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Calcaneal Apophysitis


That painful growth injury that makes your child limp on and off the field.

with Doug James – intraining Running Injury Clinic Physiotherapist & Podiatrist

READ Doug’s article below to give you and your child a quick guide to help you tackle Heel Pain in kids.

Calcaneal Apophysitis  (formerly known as “Sever’s Disease”)

Calcaneal Apophysitis is one of the most common injuries in early adolescents, though its name is probably unfamiliar to most who would refer to it as “Sever’s Disease”, or more simply “Sever’s”. It is pain felt on the back of the heel bone (calcaneus) around the base of the Achilles tendon in some young people sometime between the age of 7-15 years old [1-5] (the age ranges vary by source but usually falls within 1-2 years of the upper and lower limits). This injury was first identified in 1912 by Dr James Sever, after whom the injury was named[2].

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What’s in a name?

While the term “Sever’s Disease” is commonly used today, it is falling out of favour with the medical world. In the past, a medical condition or disease would often be named after the person that studied and identified it. Injury names become increasingly difficult to pronounce when a team of people lay claim to the identification of a condition such as the wordy “Sinding-Larsen-Johansson Syndrome” (a knee pain condition in teenagers), or Klippel–Trénaunay–Weber Syndrome (a blood vessel disorder).

The favoured and current approach is to refer to these “diseases” with a more accurate pathophysiology (problematic process) title so as to better describe the “where and what” of the condition. This move also aims to replace using inaccurate and vague terms such as “syndrome” and “disease” as these names can carry a certain stigma.

So, what is a Calcaneal Apophysitis?

The individual components within the name “Calcaneal Apophysitis” gives a clue as to its nature and location. The Calcaneus is the heel bone. An Apophysis is a bone protuberance or small lump formed on the bone where tendons or ligaments attach, in this case, it is on the back part of the bone where the Achilles tendon attaches. Lastly, the term “-itis” refers to an irritation or inflammation of an attachment site on the heel bone. Put together, these terms describe irritation of the back of the heel bone.  

How does it develop?

There are a few theories about the factors that lead to how and why Calcaneal Apophysitis develops and what the actual source of pain is. One theory is that the Apophysis becomes painful from the Achilles tendon applying repeated or continuous tension to it [5].

Another thought is that the underlying Calcaneus bone (not simply the apophysis) that may be the source of pain. The human skeleton grows primarily from ossification centres. These are the foundations from which bones lengthen and expand making us taller (and wider). The calcaneus has two ossification centres that are located in the middle and rear of the bone, which eventually disappears once the bone has finished growing – usually in the early teenage years.  The rear ossification centre is thought to become painful as it undergoes stress from tension. Clinically, it’s not uncommon to observe tenderness in the lower part of the Achilles tendon as a standalone presentation, or along with the bony heel pain, again possibly due to tension, or possibly trauma. In more severe cases the growth plate can become fragmented (see image 1).

What is the source of the tension?

Calcaneal Apophysitis is often observed in young people that have had a recent growth spurt (but not always). When the shin bones grow (resulting in increased overall height), the muscles and tendons need time to elongate to the optimum length for the newly lengthened legs. In the weeks (and sometimes months) following a growth spurt, adolescents may complain of calf muscle tightness due to the relative shortness of their calf muscles. This muscle tightness can exert a constant strain on the Achilles tendon and the Calcaneal Apophysis which serves as its anchor point and may irritate the Calcaneal Ossification Centre [5].

The Achilles tendon is also subjected to increased tension in flat-soled, and low heel drop shoes. Adolescents with heel pain should be encouraged to avoid walking around in flat shoes, thongs, or bare feet. Calcaneal Apophysitis is fairly common in active young people [1-5]– notably those playing one of the football codes. Many football boots have a low heel drop (minimal height difference between heel and forefoot) which increases pressure on the calf muscle, Achilles tendon and heel. Playing football involves bursts of sprinting which is another activity known to irritate the injury.

Management of the injury

Just as there is little consensus as to the exact nature of the injury, there is no agreement on a universal fix. This may be due to the fact that there are a number of different contributing factors in each individual presentation. As such, each case needs to be assessed and managed uniquely. The most common theme in management strategies is finding a balance of rest and sport/running within an acceptable level of discomfort, as rest alone doesn’t lead to faster improvement [5]. In cases where pain levels are severe, abstaining from any pain provoking activity becomes necessary, though this is thankfully usually rare.

Footwear factors can play a major role in the successful management of the injury, and being able to modify aspects such a heel drop by using firm heel lifts, or cushioned heel cups can be beneficial. Research has also examined whether orthotics play a role in managing Calcaneal Apophysitis though the results are inconclusive [2] (possibly due to the limitations of research that requires a standardised orthotic be used in all patients). Addressing muscle tightness issues when present is also important for managing pain levels, and expediting recovery time. This can take the form of calf muscle massage, ankle mobilisation, and where appropriate – a targeted stretching program.

How long does the injury last?

It can be difficult to predict how long Calcaneal Apophysitis will last. In a majority of cases, there is a resolution of symptoms soon after the sporting season finishes. In a smaller number of cases, the pain can persist for up to a year, or longer in an unlucky few.

Imaging such as X-rays are not always necessary, but in more severe cases can be helpful to assess any derangement of the Calcaneal growth plate which is often associated with greater pain and longer recovery times.

When to seek treatment?

It is useful to have an assessment when heel pain symptoms first present (which is often in the first few weeks of a new sports season or following a significant growth spurt). Learning ways to manage the pain is crucial to helping settle the symptoms and improve quality of life, while hopefully allowing a continuation of physical activity. An assessment of the patient’s footwear, walking and running biomechanics, and muscle testing can help to develop a personalised treatment and successful treatment approach.

For a thorough assessment of adolescent heel pain, contact the intraining running injury clinic for an appointment to see a Podiatrist or Physiotherapist who can assess the injury and design a custom management plan.

