Overuse injuries in runners

The majority of the exercising population have turned to jogging as their answer to a regular exercise programme. In addition, competitive runners are training harder than ever before, stressing their bodies beyond the normal limits of endurance. It is not surprising then, that overuse injury of the legs is becoming more commonly seen by general practitioner and specialist alike. In an effort to understand, diagnose accurately and treat appropriately the many syndromes associated with overuse, the subspecialty of sports medicine was born. The medical literature is replete with descriptions of athletic ailments along with suggestions for their diagnosis and management. It is the purpose of this paper to present some of the more common overuse injuries of the lower extremity in the jogger and distance runner. Etiology, pathogenesis, differential diagnosis and management are discussed. Overuse injuries are best treated by prevention. The vast majority of injuries among runners result from improper training technique. Anatomical factors may be involved and should always be considered during evaluation. The term 'shinsplints' represents a variety of clinical entities and a specific diagnosis should be established in order to appropriately manage the patient with leg pain. Many treatment regimens have been suggested but rest is still the most effective therapy for most overuse syndromes, except where surgical repair is necessary. Achilles tendonitis represents one of the most difficult overuse injuries to treat. Much work still needs to be done in this area before the etiology pathogenesis and appropriate management of runners' ailments are fully understood. Although many of these syndromes are present in both adults and children, the anatomical expression of overuse may be different in children because of the differences in the growing skeleton.