Preventing Common Running Conditions Ryan Hudson MD Sports Medicine Specialist University of Chicago Dept of Orthopaedics & Rehabilitation
Running I...
• 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
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Repetitive stress and impact mismatch of bone formation and bone destruction.
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Changes in training: rapid increase in distance, speed, or duration
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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
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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
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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”
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Knee cap tracking error
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cartilage on the underside of the patella rubbing against the femur.
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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
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Friction at bony prominence
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Develops due to lack of hip control
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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