Doug James – intraining Running Injury Clinic Physiotherapist & Podiatrist


  1. Uvelli, K. O., Neher, J. O., & Safranek, S. (2017). Treatment for Calcaneal Apophysitis. American Family Physician, 96(2), 126–127.
  2. James, A. M. M., Williams, C. M. P., & Haines, T. P. (2013). “Effectiveness of interventions in reducing pain and maintaining physical activity in children and adolescents with calcaneal apophysitis (sever’s disease): A systematic review” Journal of Foot and Ankle Research, 6(1), 16.
  3. James, A., Williams, C., & Haines, T. (2013). Contributing factors in children who present with calcaneal apophysitis. Journal of Science and Medicine in Sport, 16, e26–e26. 
  4. James, A. M., Williams, C. M., Luscombe, M., Hunter, R., & Haines, T. P. (2015). Factors Associated with Pain Severity in Children with Calcaneal Apophysitis (Sever Disease). The Journal of Pediatrics, 167(2), 455–459.
  5. Williams, C. (2016). Wait and see, heel raise and eccentric exercise may be equally effective treatments for children with calcaneal apophysitis [commentary]. Journal of Physiotherapy, 62(2), 112–112.

Image 1: Sourced on 07.10.20 from

intraining Running Injury Clinic

Your  Running Injury Helpline


(07) 3367 3088| [email protected] | Book an appointment



How do you know if it’s the shoes, your training, or…   ‘gulp’…   your age. 

With Margot Manning, podiatrist, coach and runner

We all have those runs you slog it out and your body just does not seem to recover.  

While there are many possible reasons for this there are two biggies that you need to check first, and I’m not going to let you use ‘age’ as the excuse!!

Firstly, no one needs to admit that age is the reason for feeling flat and worn out.  We all know how to modify our training to suit the next decade of life.  This means that it’s either training, our shoes, or a combination of both that could be contributing to feeling worn out.  

The important message for you is to recognise when you are not feeling great and take the steps to regain your bounce and keep loving your running.  

Here are 3 signs you need to recognise and act on.  

1.Throbbing feet

Throbbing feet = old shoes…   (usually!!)

That is the most common reason for knowing your shoes are dead.  This usually happens after your long runs or towards the end of them.  You may even have felt a bit flat in your run.   Your feet and legs will have a tender or dull achy sensation.  

Don’t hesitate on this one. Race into you our running shop and get yourself a new pair.   It only leads to more trouble if you don’t change your shoes soon!!  

2. Old injuries resurface or a new niggle starts

Niggles can be signs of fatigue after an increased training load or old shoes that cause pain.   Before you let this one turn into a full-blown injury, check your SHOES and your TRAINING.

Shoes wear out and it’s surprising how fast the months went by since you purchased your last pair.  Combine this with an increase in your training and little niggles just keep popping up.  

Training can have a huge impact on your body, particularly if you have increased the load, or moved into new programs and over different surfaces.  

3. You’re not sleeping or feeling extra tired at work

Failure to launch is a true phenomenon for a runner.  This happens when your body is not recovering as fast from your training as you would like and you struggle to get out of bed.  You will fatigue faster and be less productive during the day.  

If you don’t have a recovery day soon you can even lose your appetite.   Take a day or two off from running if this is you.  You’re worn out body will feel so much better, less cranky and be excited about your next run.  

HERE is an easy check for your running shoes. 

If you answer YES to more than three of these then you need to check your shoes.

My running shoe checklist...


If you are still not sure why you are feeling worn out, an easy test is to come into our intraining store and have a run in a new pair of shoes.  Your tired and worn out body will immediately feel that freshness and bounce missing from your runs.   

At intraining we look after your feet, we write programs, and we manage injuries.  Running shoes are our specialty.  You’ll really love our running track because you can feel the difference between new and old shoes when you try them out.  



Come and see us at intraining for all your running needs or 

CALL us on 07 33673088 for Shoes, Podiatry, Physiotherapy, and Training Programs. 


Looking for some help with your running shoes?

Here are 3 ways you can use our services at intraining Running Centre when you need some help with your running shoes:

#1  Come into the store and see our Running Team.  

They will have you try on and run in a range of shoes until you find the right one.  Plus they LOVE to talk running and hear what you are wanting to do with yours

#2  Book a shoe fitting appointment with Steve, Doug or Margot (Our Podiatry and Physiotherapy team).

We are all runners and have worked with runners for years.  This works really well if you have more difficult feet to fit, or you are just unsure.  

#3  For Injuries… 

You’ll need to book in to see our Running Injury Clinic team.  We can help you treat, manage and get you back to running. 

Your Running Injury Helpline 

(07) 3367 3088 | [email protected] | Book an appointment

How to treat shin pain

How to treat shin pain?

Shin splints are a generic term that many runners use to broadly cover shin pain. Sports medicine practitioners have needed to develop more specific terms to differentiate conditions and treatments required when addressing shin pain.

These terms try to reflect the tissues affected and their different causes. Whilst some shin pain may present similarly, it is important to correctly identify the pain and provide appropriate treatment. Below are common shin pain issues we see at intraining Running Injury Clinic.

  • Medial tibial stress syndrome
  • Stress fracture
  • Compartment syndrome
  • Nerve entrapment
  • Muscle and tendon strain

Below we briefly describe; how to diagnose shin pain, common symptoms and how to treat the injury appropriately. If you have shin pain that is holding you back from enjoying your running, click the button below to make an appointment to see one of our podiatry or physiotherapy team.

Make an appointment to see Steve
Steve Manning (podiatrist, coach and runner)




The most common cause of shin pain is medial tibial stress syndrome. This pain hurts along the inside of the shin most commonly in the lower half and isolated to the medial border of the shin bone, the tibia. It is an inflammation of the tibial skin, called the periosteum, where the fascia of the leg attaches. The fascia is the stiff layer of tissue that holds all the muscles in place. Little tears occur along this attachment causing inflammation and pain.



