The Center for Podiatric Care and Sports Medicine

Cross-Country Running: Injuries That Take A Heavy Toll On High School Girls

Posted by on Thursday, August 22nd, 2013


Cross-country running has the highest injury rate of any high school sport — even worse than football, wrestling and soccer. The NY Times cited a massive study of 60,000 high school athletes in Seattle, which ran from 1979 to 1992. The study found that one out of every three cross-country runners suffered an injury. On average, runners had two injuries per season.

Most Common Cross-Country Running Injuries

Researchers found that the most common cross-country suffered from…

Tendinitis of the Knee: Tendinitis is chronic inflammation of the tendons, which connect muscle to bone in the knee. This overuse injury can be caused by running on uneven surfaces, increasing distance or intensity of training, wearing running shoes too long, weakened quadriceps, or poor body alignment. Conditions like overpronation, knock knees and a tightened iliotibial band can contribute to the development of tendinitis. According to Runner’s World, one of the better treatments includes the use of a counter-force strap to compress the tendons and redistribute tension. Runners may need to wait a full 120 days for this injury to heal.

Shin Splints: Tibial stress syndrome (shin splints) develops from inflammation of the muscles, tendons, and the thin layer of tissue covering the shin bone. Most runners will suffer from this common over-training injury at some point in their running careers. Other contributing factors include: flat feet, running on hard surfaces, or using shoes that have traversed more than 500 miles. Shin splint treatment involves rest, ice, better shoe support, anti-inflammatory medication and physical therapy range-of-motion exercises.

Ankle Sprains: Ankle sprains are all too common when running over rough, uneven terrain. Runners with high arches tend to suffer more sprains because their ankles are rotated too far outward as they land. Sprain severity ranges from grade one (a stretching of the ankle ligaments), to grade two (inflammation and a partial-tear) and three (an actual tearing of the ligaments away from the bone). Runners need to take two to seven days off for a moderate sprain — icing, air-splinting, stretching, and going through range of motion exercises. However, a severe sprain could require up to three weeks in a short cast. Surgery is rarely required.

Leg Stress Fractures: What may feel like shin splints at first may actually be small hairline fractures in the tibia bones. Runners can expect a six to eight week recovery, with much of that time spent in a boot or walking cast. Minnesota researchers found that the best way to avoid stress fractures is to work on strengthening the calf muscles. Just rising up onto one’s toes ten to twelve times a day may be enough to do the trick. Another preventative method is to shorten one’s stride by about 10%, scientists said.

Why Are Cross-Country Injuries So Prevalent In Young Women?

There are several reasons why there are 61.4 injuries for every 100 runners. For one, the sport takes place in the fall — like three of the other sports in the list of “top five injuries.” There is not as much time for runners to train and get in shape for the sport, as only a handful of the most dedicated athletes actually work with a trainer over the summer months.

Secondly, the growing popularity of cross-country running, with a participation of over 160,000 runners, has made the atmosphere more competitive. Girls seeking a scholarship need to train harder to get ahead. Some girls are running 60 to 80 miles per week, when they should be doing no more than 40.

Thirdly, female anatomy is partly to blame. Young girls’ estrogen levels have not reached maximum bone density yet, which would explain some of the cross-country injuries. Also, the wider hips and sharper thigh angulation can weaken the knee muscles more for girls than boys.


NYC Podiatrist Treats Sports Injuries In Cross-Country Runners

The Podiatric Center for Sports Medicine in New York City is not just for people with foot problems. We see cross-country runners for shin splints, knee pain, stress fractures and many other conditions as well. For your convenience, we have two locations in White Plains and Manhattan.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.