2Patellofemoral pain Knee injuries are most common for runners Maltracking of the patella (knee cap) at the kneePain behind patella at foot strike mostly (pain also with stairs and after sitting for a while)TreatmentTaping may helpMay be related to foot pronationMay be related to weak hipsStrengthen quads in midrange
3Patellofemoral pain Hip strengthening Squats (NOT FULL) Single leg squats (NOT FULL)Backward walking with elastic bandsControlled landings
4IT Band Syndrome Pain on outside of leg or at knee Usually due to tightnessMay also be due to weakness of the hipOverpronationTreatmentLamppost StretchSeated stretchSTRENGTHEN HIP
5Posterior Tibialis Tendonitis Pain behind medial malleolus (inside of ankle)Due to excessive pronationRest and ice initiallyPreventionStrengthen posterior tibSingle leg standingStrengthen hip abductors and ERs
6Tarsal Tunnel Syndrome SymptomsPain behind medial malleolusReferred pain on medial and lateral plantar surface of footNumbness and tinglingPossible weakness of foot musclesSERIOUS CONDITION
7Achilles Tendonitis Pain in distal 1/3 of posterior calf May be due to weakness of calfStretch HAMSTRINGSStretch CALFPreventionStrengthen calf and hamstringsMay use heel lift during initial flare up
8Tibial Stress Fracture Usually in distal 1/3 of tibiaPoint tenderness over tibiaNot diffuseNot over muscle bellySeen more in women than menDue to excessive repeated stressUsually vertical
9Tibial Stress Fracture TreatmentREST!!!Decrease mileageIsometricsOrthosesDepends on foot typeShoesDepends on foot type and motion
10Sprains Most common injury at the ankle Lateral (outside) 90 to 95% of sprainsAnterior talofibular ligamentCalcaneofibularPosterior talofibularBifurcate ligament
11Sprains Grading Grade I Grade II Grade III Minimal functional loss Mild swellingMicrotearingTenderMild painAble to run in 1-2 daysGrade IIModerate functional loss (difficulty walking)SwellingDiffuse tendernessAble to WALK in 7 daysGrade IIISevere functional loss (crutches)Severe swellingBruisingUnable to walk NORMALLY in days.
12Sprains High Ankle Sprain (distal tib/fib sprain) Swelling more proximalUsually accompanies other sprainsTender with rotation of footMore severe sprainPainful from midstance to pushoffMay need bracing to prevent DF
145th MT Fractures Prevention Shoes Calf stretching Balance training Orthotics
15Plantar Fasciitis Symptoms Pain in the morning Pain after inactivty Medial calcaneal tuberclePain after inactivtyPain is reduced with activity INITIALLYPain usually lasts 8-10 MONTHS!
16Plantar Fasciitis Factors Tight Achilles Leg length discrepancy Poor footwear on hard floors (think about your feet when you are NOT running)Pes Planus (flat feet)Stretch plantar fascia at end rangePes Cavus (high arched feet)Tight and can’t stretchHeel spur??
17Plantar Fasciitis Treatment Rest Stretching IF NEEDED Heat Use a heel lift ONLY in acute stage then wean off.Stretching IF NEEDEDPlantar fasciaAchillesHeatDeep friction massageIce massageTapingFoot orthosesShoes
18Sinus Tarsi Syndrome Signs and Symptoms Pronation Past lateral ankle sprainGradual onsetUsually on one side onlyRadiating pain on top/outside of footPain with inversion & PF PROMPeroneal muscle weaknessRearfoot instability
19Sinus Tarsi Syndrome Treatment Get rid of inflammation Electrical stim works wellCortisone shotFoot Orthotic DevicesControl pronationOver the counterCustom molded
20Others Cuboid Syndrome Spring Ligament Sprain Lateral instabilityTapingSpring Ligament SprainDifferent from plantar fasciitisPain in back of archTaping, orthoses or motion control shoeLis Franc Sprain (midfoot pain)Fat Pad syndromeRestCushioning shoes or orthoses
21Final Thoughts Strong core and hips! Cross Train Nutrition Large majority of injuries are due to improper trainingToo muchToo quickToo fast
22THANK YOU!I plan to be running as long as I can and have no plans to stop. -Frank Shorter