The pain can sometimes hurt after waking or rest but most commonly hurts at the beginning of a run before warming up. When bad it can begin to hurt again at the end of a run and will hurt a lot afterwards.


Treatment involves a direct icing technique for a few days with the addition of a gentle distraction massage after that time. Screening for any underlying biomechanical causes may be necessary if continued running aggravates the injury. Extended rest is not recommended as the scar tissue may become more entrenched and harder to resolve in the long run.


Prognosis is generally quite good with a significant (greater than 50%) reduction of pain within a week and complete resolution within a month.



Medial tibial stress syndrome that goes untreated may lead to more severe injuries to the bone like bone stress or stress fractures. Stress fractures are most commonly found on the inside (medial) border of the tibia but may also occur on the front (anterior) border. It is often overtraining that is the culprit, where it has occurred more than a month prior to injury onset.

MTSS Pain1Symptoms

Pain usually occurs at the start of a run and gets worse without going away. It can ache afterwards and sometimes the pain will wake you at night. Pain is usually localised to a spot on the bone and may hurt on both borders and the shaft. Normal x-rays may pick up a stress fracture after 3-4 weeks but an MRI is the best scan to use.


Unfortunately bone injuries are one of the few injuries that require complete rest from activity. If it is bone stress than after a week there will be significant improvement in point tenderness while a stress fracture will take at least three weeks. With bone stress you can return to running when the pain is gone but stress fractures require 6 to 8 weeks of no running. Once the stress fracture has healed adequately there is less chance of recurrence in the same location.



A compartment syndrome can be defined as the increase in pressure within the limited anatomical space of a fascial compartment which compromises the circulation and function of the tissues within that space. If compartment volume is limited or decreased due to tight or thickened fascia then compartment pressures can increase upon normal muscle swelling during exercise. The anterior compartment muscles are most commonly affected in running.


Generally there is no pain at rest or at the start of a run. Pain comes on at a certain distance of each run and is quickly too severe to continue. The muscle feels tight and may be firm to the touch. Within a few minutes of stopping the pain has gone completely. If the anterior compartment is affected, the foot may ‘slap’ excessively when running. This is because the purpose of the anterior compartment muscles are to control ankle movement as the runner lowers the forefoot to the ground after heel strike.


Non-surgical treatment includes changing biomechanics through form modification, change in footwear or orthotics. Avoiding hills or rough surfaces may help as will a reduction of training below the threshold distance of onset of symptoms. Icing and Myofascial release massage techniques can help to release the adhesions between fascia and muscle that may be causing the compartment syndrome.


While immediate improvement can occur complete resolution can take a very long time. In some cases surgical intervention is the only successful treatment.



There are more rare forms of shin pain may mimic some of the more common injuries as described above. Entrapment of the popliteal artery has the same symptoms as compartment syndromes but the onset seems to be more related to intensity of activity rather than duration. Neural entrapments can feel like stress fractures but have less consistent symptoms.


Arterial entrapment will give a lack of pulses at onset which does not occur with chronic exercise induced compartment syndromes. The symptoms of neural entrapment can be reproduced by palpation or percussion of the affected nerve.


Physiotherapy is the best initial treatment however surgery may be required.



The posterioral tibialis muscle is the most common strain in the shin. This muscle acts to control pronation in a similar way that the anterior compartment muscles control ankle motion. The peroneal muscles on the outside of leg, control supination of the foot (roll out), to prevent ankle inversion sprains. Peroneal muscles may also be strained. Pain is usually related to activity and may last for a long time after a run. Pain may occur during other activities of daily living.


Damage may just be normal delayed onset muscle soreness (DOMS) caused by unaccustomed activity or it may be more severe rupture of muscle or tendon. More commonly there was a traumatic event that occurred to cause the injury.


Treatment requires rest and icing for 72 hours. Massage, stretching or heat during this time will make the injury significantly worse. After the 72 hours then a gradual return to activity with massage, stretching and continued icing should see most strains resolve within a week. If the tendon was damaged, or if it was a chronic strain, then a much longer rehab period will be needed.


From these brief descriptions of some of the more common injuries you can see how important correct diagnosis and treatment can affect the outcome and subsequent return to exercise. Incorrect diagnosis can prolong the healing period and can also lead to further injury and increased delay in return to activity.

Steve Manning is the owner and CEO of the intraining Running Centre and works as a podiatrist at the intraining Running Injury Clinic in Milton.

If you have shin soreness and want to get back out and running as soon as possible, visit the intraining Running Injury Clinic. Our podiatry and physiotherapy are all runners and understand how important it is to correctly diagnose and treat your injury to ensure you can return, pain free, to running as quickly as possible.

For bookings, please call us at the intraining Running Injury Clinic on 3367 3088, or book online.


Is your gait causing shin pain?

Article by Doug James (intraining physiotherapist and podiatrist)
Article by Doug James (intraining physiotherapist and podiatrist)

Gait related shin pain

Running injuries are common. In a given year, runners have a 70-80% likelihood of developing an injury that will prevent them from running pain free for at least a week. While there are many different types of injuries that can occur, some people may be more prone to a particular injury while seemingly resistant to others. There are a lot of different factors that can account for this including age, sex, training history, biomechanics (and more) however of these, running technique is one of the few factors that can be changed.

It needs to be mentioned that no particular running technique can guarantee that you will be injury free. Different, and sometimes worse injuries can develop when people attempt to change their running style. The aim of this article is understand the types of shin injuries that can develop from running, and the factors influencing them.

Shin injuries are commonly lumped under the umbrella term of ‘shin splints’ by some medical professionals. This rather obtuse term neglects the specific location, onset and severity of the injury – all factors required for correct diagnosis and subsequent treatment.

