Presentation on theme: "Common Running Injuries"— Presentation transcript:
1Common Running Injuries Robert P. Wilder, MD, FACSM Chair, Physical Medicine & Rehabilitation The University of Virginia Medical Director, The Runner’s Clinic at UVA Team Physician, Ragged Mountain Racing
2Objectives Identify common contributors to running injuries Describe treatment for heel pain, stress fractures, and patellofemoral pain syndromeUnderstand the importance of proper mechanics in managing injuryOutline criteria for running while treating injury
3Epidemiology of Running Injuries 30 million active runners 70% all runners sustain significant injury 40% knee 15% each: shin, achilles, hip/groin 10% foot and ankle 5% spine 25% recreational 5% elite
4Epidemiology of Running Injuries 4% bit by dogs 0.3% hit by bicycles 0.6% hit by cars 7% hit by thrown objects
21Plantar Fasciitis 10% U.S. Population 600,000 outpatient visits annually7-9% all running injuries
22Plantar Fascia Thick aponeurosis Arises from medial calcaneal tuberositySpans archBands circle flexor tendonsInsert proximal phalanx
23Functions During Gait Cycle Heel strike: Allows midfoot to become flexible, absorb shock, conform to uneven surfaceToe off: Windlass Mechanism: Shortening increases arch, locks midtarsal, stabilizes toe off
52Patellofemoral Syndrome Pain associated with the articular surface of the patella and femoral condyles, its alignment and motion“Runners Knee” #1 presenting complaint to Runner’s Clinics#1 cause lost time in basic training military recruits
53PFS - Classification Patellofemoral instability PFS with malalignment PFS without malalignment
62Shoes Lots of options (a good thing) Can affect impact forces, loading rates, torque forces? Relation to shoes, form or bothRarely does “one size fit all”If it ain’t broke, don’t fix it?All transitions gradualWith barefoot, minimalist ensure stability and form cues
64Cross train (aqua run, eliptical bike) Walk, then walk – jog, then run10% per week ruleLong run increases no more than 2 miles
65Relative Activity Modification Guidelines Rule #1If you feel mild pain (0-3/10): it is OK to runIf you feel moderate pain (4-6/10): reduce activity until pain level is mild.Severe pain (> 7/10): no running
66Relative Activity Modification Guidelines Rule #2Pain that decreases with activity is OK.Pain that gets worse with activity is bad; time to reduce or stop activity.
67Relative Activity Modification Guidelines Rule #3No limping allowed.If the pain alters your gait pattern, it is time to reduce or stop the activity until you have normal biomechanics.