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The Informed Parent

Running Injuries: What Parents Need To Know

by Lori A. Livingston, M.D., F.A.A.P.
Published on Nov. 18, 2013

No doubt your pediatrician has recommended your child should eat a nutritious diet and participate in physical activity every day for at least 30 to 60 minutes. Whether they are involved in organized sports, physical education at school or just playing at the park, running is likely a large part of your child’s exercise.

So what do you do when all that healthy running causes an injury? Here is some insight into the most common running injuries in kids, and what you can do as a parent to prevent and treat them.

1. Muscle Strain

  • As children grow, bones lengthen before muscle, tendons, and ligaments. This causes decreased flexibility and more potential for injuries.
  • Hamstring (back of the thigh) and quadriceps (front of the thigh) strains are the most common in runners.
  • Complete rest from activity is required to allow healing. Icing the injury should be started right away and continued for 2-3 days, then heat therapy to help restore full range of motion of the muscle.
  • Recovery time ranges from 2 weeks for a minor strain up to 3 months if the muscle completely tears.
  • Return to running should begin slowly and should be pain free.

2.  Apophysitis

  • Muscle tendons attach to bone at an apophysis. This growing part of the bone is weaker during growth spurts in children and can easily become inflamed and injured, which is called apophysitis.
  • This happens most commonly on the patella (called Sinding Larsen Johanssen syndrome), the tibial tubercle below the knee (called Osgood-Schlatter disease), or the heel of the foot (called Sever’s disease).
  • Treatment is rest from activity, ice, stretching and strengthening.
  • A patellar strap or gel heel insert for the shoe can also be helpful.
  • More sudden or severe pain at an apophysis may be due to a fracture of the bone, which is more serious. Your doctor can determine this with an x-ray.

3.  Patellar Femoral Pain Syndrome

  • This is a common cause of achy pain around the patella and front of the knee in runners. Pain may be worse with sitting or climbing stairs.
  • Treatment includes rest, ice, ibuprofen, orthotic support for flat feet, and knee bracing or taping.
  • Quadriceps strengthening is the best treatment as well as prevention for this syndrome.

4.  Iliotibial Band Syndrome

  • This band of strong tissue found along the outer thigh can cause pain from the knee up to the hip due to excessive friction on the bone with running.
  • Rest, stretching, strengthening gluteal muscles, physical therapy, and ibuprofen are all potential treatments.

5.  Shin Splints

  • Also called medial tibial stress syndrome, this is inflammation of the tibia (the lower leg bone) usually due to running on inclines, hard surfaces, or long miles. Flat feet and old running shoes also put children at risk.
  • Treatment, as usual, is rest from activity until pain free, ice and stretching. Also massage, taping the shin and arch supports can be very helpful.
  • This injury can progress to a stress fracture. So be sure to see your doctor if pain is worsening. 

6.  Stress Fractures

  • This overuse injury can occur in the tibia, the bones of the foot, the heel, and less commonly the hip or pelvis.
  • Worsening pain with activity is a sign of possible stress fracture, and hopping on the affected leg may reproduce the pain.
  • X-ray or MRI are needed to find a stress fracture.
  • Rest, bracing, casting or even surgery may be needed to treat this injury.

7.  Ankle Sprains

  • Ankle injuries occur most often when running on uneven surfaces, or when there is a history of ankle sprain. Typically, inversion of the foot occurs, leading to over-stretching the ankle ligaments, swelling, bruising and pain.
  • X-rays may be needed to look for a fracture.
  • Treatment, as before, is best remembered as RICE: Rest, Ice (4 times per day for 20 minutes each time), Compression (bracing), Elevation.

8.  Prevention

Prevention of injuries is much easier than treatment. No child wants to miss an important game or playing with friends because of an injury! So what can a parent do?

  • Encourage consistent stretching before and after running as well as strengthening/conditioning.
  • Assure proper nutrition and frequent hydration with water.
  • Go to to develop your well-rounded diet for the family.
  • Calcium, specifically 1200 mg/day, and iron are essential for bone health.
  • Watch for signs of an eating disorder. Runners and girls, even at a young age, are at increased risk for disordered eating and distorted body image.
  • Loss of menstruation in a female is a risk factor for bone injury with even mild activity.

Running is excellent exercise for all ages! Despite its small risks for injury, running is an activity ANYONE can participate in. Running does not require special skills. It builds self-esteem and helps children and teens develop a positive body image. Running programs for kids across the country foster teamwork and confidence which are needed for our children’s success in the future. Have fun running!

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