Make appointment

Running can cause injuries to muscle and bone in the shin
Running can cause injuries to muscle and bone in the shin

 Antero-lateral shin pain

Pain on the outside part of the front of your shin is usually related to the Tibialis Anterior muscle. This long muscle is responsible for lifting your foot upwards at the ankle joint. The muscle can become overworked if subjected to more exercise than it is used to and tends to become sore after the run, with pain disappearing a few days later. This injury is frequently seen in those that are new to running, or returning after time off from the sport. People that tend to heel strike (i.e. land heel first) are far more likely to be affected by this injury, and athletes are also more at risk if running in incorrect footwear – particularly if the shoe is too stiff (resulting in foot slapping), or lacks adequate pronation support.

Heel striking occurs when the runner’s heel lands on the ground first – usually in front of their centre of mass – and the further in front, the more of a problem this poses. In this position the Tibialis Anterior muscle is working to have the toes lifted higher than the heel to prevent tripping. The forefoot then rapidly lowers putting further strain on the Tibialis Anterior as it is responsible for the controlled descent of the foot. Once the foot is flat on the ground, the Tibialis Anterior may be subject to further strain if the foot heavily and/or rapidly pronates (rolls inwards).

The Tibialis Anterior can be put under even greater levels of strain when running downhill as this tends to amplify the slapping movement of the heel-to-toe progression.

Key points you should know

  • Your running technique can predict the type of injuries you get
  • “Shin Splints” is a commonly used term but utterly innaccurate
  • A running assessment can help identify faults leading to shin injuries

Postero-medial shin pain

Pain felt on the inside part of the shin along the edge of the tibia (shin bone) is often diagnosed as Medial Tibial Stress Syndrome (MTSS), or more recently known as Medial Tibial Traction Perisostitis (MTTP). Irrespective of the nomenclature, the injury usually begins as a broad area of discomfort along the inside part of the shin. This usually starts as a mild discomfort at the start of the run, but resolves after a few minutes. The pain is usually a response to an increase in loading along the edge of the tibia causing swelling around the periosteum (outer lining of the bone) initially, which can progress to bone damage thereafter. The increased loading is usually from higher running volume or intensity (or both) than is usual. Conjecture exists as to whether damage is due to force generated at foot strike, associated muscle tension from the Posterior Tibialis muscle, or some combination of both.

Training load plays a large role in the development of this injury, however there are certain gait factors that may increase the likelihood of developing it. Over-pronating can play a part in increasing the tension in the Posterior Tibialis muscle, which in turn exerts a traction force on the tibia. Overstriding (landing too far in front of the centre of mass) increases the initial impact forces transferred through the lower limb and shin that can also damage the tibia. Additionally, running in shoes that offer insufficient cushioning (i.e. are worn out, or offer less support than the athlete is accustomed to), and under-pronating can increase shock that also affects the tibia and lower limb.

Worse still…

Overstriding and heel striking are two common factors in shin pain
Overstriding and heel striking are two common factors in shin pain

With both of the injury areas mentioned above, after a sufficient reduction in training (and in some cases complete rest) for a suitable period, the injury will recover and heal. There are two notable exceptions to this however – shin injuries where pain becomes worse with running need to be investigated immediately. Sharp localised pain (on the front or side of the tibia or fibula) can be the sign of a stress fracture and should never be run on as this will steeply increase the injury severity and healing time required. Management usually involves rest (the amount of which can be calculated somewhat more precisely with the aid of an MRI scan), a fracture boot (in some cases), and a considered return to exercise plan.

The other critical shin injury not to miss is compartment syndrome. This is a dangerous injury where pressure builds up in the muscle sheath persisting for hours after exercise and can lead to permanent damage to the muscle and nerves in the leg and foot. This often requires surgery. If you suspect you have a stress fracture or compartment syndrome this should be investigated immediately.

For the injuries mentioned earlier, specific changes in running gait, footwear, and training can help to reduce the severity and reoccurrence of these injuries and possibly lead to better performance as well. If you’ve been dealing with running related shin problems, contact the intraining Running Injury Clinic for an appointment.

600x600-workshops-logoIf you are training more without realising the benefits of increased performance, it may be a simple modification to your running form that will result in the benefits you are looking to achieve. The intraining Running Injury Clinic conduct running form workshops on a regular basis.

If you are interested in improving your running form or reducing your risk of injury, sign up for the Running Form Workshop on 8 October or 3 December 2017.

For more From the Sole injury articles click here.

Lateral knee pain

Lateral Knee Pain

Lateral knee pain on the outside of the knee is most often ITB Friction Syndrome, however the rarer types of lateral knee pain should not be missed as the optimum treatment will differ between them.  Lateral knee pain is one of the most common injuries for runners.


The Illiotibial band (ITB) is a long tendon of a small muscle from the hip – the Tensor Fascia Latae.  Gluteus Maximus also partially attaches to the ITB but at an oblique angle so that it has less mechanical advantage then the Tensor Fascia Latae.

The purpose of the ITB is to add to the lateral stability of the knee.  Through most of its length the ITB is a flat thickening of the deep fascia that holds the muscles in place.  However it becomes more like a thick cord as it approaches and passes the knee joint to attach to the main lower leg bone, the Tibia.


The pain in ITB friction syndrome is rarely within the ITB itself.  It is more commonly caused by inflammation or irritation of a bursa on a bump on the thigh Bone (femur). Bursa’s are lubricating sacks that help to reduce the friction between a tendon and the bone.

Excessive compression force from the ITB as it slides past the bursa during gait can cause trauma to the Bursa triggering the injury.  This usually happens just after footstrike at about 20 degrees of flexion.  The pain from ITBFS can be sharp and intense or aching.  It will usually not warm up as you run but get worse the longer you go.  Downhill running with its increased impact forces are more painful than running on the flat.

