: Wear properly supportive running shoes and stretch your calf and plantar fascia before and after running.

• Medial tibial stress syndrome — Medial tibial stress syndrome — the dreaded shin splints — is an inflammation of the tendons, muscles and attachment sites along the inner side of the shinbone. The pain is sharp or sometimes dull and aching and can be present during running, after running or both. Identifying a reason is tough, but causes of onset may include quickly increasing your running distance and intensity, improper footwear, lower leg muscle weakness and abnormal foot shape. Medial tibial stress syndrome can be hard to treat and can lead to more serious issues.

Prevent and alleviate: Build gradually. Avoid running too much too soon, and be sure to increase both your speed and distance gradually.

• Stress reaction/fracture — The cumulative pounding on the bones of the lower legs of runners can take its toll. Too much force too fast can cause bone to have a “stress reaction.” As this process gets worse, the bone becomes weaker and more fragile. It’s not only painful, but this condition can predispose you to stress fractures.

Prevent and alleviate: Cross-train, avoid too much too fast and wear the right shoes.

Trail running is fun, healthy and never boring. Pay attention to your body, use the proper footwear, and watch where you’re running, and you shouldn’t have issues.

Dr. Rick Cunningham is a knee and shoulder sports medicine specialist with Vail-Summit Orthopaedics. He is a physician for the U.S. Ski Team and president of Vail-Summit Orthopaedics. Do you have a sports medicine question you’d like him to answer in this column? Visit his website at to submit your topic idea. For more information about Vail-Summit Orthopaedics, visit

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