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SYMPOSIUM ON RUNNING INJURIES on 15 . 03 . 2010
V.PADMA SHEELA IIYEAR
MPT
Running Injuries - Running Injury Welcome to the quest of running injury free! This site is for the thousands of runners, joggers, and walkers who are not concerned with how fast they can ... www.runnersrescue.com/ - Cached - Similar Running Injury - Common Injuries in Runners 21 Dec 2009 ... Running places extraordinary demands on an athlete's feet, legs, and entire body. Many common conditions affect runners, ... orthopedics.about.com/cs/sportsmedicine/.../ru nninginjury.htm - Cached - Similar PDF] Microsoft PowerPoint - Common Orthopedic Running Injuries File Format: PDF/Adobe Acrobat - Quick View Running Injuries: An Illustration. Dr. Raju
TOPICSIntroduction Biomechanics of running Common Injuries and Treatments Causes of Common Injuries Measures to Avoid Injury
BIOMECHANICS OF RUNNING
MOST COMMON RUNNING INJURIES Acute
Muscle Tears Low back pain Medial Tibial Stress syndrome ( shin splints ) Iliotibial band syndrome Quads strain Hamstring strain Runner s knee Runner s cramp Peroneal
Ankle
sprain Plantar Fasciitis Stress fractures Hip bursitis Groin pain Patello femoral pain syndrome ACL / PCL injury Meniscal injury Prepatellar bursitis Popliteal cyst
MOST COMMON RUNNING INJURIESOsgood
schlatter s disease Osteoarthritis Side stitch Athletes foot Blisters Verruca ( warts ) Hadelung deformity
o Turf toe Calcanei apophysitis Morton s neuroma Metatarsalgia Entrapment syndromes Compartment syndromes
CAUSES OF INJURIESCaused
by 1) Training errors 2) Inappropriate footwear 3) Inadequate strength 4) Inadequate flexibility 5) Poor biomechanics
FACTORS RELATED TO RISKS OF RUNNING INJURIES
Previous injury Lack of running experience Competitive running Excessive weekly running distance Low body mass
GENERAL EVALUATIONHistory Shoe
Assessment Physical Assessment
COMMON ANATOMICAL DISORDERSReduced ankle ROM Leg- length asymmetry Increased quadriceps angle Bow legs Knock knees, club foot Subtalar hyper mobility High arch/flat foot
OVER PRONATION
ACUTE MUSCLE TEAR
Treatment :Ice Strengthening Stretching
CHRONIC MUSCLE TEAR
Treatment :Stretching Strengthening
LOW BACK PAIN
Contributing factors : Weak abdominals Back muscles Tight hamstrings Foot imbalance
SHIN SPLINTS
caused by : Running on hard surfaces, Running on tip toes & sports where a lot of jumping is involved.
ILIOTIBIAL BAND SYNDROME
ITBS
SITE OF PAIN
Signs / Symptoms : Pain on outer side of knee Pain usually increases with run Subsides slowly after run
QUADS STRAINGrade I strain: C/o tightness in thigh Passive knee flexion beyond 90 painful Grade II strain : Snapping/tearing during explosive activities Grade III strain : Extremely painful & ambulation not possible.
HAMSTRING STRAINMost
frequently strained muscles in the body & are typically caused by rapid contraction of muscle during ballistic action/ violent stretch.
RUNNERS KNEE
CAUSES : Over pronation Weak quadriceps Incorrect/ worn shoes Over training
CRAMP
RUNNERS
cause of cramps is
Occurs as lack of stretching/ loosening of muscles Occur from dehydration/ electrolyte deficiency shallow breathing which ultimately leads to a lack of oxygen. cramps is eating too much / not enough before a race or workout. Some foods that take longer to digest could be in your stomach for hours &will likely make their presence known if you chose to eat & run.
SIDE STITCHExercise-induced
abdominal pain
Cramp
of the diaphragm muscle
Occurs
with fast running & uncomfortable breathing requires breathing out fully rather than panting
Treatment
PERONEAL TENDONITIS
TREATMENT : Immobilization Medications Physical therapy Bracing
ACHILLES TENDONITISDefinition :
Inflammation of the Achilles tendon most often occurring at the insertion on the back of the heel.
TOTAL RUPTURE OF ACHILLES TENDINITISCommon in older men who are recreational athletes.
CALF STRETCHES
ANKLE SPRAIN
CAUSES: Running on uneven surface. Foot imbalance Over pronation
PLANTAR FASCITIS/ HEEL PAIN
The Plantar Fascia is a broad, thick band of tissue that runs from under the heel to the front of the foot
PLANTAR FASCITIS/ HEEL PAIN
DEFINITION : Inflammation of plantar fascia most often occurring at the origin on the heel (inside edge).
TREATMENTS OF PLANTAR FASCIITIS
METATARSAL STRESS FRACTURE
CAUSES :Abnormal
concentration of stress Bones insufficiently strong Abnormal foot structure / mechanics.