Are you experiencing ITBFS? Click here to see one of our podiatrists at intraining Running Injury Clinic


One interesting factor in ITBFS is that it can be caused by two opposite motions.  Excessive pronation or rolling in of the foot causes a stretching strain of the ITB as the pronation results in internal rotation of the knee.  Lateral instability and rolling out of the foot also puts tension and strain on the ITB.  It is critical that the biomechanics that is causing the tension be identified as any orthotic or footwear intervention can make the problem worse if misdiagnosed.

Foam rolling

Tightness of the ITB or adhesion’s to the deeper muscle are a factor in the risk of ITBFS.  Stretching of the ITB has not been shown to be effective.  Mechanically stretching the ITB with massage is much more effective at increasing flexibility and reducing adhesion’s.  Regular use of ITB rollers will reduce recovery time and the risk of recurrence of the injury.  Icing and anti-inflammatory gel will quickly reduce the severity of symptoms.


One injury often misdiagnosed as ITBFS is tendinopathy of Biceps Femoris one of the hamstring muscles.  It usually hurts just before its insertion on the head of the smaller leg bone the Fibula.  The symptoms can be very similar to ITBFS however the location of pain is distinctly different being more posterior.  Sometimes tension from Biceps Femoris affects the fibrous joint between the two lower leg bones requiring mobilisation.


Pain on the knee joint is often from trauma or degeneration to the lateral meniscus.  The knee sometimes gives way when there is a tear in the meniscus.  It is sore along the joint line crossing under the ITB and below where the ITB usually hurts.  Clinical tests can often identify meniscal abnormality but an MRI may be needed.  Osteoarthritis in the lateral knee compartment can also cause joint line pain.

Lateral knee pain is one of the most common injuries for runners.  It is important that you have an accurate diagnosis in order to recover from the injury and reduce risk of it recurring.

Article by: Steve Manning – Podiatrist and coach at intraining Running Injury Clinic
Article by: Steve Manning – Podiatrist and coach at intraining Running Injury Clinic

The podiatrists at the intraining Running Injury Clinic are experienced at treating lateral knee pain. All of our clinicians are runners and share your passion. Our team of clinicians can help plan a safe return to running with a specifically designed rehabilitation training program to get you back running, sooner.

If you have had lateral knee pain that lasts longer than two weeks or is severe enough to make you limp then you should make an appointment to see one of the podiatrists at the intraining Running Injury Clinic – Milton and Indooroopilly.

For more From the Sole injury articles click here.

Pain in the heel?

Pain in the heel becoming a pain in the butt?

Feetures_PFsockLet’s face it, having a pain in the heel is a huge pain in the butt. Plantar Fasciopathy and/or Fasciitis is a prevalent injury amongst runners and the general public alike. Plantar Fasciopathy causes significant and often debilitating pain that affects not only running, but everyday life. Most often pain is experienced in the heel, but it can also extend through the medial arch of the foot.

Enter the new Plantar Fascia compression sock from Feetures. This is the latest high-quality recovery focused foot garment to hit the shelves at intraining Running Centre. Whilst not the silver bullet in curing plantar fascia pain, they’re a great adjunct treatment for sufferers of Plantar Fasciopathy. The Feetures sock assists in relieving tension through the plantar fascia and providing lasting support and symptomatic relief.

Three key areas the Feetures PF sock can help

  1. Eases heel and arch pain
  2. Targeted compression lifts, stretches and stabilizes the plantar fascia and supports the Achilles tendon
  3. Easy to wear sock provides convenient relief

If you are looking for a compression sock that will assist in your recovery process and help reduce the pain in your heel, these are worth a try. Not only will they offer Plantar Fasciitis sufferers in managing pain, the socks provide fantastic comfort and can be worn both during and after running.

Article by Emily Donker. Podiatrist, coach and runner
Article by Emily Donker.
Podiatrist, coach and runner

The Plantar Fascia Compression Socks from Feetures have recently been launched worldwide. We are excited that intraining Running Centre is one of the first few locations you can get your hands on a pair … well, your feet in a pair!


Knee pain in teens

Knee Pain, Teens, & Pre-teens

Knee pain is a common injury affecting one third of adolescents and causing disruption to their sports training & performances. (Rathleff et al, BJSM, 2015) The most common knee injury is Patella Femoral Pain Syndrome (PFPS).  Girls are affected more than boys and adolescent girls are also affected with ACL injuries 2-10 times more than boys.  (Myer, 2013).

Myer’s research paper also suggested that one of the major differences between girls & boys during a landing task was the overactivation of the quadriceps with decreased hip flexor activation in girls.  This led to an increase in rotational forces at the knee, called knee abduction moments.  Knee Abduction moments appear as a movement of the knee inwards or internally rotating over the planted foot.  (see image)  This is clearly visible during landing in volleyball, netball, and basketball.

kneeSports that involve cutting movements such as football and touch increase the force of Knee Abduction Moments (KAM) due to the higher speeds of landing and rotation in a single leg stance. The greater the increase in the KAM, the greater the risk of PFP & ACL injuries.

During maturation, boys had shown to have the opposite muscle activation to girls with an increased hip flexor activation.  This higher activation of hip flexor muscles in the body could potentially balance the quadriceps activation & limit rotational forces at the knee.  Myer also suggested that during maturation phases, girls with increased height and mass are more prone to earlier onset of PFPS.

Based on these findings and on the more widely known understanding of quadriceps involvement, students who are experiencing PFPS need to undertake a quad strength, and neuromuscular exercise plan. Most of these students will respond well to a specific & individualised program designed by a qualified health professional.  They also need to relearn jump landing strategies, cutting movements, and single leg movement patterns for their sport.  Sometimes other interventions such as footwear, and added support such as orthotics may be required if there are more specific anatomical and biomechanical issues.

A recent paper published this year in the British Journal of Sports Medicine found that additional exercise sessions done at school helped increase the recovery time for PFPS in adolescents.  (Rathleff, 2015).  These can be conducted by the sports educator / trainer as part of the warm up routine with the team.  FIFA have thoroughly researched ways to reduce injury risk and have produced an exercise routine called FIFA 11+  that is readily accessible online.

