1. Common Running Injuries

2. Patellofemoral pain Knee injuries are most common for runners
Maltracking of the patella (knee cap) at the knee
Pain behind patella at foot strike mostly (pain also with stairs and after sitting for a while)
Treatment
Taping may help
May be related to foot pronation
May be related to weak hips
Strengthen quads in midrange

3. Patellofemoral pain Hip strengthening Squats (NOT FULL)
Single leg squats (NOT FULL)
Backward walking with elastic bands
Controlled landings

4. IT Band Syndrome Pain on outside of leg or at knee
Usually due to tightness
May also be due to weakness of the hip
Overpronation
Treatment
Lamppost Stretch
Seated stretch
STRENGTHEN HIP

5. Posterior Tibialis Tendonitis
Pain behind medial malleolus (inside of ankle)
Due to excessive pronation
Rest and ice initially
Prevention
Strengthen posterior tib
Single leg standing
Strengthen hip abductors and ERs

6. Tarsal Tunnel Syndrome
Symptoms
Pain behind medial malleolus
Referred pain on medial and lateral plantar surface of foot
Numbness and tingling
Possible weakness of foot muscles
SERIOUS CONDITION

7. Achilles Tendonitis Pain in distal 1/3 of posterior calf
May be due to weakness of calf
Stretch HAMSTRINGS
Stretch CALF
Prevention
Strengthen calf and hamstrings
May use heel lift during initial flare up

8. Tibial Stress Fracture
Usually in distal 1/3 of tibia
Point tenderness over tibia
Not diffuse
Not over muscle belly
Seen more in women than men
Due to excessive repeated stress
Usually vertical

9. Tibial Stress Fracture
Treatment
REST!!!
Decrease mileage
Isometrics
Orthoses
Depends on foot type
Shoes
Depends on foot type and motion

10. Sprains Most common injury at the ankle Lateral (outside)
90 to 95% of sprains
Anterior talofibular ligament
Calcaneofibular
Posterior talofibular
Bifurcate ligament

11. Sprains Grading Grade I Grade II Grade III Minimal functional loss
Mild swelling
Microtearing
Tender
Mild pain
Able to run in 1-2 days
Grade II
Moderate functional loss (difficulty walking)
Swelling
Diffuse tenderness
Able to WALK in 7 days
Grade III
Severe functional loss (crutches)
Severe swelling
Bruising
Unable to walk NORMALLY in days.

12. Sprains High Ankle Sprain (distal tib/fib sprain)
Swelling more proximal
Usually accompanies other sprains
Tender with rotation of foot
More severe sprain
Painful from midstance to pushoff
May need bracing to prevent DF

13. Fractures Fifth metatarsal Stress fracture Avulsion fracture
Supinators
Unload
Cast-nwb 3-4 weeks
Avulsion fracture
Base fracture
Peroneus brevis
Taping
Jones fracture
Proximal 1/3
Rod
Dancer’s fracture
Spiral fracture at neck
Inversion

14. 5th MT Fractures Prevention Shoes Calf stretching Balance training
Orthotics

15. Plantar Fasciitis Symptoms Pain in the morning Pain after inactivty
Medial calcaneal tubercle
Pain after inactivty
Pain is reduced with activity INITIALLY
Pain usually lasts 8-10 MONTHS!

16. Plantar 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 range
Pes Cavus (high arched feet)
Tight and can’t stretch
Heel spur??

17. Plantar Fasciitis Treatment Rest Stretching IF NEEDED Heat
Use a heel lift ONLY in acute stage then wean off.
Stretching IF NEEDED
Plantar fascia
Achilles
Heat
Deep friction massage
Ice massage
Taping
Foot orthoses
Shoes

18. Sinus Tarsi Syndrome Signs and Symptoms Pronation
Past lateral ankle sprain
Gradual onset
Usually on one side only
Radiating pain on top/outside of foot
Pain with inversion & PF PROM
Peroneal muscle weakness
Rearfoot instability

19. Sinus Tarsi Syndrome Treatment Get rid of inflammation
Electrical stim works well
Cortisone shot
Foot Orthotic Devices
Control pronation
Over the counter
Custom molded

20. Others Cuboid Syndrome Spring Ligament Sprain
Lateral instability
Taping
Spring Ligament Sprain
Different from plantar fasciitis
Pain in back of arch
Taping, orthoses or motion control shoe
Lis Franc Sprain (midfoot pain)
Fat Pad syndrome
Rest
Cushioning shoes or orthoses

21. Final Thoughts Strong core and hips! Cross Train Nutrition
Large majority of injuries are due to improper training
Too much
Too quick
Too fast

22. THANK YOU!
I plan to be running as long as I can and have no plans to stop. -Frank Shorter