The nature and response to therapy of 196 consecutive injuries seen at a runners' clinic.

We studied a series of 196 running injuries to determine the nature of the common injuries, the type of runners with the different injuries, specific factors causing the most common injuries, and the response of these injuries to correction of the biomechanical abnormalities believed to cause them. The four commonest injuries were 'runner's knee' (peripatellar pain syndrome) (22%), 'shin splints' (posterior tibial stress syndrome) (18%), the iliotibial band friction syndrome (12%), and chronic muscle injuries (11%). Within 8 weeks of following the biomechanically based treatment regimen, between 62% and 77% of the runners with the commonest injuries were completely pain-free and running almost the same training distance as before injury. Only 13% of runners were not helped at all, but most of these had not adhered to the prescribed treatment. The response of the iliotibial band syndrome to treatment was less predictable, however, and some runners who followed the advice faithfully were not helped. These data therefore confirm the importance of biomechanical factors in running injuries and indicate that practitioners involved in the care of injured runners need to know not only how to diagnose the conditions accurately but also which running shoes are appropriate for the different running injuries, how to detect subtle lower limb structural abnormalities, in particular foot abnormalities and leg-length inequalities, and when to prescribe in-shoe orthoses.