As sports educators, coaches and trainers are usually the first person to recognise injury and or complaints of pain by adolescent sports girls & boys.  It is worth talking to the students, and referring them for further investigation with the view that they will be given an appropriate strength program.  Further helping them at training by including their exercises into the warm up routine is more likely going to keep your players on the field for longer and hopefully performing without pain, or with less pain throughout the season.

Margot_ManningAt intraining, we have a team of health professionals including podiatrists & physiotherapists who are experienced in treating sports related biomechanical injuries. Our clinicians understand the need to help students cope with the high loads of sporting commitments and injuries they experience. If you wish to discuss any concerns regarding injuries please contact us here.

Written by Margot Manning
Podiatrist, Level 2 Athletics Coach, Runner & Owner of intraining Running Centre
intraining Running Injury Clinic


1.    Rathleff, M., Roos, E.M., et al. Exercise during school hours when added to patient education improves outcome for 2 years in adolescent patellofmoral pain:  a cluster randomised trial.  Br J Sports Med 2015; 49:406-412
2.    Myer, D., Ford, K., et al.  high knee abduction moments are common risk factors for patellofemoral pain(PFP) and anterior cruciate ligament (ACL) injuries in girls:  IS PFP itself a predictor for subsequent ACL injury?  Br J Sports Med 2015; 49:2 118-122
3.     FIFA 11+

New Year, New You

Hit the ground running in 2017 with two courses that will get you back on track in the new year.

Run101 Conference Day – A running masterclass

Join industry experts at the Run101 Conference Day on 22 January for a complete look at everything running. From running injury and footwear selection through to nutrition, running biomechanics and everything in between.

weightThe single day course is ideal for beginner runners looking for some direction and how to get the most out of themselves as well as seasoned runners who are ready to revitalize their running senses for the year ahead.

Morning tea and lunch will be provided and prepared by marathon runner, chef and nutritionist, Liz Lovering.


When: Sunday 22 January 2017
Time: 9:00am – 4:00pm
Location: 33 Park Road, Milton

Keen to find out more? Click here…

Running Form Workshop Series 2017

A beautiful woman happily running outdoors on a Summer's day

Struggle to find your rhythm when running? Find running difficult? Hit a plateau? Or just want to run with less effort? A key component of running is your running form. A solid foundation in running form can help further your running potential as well as improve your confidence when running.

Whether you are new to running or have been doing it for years, running form is always something that can be improved. The three part Running Form Workshop Series will set the foundation for your 2017 and help you reach your goals.


When: 28 January | 4 February | 11 February
Time: 3:00pm (beginner) and 4:30pm (advanced)
Location: St Lucia, Brisbane

Put the right foot forward and find out more here…


Love2Run – November16 enews

intraining’s monthly Love 2 Run eNews – November 2016
Although the official running season in Queensland is complete for 2016, it doesn’t mean your running should take a back seat. The summer months, whilst warm are a great time to get out and enjoy a couple more parkrun’s, work on fine tuning your running form or even set some summertime goals like attempting a trail run or two. This months edition of Love2Run focuses on injury management, setting goals for 2017 and a getting yourself organised for Christmas.

In this this issue:
Christmas Gift Ideas: Take the stress out of buying Christmas gifts
WIN $1030 Suunto watch: Spend over $300 in one transaction & WIN
Pain in the calf?: Learn when to stop running with a calf injury
Used your private health?: Make an appointment before 31 December
Running Form Workshop: Last chance to register for the workshop
Twilight Running Festival: Lace up… Twilight is on 19th March 2017

Did you know running facts – Part 30
Serge Girard - Ultra Marathon RunnerThe longest distance ever run in a year was 27,011km. French Ultra marathon runner Serge Girard covered the distance in 365 days at the age of 57 between 2009 and 2010 without missing a day of running. How is that for love of running!

Based on the distance covered, Serge would have worn through a pair of shoes weekly for an entire year!

Whilst we don’t recommend running an average of 74km per day, running just three times per week for just 20mins a session has been shown to increase bone density and prevent heart disease.

Stay healthy, keep active and have a happy run!


Take the stress out of Christmas gift giving in 2016
The gift catalogue for that runner in your life
It is no secret that buying a gift for someone involves a lot of thought and walking around deliberating, so much so, you almost need to buy a pair shoes dedicated to the gift hunt.

intraining's Christmas Gift Ideas Catalogue 2017We have taken the stress and hassle out of your Christmas shopping this year and have put together our top Christmas Gift Ideas catalogue for 2016.

From compression socks and GPS watches through to the Secret Santa suprises. We have a solution for every budget with a huge range of gifts any running enthusiast will love. Take a look at the intraining Christmas Gift Ideas catalogue for 2016.

Need some sustainance for the shopping ahead? Check out the ‘Fruity Christmas Coconut Truffle’ recipe provided by intraining dietitian Liz Lovering.

Christmas treats to get into this festive season!


WIN yourself a $1030 Suunto Spartan Ultra GPS watch
Spend over $300 and you could WIN
Christmas has come early with intraining Running Centre and Suunto. For the month of November until 20 December we have the ultimate Christmas gift up for grabs; Suunto Spartan Ultra Titanium GPS watch worth over $1000. Simply spend over $300 in a single transaction at the intraining Running Centre and you go in the draw to WIN the $1030 watch.

The winner will be drawn on Tuesday 20th December, where one lucky winner will take home the best Christmas present ever from the team at intraining Running Centre.

intraining Christmas Suunto Super Specials
Ambit 3 Sport – Current price: $449.95  NOW $315.00*
Ambit 3 Run – $349.95 NOW $245.00*
Spartan Sport – $779.95 NOW $700.00*
Spartan Ultra – $929.95 NOW $840.00*
Spartan Ultra Titanium – $1029.95 NOW $925.00*
Ambit 3 Peak – $549.95 NOW $495.00*

*Save even more with up to $100 more off with Suunto cash back

WIN a Suunto Spartan Ultra Titanium worth $1030


Calf strengthening and injuries – by Margot Manning (podiatrist)
Injured calf? When should you stop running?
The calf muscle is one of the most common site of injury experienced by runners. Calf injuries are often made worse when the initial symptoms are sometimes not severe enough to stop running. Stopping immediately is the key to faster recovery and a less significant injury.

