Preventing Common Running Conditions

Preventing Common Running Conditions Ryan Hudson MD Sports Medicine Specialist University of Chicago Dept of Orthopaedics & Rehabilitation Running I...
3 downloads 2 Views 1MB Size
Preventing Common Running Conditions Ryan Hudson MD Sports Medicine Specialist University of Chicago Dept of Orthopaedics & Rehabilitation

Running Injuries



Running injuries effect 30-50% runners per year



Overuse and generally self-limited



Training miles per week and history of running injury •  at 19 miles/wk. •  at 40 miles per week

Preventing Injury •

Condition and Recovery • • • •

Do not skip shorter runs Rest days Should not make more than one change at a time Condition and Stretch during off days

Preventing Heat Illness



Start in Hydrated state (ounce per Kg)



Drink according to thirst for runs > 1 hour



Weigh yourself before and after runs (you should not lose or gain more than 2 pounds) – 16oz fluid per pound



Acclimatization to warmer environments – gradually increasing mileage/intensity over 10-14 days

Injury Prevention: Knowing when to stop •

Limping or changing gait pattern



Escalating pain greater than 3/10



Needing “pre-medication”



Wakes up at night



Persists with rest

Shoes



Get shoes at a running shoe store – pronation, supination, nuetral



Immediate feel



Write date on shoe and/or keep track of mileage on each pair



~ 300-400 miles

Common Running Injuries 1. Stress Fractures 2. Plantar Fasciitis 3. Achilles Tendinitis 4. Shin Splints 5. Patellofemoral Syndrome 6. Iliotibial Band Syndrome

Why Do These Injuries Occur?

• Progressing too quickly in mileage and speed • Lack of regular stretching • Not changing out running shoes frequently enough • Imbalance between opposing muscle groups

Stress fractures



Repetitive stress and impact  mismatch of bone formation and bone destruction.



Changes in training: rapid increase in distance, speed, or duration



Activity related pain which may progress

Stress Fractures

• Signs and Symptoms – Sharp pain in the weight-bearing bones of the lower leg and foot while running – Mild swelling – Tender to the touch

Diagnosis

11

Treatment – – – –

Depends on location Modify activities for at least 6 wks (avg bone healing time) May require assistive devices (boot/crutches) to take pressure off Surgery if at high risk location

12

Stress Fractures

• Prevention – Slowly increase any new sports activity – Maintain a healthy diet, including calcium – Do not wear old or worn running shoes – If pain or swelling occurs, immediately stop the activity and rest for a few days – If continued pain persists, see a sports medicine specialist

Plantar fasciitis

Plantar Fasciitis

• Causes – Weak foot muscles – Tight Achilles tendon – Flat or high arches – Poor shoe support – Sudden increase in activity level – Sudden increase in weight

Plantar fasciitis Treatment includes: •Temporarily decrease training intensity •Stretching calf muscles •Core strengthening and Foot strengthening •icing, massaging •Avoid Barefoot •proper arch support, night splints •anti-inflammatories •Injections – PRP1, Cortisone

•Tenex •Surgery 1Peerbooms

JC, van Laar W, Faber F, Schuller HM, van der Hoeven H, Gosens T. Use of platelet rich plasma to treat plantar fasciitis: design of a multi centre randomized controlled trial. BMC Musculoskelet Disord. 2010;11:69

Plantar Fasciitis

• Prevention if prone to this: – Wear orthotics • prevent excess pronation • prevents lengthening/tearing of the plantar fascia

– Stretch regularly

Patellofemoral “runner’s knee”



Knee cap tracking error



cartilage on the underside of the patella rubbing against the femur.



Due to lack of hip control/strength, imbalance in quad strength and/or improper balance

Patellofemoral Syndrome

• Signs and Symptoms – Pain may be felt behind or around the knee cap – Grinding noises may be heard during bending or straightening the leg – The knee may feel like it gives-way without any particular reason – Pain occurs while going up and down stairs, as well as after prolonged periods of sitting

Patellofemoral Syndrome

• Treatment/Prevention – – – –

Temporarily decrease training Temporary artificial control (taping/bracing) Ice, Anti-inflammatory Medications Improve Mechanics: • • • •

Core/hip/quad strengthening Balance/single leg stability training Strengthening the quadriceps Stretching the hamstrings

Iliotibial (IT) band syndrome •

Tension of the band running from your hip to your knee



Friction at bony prominence



Develops due to lack of hip control



Usually worsens as you fatigue

Iliotibial Band Syndrome

• Signs and Symptoms – Pain localized over lateral femoral condyle – Discomfort initially relieved by rest – Pain may radiate toward the lateral joint line and proximal tibia – Worse if a person continues to run – No symptoms of internal derangement – Symptoms frequently develop during downhill running

Iliotibial Band Syndrome

• Treatment and Prevention •

Relative Rest •

Avoid hills, shorten stride, and run on alternate sides of road



Ice, Stretching, Conditioning



FOAM ROLLER



Cortisone injection

QUESTIONS?

THANK YOU!

Have Fun. Stay Safe.

25