HIP BURSITIS
REHABILITATION :Icing ,
NSAIDs , rest , u / s , IFT . Strengthening of hip abductors . Stretching for ITB , hip flexor , hamstring , gluteus .
GROIN PAIN
TREATMENT:
Phase I : Static adductor exercise Abdominal curls Phase II : Gluteal leg raise Single leg squats Slide board skating
PATELLOFEMORAL PAIN SYNDROME
ACL INJURY
MANAGEMENT : CPRICE CROM within pain free limits CStrengthening exercises CCV fitness CBalance & proprioception CFunctional activities.
C
POSTERIOR CRUCIATE LIGAMENT INJURY
SIGNS & SYMPTOMS : Milder cases : Intense pain & sense of stretching . Total rupture : characteristic pop / snap is felt . Effusion & hemarthrosis occur rapidly .
MENISCAL INJURY
SIGNS & SYMPTOMS: o Localized pain & joint line tenderness. o Pain will occur on rotation & extreme flexion of knee (deep knee squats) o May experience popping, grinding/clicking sensation
PREPATELLAR BURSITIS
TREATMENT : Ice therapy A compressive wrap NSAIDs Avoid activities that irritate the condition Corticosteroid injections.
POPLITEAL CYST Baker
cyst is swelling caused by fluid from the knee joint protruding to the back of the knee. When an excess of knee joint fluid is compressed by the body weight between the bones of the knee joint, it can become trapped & separate from the joint to form the fluid-filled sac of a Baker cyst.
OSGOOD SCHLATTERS DISEASE
TREATMENT: vReduce running & jumping activities vIcing vStretching quads.
OSTEOARTHRITIS
DEFINITION :Osteoarthritis
(also called degenerative joint disease) is the degradation and degeneration of this articular cartilage
ATHLETES FOOT
CAUSES : Due to excessive sweat. Fungi thrive in warm, moist environments . Not changing your socks . A common port of infection is in changing rooms in the gym as this condition can spread between individuals.
BLISTERS
Blisters can occur anywhere on the foot but they are more likely to occur on the toes & the sole of the foot due to friction & traction forces.
VERRUCA (WARTS)
HAGLUND DEFORMITY Is
a bony enlargement on the back of the heel. The soft tissue near the Achilles tendon becomes irritated when the bony enlargement rubs against shoes. This often leads to painful bursitis, which is an inflammation of the bursa (a fluid-filled sac between the tendon and bone).
FLAT FEET
CAUSES : COver pronation CHereditary factors
TURF TOETurf toe can occur after a very vigorous upward bending of the big toe
SEVERSDISEASE/APOPHYSITIS CALCANEI
TREATMENT: Rest Icing, NSAIDs Heel lifts, heel cups Strapping the foot Flexibility exercise Strengthening exercise
NEUROMA
MORTONS
SYMPTOMS: 1. Numbness / tenderness in the foot 2. Pain, numbness, burning & tingling sensations can radiate around the foot. 3. Severe pain may be present at weight bearing.
METATARSALGIA
Mechanism of Injury : qFaulty distribution of weight on the forefoot. qSudden trauma
ENTRAPMENT NEUROPATHIESFemoral
Neuropathy Sciatic Neuropathy Meralgia Paresthetica Common Peroneal Neuropathy Tarsal Tunnel Syndrome Tibial nerve entrapment Sural nerve entrapment Distal Peroneal Neuropathy
COMPARTMENT SYNDROMES Exertional
compartment syndrome deep posterior compartment (2030%)
Lateral
compartment(1020%) Anterior compartment syndrome (50-60%)
HOW TO AVOID INJURYProper shoes
Warm-up
Training methods
Stretching
Muscle strengthening
SIDELINE PREPARATION FOR TEAM PHYSICIAN
GOAL : Adequate onsite medical care & the safety of every athlete . This goal can be accomplished by intergrading medical systems that include Preseason planning Game - day planning & Post - season evaluation
DIETARY SUPPLEMENTS & ATHLETICSReasons for taking supplements: Recommended by family member/friend Recommended by coach/trainer Recommended by nutritionist/dietician Recommended by physician/pharmacist Inadequate diet Improve athletic performance
Contd.Feel
better/increased energy levels Prevent illness Prevent disease Build muscle
THE AGING ATHLETE: RISKS & BENEFITS OF EXERCISEPhysiological changes of cardiopulmonary system that affect exercise. Decline in cardiac output Decline in max. HR Decline in VO2 max Decrease capillary- muscle peripheral blood flow Decrease myocardial muscle mass.
Physiological changes in MS that affect exercise after age 50. Decreased collagen water content Decreased lean body/muscle mass Decreased strength Decreased type II muscle fibres Decreased type IX articular cartilage Increased body fat
SOME BASIC TIPSCDo not increase mileage by more than 10% a week. CDo not run more that 45 miles a week. CDo not run / stand on uneven surfaces. CDo not run on sand. CDo not run through pain. CIce often. CChange your running shoes every 450 miles. CWork regularly on strengthening.