Calf muscle tearVague symptoms are harder to determine whether to stop during a run or even to start a run.  However, there are a few simple rules you can follow to help make the decision.

  1. If the muscle gradually tightens and becomes worse as the run continues…STOP.
  2. If the muscle tightens quickly or ‘grabs’ and does not relax shortly after…STOP.
  3. If there is pain, an ache or constant niggling sensations during the day following the above symptoms, have a few days rest from running…DON’T START.
  4. If you are uncertain and just ‘have to run’, stay close to home, do small laps and run on your own knowing that if the above symptoms persist or increase, you can STOP.

Learn more about calf injuries from our podiatry and physiotherapy team, including when you can return to running as well as three key exercises you can perform to prevent and even recover after injury. Click here to view the full article in November’s From the Sole newsletter, by dietitian, Liz Lovering and get yourself hydrated this summer.

Calf Injuries - How to manage your running

‘From the Sole’ articles are written by our intraining Running Injury Clinic podiatry, physiotherapy, dietitian , massage therapy  and coaching team.

Make an appointment to see one of our clinicians who can assist with diagnosing and treating your running related injury.


Private health fund rebates end 31 December
Don’t wait until it is too late – get in before your rebates end
Time is running out to take advantage of your Private Health Fund privileges for 2016. Remember, your personal benefits don’t roll over into 2017 – so get organised and make the most of it before 1 January!

If you are looking to get an injury assessed, need replacement orthotics or simply want to book in to consult one of our podiatrists, physiotherapist or dietitian, make sure you book in before 31 December.

At intraining Running Injury Clinic we offer on the spot claims to most major private health fund providers with the HICAPS system.

Appointments can be made online or by phone on 07 3367 3088. Ensure you organise your appointment time early to avoid missing out.

Private health fund lifecycle ends 31 December - Book now

Running Form Workshop – 3 December 2016
Improve strength, coordination and running speed
With just over one week until the December Running Form Workshop, it is now or never to make the decision to sign up.

Sign up today for the
Running Form Workshop
3rd December 2016

Who is this for?
This workshop is ideal for runners who have participated in a previous running form workshop. The session will have an emphasis on improving technique through running drills and feedback. Under the guidance of the intraining physiotherapy, podiatry and coaching team, this session will fine tune running skills and drills learned previously and give you a plan of attack to work on throughout the summer.

When: Saturday 3 December
Time: 4:00pm – 5:30pm
Dress: Running clothing and footwear
Cost: $30 or ($25 for intraining club members)

If you are a beginner runner or can’t attend the December workshop, the three part Form Workshop in February 2017 will provide a greater emphasis on how to perform drills and develop these skills over three hands-on sessions.

Click here for more information

December running form workshop


Twilight Running Festival 2017
Lace up those shoes… Twilight is coming…
Lace up those shoes and get ready for the 9th annual Twilight Running Festival which will be held on 19th March 2017.

We are excited to announce more freedom, more fun and more friends in 2017 with cheaper entry fees so you can make the start line. Whether you are new to Twilight or back for your 9th. Come along and join in the biggest Twilight Run event in Australia.UQ Twilight Running Festival 2017

2017 Super Early Bird Entry Fees
Half Marathon: $70.00
10km Run/Walk: $45.00
5km Run/Walk: $35.00
1km Active Kids Run: $20.00

This is a running event you do not want to miss. Run under the moon and stars in 2017. Online entries are coming soon…

Register your interest online


Join us on facebook

Lace up your shoes - Twilight Running Festival is coming...

Love 2 Run August16 enews

intraining’s monthly Love 2 Run e-News – August 2016
Spring is here and running season is almost complete in Queensland. If you thought that this means a time for rest, think again! This is no time to rest on your laurels, it is the best time to start planning for what goals you have ahead.

Are you looking to start running? Better your personal best? Run a marathon? Or just finish your local parkrun without stopping? Start your planning now. Spring time is a great time of the year to head out and enjoy the earlier sunrise and sunsets that greet us each day.

Twilight Bay Run - Saturday 24 September 2016

In this this issue:
Springtime wardrobe: Refresh your running attire for Spring…
A new taste sensation: Mmm…mid run salted caramel treat
Footwear patterns: They key to knowing the way you run
Twilight Bay Run: Limited time discount offer to Twilight Bay Run.
Never run before?: Check out our success stories… from 2mins to 10km
Running Form Workshop: Transform your running in December 2016

Did you know running facts – Part 27
The Olympic Games has been and gone and it will be another 4 years until we are treated to watching the worlds best compete. Did you know how successful the Rio Games were?

Over 19 days, there were 19 world records broken and 65 Olympic records broken. In terms of athletic performance, the Rio Games has been the most successful games in history.Michael Phelps

Whilst any medal is an achievement, there were amazing standouts, that included Michael Phelps (totaling 28 Olympic medals in this career) and Usain Bolt who as a track sprinter has completed something nobody thought would be possible and accomplished three Olympic gold medals in each of the last three Olympic Games. What a great era of sport we live in!

Stay healthy, keep active and have a happy run!


**NEW** Spring/Summer clothing range in store
Refresh your Winter wardrobe with the latest running apparelNEW Asics 'Emma' race back with support and comfort to match
With Spring on our doorstep, it is time to peel off the Winter layers and let your skin see the light of day. There is nothing more uncomfortable than running in clothing that either doesn’t fit right or is not fit for the conditions.

The latest range of Spring/Summer clothing has arrived at intraining Running Centre.

