Nothing can destroy your motivation to exercise as much as an injury.

This column addresses six common injuries associated with running and walking, as well as prevention and treatment strategies.

Achilles tendinitis is a swelling of muscle and tendons leading from the heel to the calf muscle. In severe cases, the tendon can rupture, requiring corrective surgery. Prevention includes proper stretching, such as the calf stretch, and warming up before intense exercise. Using heel pads and limiting uphill training may also help.

Shin splints. Although the precise mechanism for shin splints is still debated, it is widely believed that most cases are due to a muscle imbalance between the anterior and posterior muscle groups of the lower leg. Prevent shin splints by tapping each foot prior to exercise (for the front of the leg) and doing the calf stretch (for the back of the leg).

Stress fractures are small hairline cracks in the bone, most often in the tibia (the largest of the lower leg bones). The most common cause is poor foot support and shoes with inadequate shock absorption. Prevention may include a professional consultation for selecting the correct shoe, taping the lower leg or running on a softer surface. Changing the direction of your walking or running course may also help.

Runner’s or walker’s knee is due to an overriding of the kneecap on the ball of the thigh bone (femur). This injury is most often caused by improper footwear with poor arch supports or insufficient shock absorption. This injury can also be caused by inadequate stretching, running on hard or irregular surfaces and muscle imbalances in the legs. Prevention includes wearing shoes offering better shock absorption, running on softer surfaces and changing directions on occasion.

Ligament sprains are caused by excessive rotation possibly due to an unbalanced foot strike associated with running on uneven or slippery surfaces. Affected joints are usually the ankle and knee. Ligaments (connective tissue that connect bone to bone) can be pulled away from the bone or even torn completely. Depending on the degree of tear, treatment can include cutting back on distance or doing another activity such as swimming until the ligament is healed.

Corns, calluses and blisters are caused by friction, most often due to wearing shoes that don’t fit properly. Prevention includes being properly fitted for appropriate shoes, breaking in new shoes slowly and wearing the right socks for the shoes and the activity. For a person with diabetes, any of these problems requires a consultation with a healthcare provider. Avoid any over-thecounter remedies unless you are specifically advised to use them by your podiatrist or physician.

The ‘RICE’ approach to healing after a workout:

• Rest
• Ice
• Compression
• Elevation of the injured area

Q: What is the cause of “side stitches” when running?

A: Although this is still debated, most researchers say the stitch develops from stretching the ligaments associated with the internal organs, especially the liver, which is caused by the jarring of running. Usually when you stop running and put pressure on the area, the pain goes away.

Q: What are some indications of overtraining?

A: Overtraining can be recognized by many symptoms, such as leg and muscle soreness that lasts longer than usual; an unusually apathetic attitude toward your workouts; and decreased resistance, resulting in headaches, colds and poor coordination and performance. Treatment includes recognizing the symptoms and decreasing training levels for a time. It’s important to schedule rest days following particularly hard workouts. You should feel refreshed following exercise, not miserable.