If you are tired of boring black or just looking to replace those shorts that leave little to the imagination, we have a great range to help you enjoy that next run just a little more.

NEW Brooks Asteria - Mens and Women's specific racing shoe now available


Endura Salted Caramel gel and other new flavours
More flavours ensure you stay on top of your nutrition
Gels… for many of us the batle in the mind between desire and need has lead to many of us having failed nutrition during training and racing. The often hard to stomach taste of gels, akin to drinking dish washing liquid, is now a thing of the past – thanks to Endura’s new flavours.

Why Take Endura Sports Energy Gels?New Endura Gel flavours now at intraining Running Centre
Endura Sports Energy Gels are a concentrated energy source, containing a combination of two specialised forms of carbohydrates to increase total carb absorption from 60 g to 90 g an hour. Each gel contains 26 g of carbs with energy boosting caffeine. Store them on you during training and racing to conveniently keep glycogen levels up, maintain vital energy reserves and prevent hitting the wall.

Three new flavours from Endura – Now available at intraining Running Centre

– Salted Caramel: Ideal for those who have a sweet tooth
– Fruit Burst: Something fresh to keep your mind on task
– Cola Kick: Subtle taste and easy on the taste buds

If you have been struggling with fuelling during runs over 1hr in duration, it may be time to get yourself some help the easy way with a gel that is easy to take on board and stay on board.


What your wear pattern means – by Steve Manning (podiatrist)
Matching your footwear pattern to the right shoes…
Wear patterns occur as your shoes age and ‘wear in’. Wear patterns can point to a sign that your shoes should be replaced. Your wear pattern can furthermore explain the forces you exert on the shoe based on your individual biomechanics. This can then help with your selection of footwear to suit your specific running style and foot structure.

If you have worn through the outsole (rubber tread) to the midsole then you will need to replace your shoes. However by this stage the midsole cushioning in the shoe has likely to be ‘dead’ (see the dead shoe test here) and not offering your joints any relief from impact. Click here to view the full article on how to decipher your wear pattern and learn what to look for in a shoe.

Click here to read the full From the Sole Clinic eNewsletter for this month

‘From the Sole’ articles are written by our intraining Running Injury Clinic podiatry, physiotherapy, dietitian , massage therapy  and coaching team.

Make an appointment to see one of our clinicians who can assist with diagnosing and treating your running related injury.


Twilight Bay Run – Saturday 24 September 2016
Just another reason to join in the Bay RunTwilight Bay 2016 singlet and towel
The ever popular family fun event under the moon and stars will be held along the Wynnum Esplanade on 24 September.

Not only do participants get to enjoy a fireworks display over the Bay at 7pm…yeah, you could be finishing under a sky full of colours, but each participant receives the popular running specific and funky limited edition Twilight Bay singlet or Twilight towel as part of entry.

Limited time discount offer
Use discount code s-tbrintrain16
for 10% off your entry
(offer valid until 10 September 2016)
Events to consider
– Half marathon: Includes towel or running singlet and finisher medal
– 10km Run/Walk: Includes towel or running singlet and finisher medal
– 5km Run/Walk: Includes towel or running singlet and finisher medal
– 1km Active Kids Run: Includes towel, free games and finisher medal

Start your Spring with a bang and get your entry in for the Twilight Bay Run and join us for the 5th year anniversary under the moon and stars.



Running Form Workshop – 3 December 2016
Improve strength, coordination and running speed
Join the intraining Running Injury Clinic and coaching team for a practical form workshop. The workshop is designed to provide a hands on focus at improving the way you run in a single day workshop.

Who is this for?
This workshop is ideal for runners who have participated in a previous running form workshop. The session will have an emphasis on improving technique through running drills and feedback. Under the guidance of the intraining physiotherapy, podiatry and coaching team, this session will fine tune the way you have learnt the running drills previously and give you a session plan to do over the summer

When: Saturday 3 December
Time: 4:00pm – 5:30pm
Dress: Running clothing and footwear
Cost: $30 or ($25 for intraining club members)

If you are a beginner runner or can’t attend the December workshop, the three part Form Workshop in February 2017 will provide a greater emphasis on how to perform drills and develop these skills over three hands-on sessions.

Click here for more information

December running form workshop

Shin Pain

Shin Pain…  By Margot Manning (intraining Podiatrist)

A preventable and manageable injury. Common causes include excessive or rapid rotation of the leg bone (tibia), and muscle fatigue.

Everyone’s foot and leg have their own ideal movement path, which should be complemented by running shoe choice. If the shoes offer too much, or not enough support, then excessive rotational forces occur and the surrounding muscles and connective tissues are strained beyond their normal range. This repetitive tension results in microtrauma and pain for the runner.

Repetitive and excessive forces on the tibia most commonly occur from overpronation of the foot. Ensuring your shoes are suited to your gait pattern and provide appropriate control is the easiest step to preventing this mechanism of injury. Some people have more unusual biomechanics that can not be controlled with footwear alone and requires more tweaking to the shoes or insoles.

Shin pain from muscle fatigue occurs because the foot loses the ability to transition from initial foot strike to toe-off. Slapping typically occurs with forefoot loading because the muscle contractions are no longer coordinated with the movement. Downhill running, increased training load, and overstriding are contributing factors. The best way to reduce the risk of shin pain from this is to be aware of your foot strike and hip position. Feeling and listening to your footfall and focusing on your hip position and being tall (rather than slumping) can help reduce the chance of shin pain.

Shin pain can be preventable in most cases by reviewing footwear, training, and running form. If you are experiencing shin pain regularly, or as a chronic or recurring injury, then it is worth seeing one of the intraining podiatrists who specialise in running injuries to manage pain and reduce the risk of repetitive injury.

If you have a running injury causing you discomfort, visit the intraining Running Injury Clinic. Click here to make an appointment online or call us on 07 3367 3088 to speak with one of our friendly staff.