Presentation is loading. Please wait.

Presentation is loading. Please wait.

2006 年 ING 國際超級馬拉松行前訓練 Physical Therapy of Marathon Runners’ Injuries -- Assessment, Judgment, and Consultation 2006 年 ING 國際超級馬拉松行前訓練 柴惠敏 台灣大學物理治療學系 951216.

Similar presentations


Presentation on theme: "2006 年 ING 國際超級馬拉松行前訓練 Physical Therapy of Marathon Runners’ Injuries -- Assessment, Judgment, and Consultation 2006 年 ING 國際超級馬拉松行前訓練 柴惠敏 台灣大學物理治療學系 951216."— Presentation transcript:

1 2006 年 ING 國際超級馬拉松行前訓練 Physical Therapy of Marathon Runners’ Injuries -- Assessment, Judgment, and Consultation 2006 年 ING 國際超級馬拉松行前訓練 柴惠敏 台灣大學物理治療學系

2 2006 年 ING 國際超級馬拉松行前訓練 Epidemiology of Marathon Runners in US, 2002 –375 marathons & ~ 450,000 completed one –30,000 in the largest marathon with 43% > 40 y/o USA Track and Field Road Running Information Center, 2003 ING Taipei International Marathon, 2005: 60,000 finished time (median) –male: 4 hours and 20 minutes –female: 4 hours 56 minutes to seek medical attention during or immediately after completing the race: 2% to 8% –17% of them MS problems –muscle cramps, blisters, and acute ankle and knee injuries

3 2006 年 ING 國際超級馬拉松行前訓練 PT of Marathon Runners’ Injuries -- Assessment and Treatment Biomechanical concerns of running injuries Physical therapy assessment Skills required for a PT on race day

4 2006 年 ING 國際超級馬拉松行前訓練 stance phase swing phase Running Cycle follow-through forward swing foot descent foot strike mid-support take-off

5 2006 年 ING 國際超級馬拉松行前訓練 Shock Absorption at Foot Strike ground reaction force at FS = 2.5 ~ 3  BW biomechanical requirements at FS –LE motions knee flexion, tibia internal rotation, and subtalar pronation –cartilage or fat pad heel pad, metatarsal pad, meniscus, IVD –extrinsic factors running shoes with large heel flare or cushion shoes taping, shoe insole, or FFO running surface gel heel pad

6 2006 年 ING 國際超級馬拉松行前訓練 Patterns of Foot Strike heel-strike –for long-distance runners midfoot- or total-sole strike forefoot- strike –for sprinter only –long-distance runnner  metatarsalgia or stress fracture of central rays frontal plane section of heel pad metatarsalgia of central rays

7 2006 年 ING 國際超級馬拉松行前訓練 Lateral Heel Flare lateral heel flare   moment arm  rapid pronation  prevention of ankle sprain posterior view of shoe heel flare

8 2006 年 ING 國際超級馬拉松行前訓練 Heel Cup heel pad atrophy use of heel cup

9 2006 年 ING 國際超級馬拉松行前訓練 Foot Motion during Mid-Support foot pronation at mid-support in order to make the foot more mobile for further shock absorption foot pronation  medial and inferior glide of talus and internal rotation of tibia  COG shifting medially   energy consumption and time to re-supinaiton strategy: hard counter for controlling COG motions counter

10 2006 年 ING 國際超級馬拉松行前訓練 Re-supination at Take-off re-supination at take-off in order to make the foot rigid and support the body weight –LE motions : subtalar joint supinaiton 、 midtarsal joint locked, first ray plantarflexion, and MP joint full extension –windlass effect of plantar fascia  ground reaction force   momentum (= mv) –  running speed –  impact force (= Ft) accumulated at metatarsal heads  metatarsalgia

11 2006 年 ING 國際超級馬拉松行前訓練 Windlass Mechanism (Truss Model) Toe neutral Toe extension plantar fascia PF of 1 st ray

12 2006 年 ING 國際超級馬拉松行前訓練 pronated foot  lower arch  plantar fascia stretched A arch support would further stretch plantar fascia Arch Support in Pronated Foot arch support plantar fascia

13 2006 年 ING 國際超級馬拉松行前訓練 Lower Extremity: High-risk in Injuries pronated foot: functional low-arch supinated foot: functional high-arch tight Achilles tendon tibial varum bow-leg pronated foot

14 2006 年 ING 國際超級馬拉松行前訓練 Functional Foot Orthosis to maintain subtalar neutral position to dissipate foot pressure

15 2006 年 ING 國際超級馬拉松行前訓練 Foot Types supinated footneutral footpronated foot

16 2006 年 ING 國際超級馬拉松行前訓練 Characteristics of Pronated Foot  arch height callus beneath 2 nd and 3 rd MTHs WB STJ neutral

17 2006 年 ING 國際超級馬拉松行前訓練 PT of Marathon Runners’ Injuries -- Assessment and Treatment Biomechanical concerns of running injuries Physical therapy assessment Skills required for a PT on race day

18 2006 年 ING 國際超級馬拉松行前訓練 etiology –  intensity or time –mal-alignment of WB joints –Insufficient or lax flexibility –muscle weakness or imbalance –poor posture –poor running surface –improper shoe fit Common Musculoskeletal Problems in Marathon Runners LBP stress fracture heel pain metatarsalgia shin splint Achilles tendinitis patellofemoral pain iliotibial band friction syndrome plantar fasciitis

19 2006 年 ING 國際超級馬拉松行前訓練 Achilles Tendinitis etiology: Archilles tendon tightness predisposing factors –sudden change in intensity –uphill running S/S –Achilles tendon pain or stiffness –unable to raise on the heel, deep squatting, or stretch Achilles tendon –enlargement of Achilles tendon

20 2006 年 ING 國際超級馬拉松行前訓練 Distinguish Tendinitis from Sprain pain on stretching in both conditions different anatomical location pain on isometric resisted test –tendinitis: positive –ligament sprain: negative muscle fiber tendon resting resistedtest stretch tendon

21 2006 年 ING 國際超級馬拉松行前訓練 Rupture of Achilles Tendon S/S –sharp pain, like be “kicked” –tenderness, swelling, or ecchymosis –dump at the rupture site –unable to one leg stance –positive Tompson test

22 2006 年 ING 國際超級馬拉松行前訓練 Plantar Fasciitis plantar fascia pronated foot neutral foot

23 2006 年 ING 國際超級馬拉松行前訓練 Anterior Compartment Syndrome shin splint muscles within anterior compartment: –tibialis anterior –extensor hallucis longus –extensor digitorum longus pathology  intramuscular pressure  compression of muscle or vessels

24 2006 年 ING 國際超級馬拉松行前訓練 Patellofemoral Pain Syndrome chondromalacia etiology –lateral tilt of patella –genu valgus –tibia torsion –pronated foot –excessive Q- angle Q angle

25 2006 年 ING 國際超級馬拉松行前訓練 Iliotibial Band Friction Syndrome lateral knee pain at  of knee flexion

26 2006 年 ING 國際超級馬拉松行前訓練 Poplitus Tendinitis etiology –downhill running S/S –pain at resisted tibia rotation at 90  of knee flexion posterior view popliteus

27 2006 年 ING 國際超級馬拉松行前訓練 Stress Fracture of Pars Interarticularis transverse process Superior facet Inferior facet

28 2006 年 ING 國際超級馬拉松行前訓練 Rotator Cuff Tendinitis S/S –shoulder stiffness, pain, or weakness –unable to raise the arm or put the hand on sacrum –drop arm test differentiation –supraspinatus –infraspinatus –teres minor –subscapularis –long head of the biceps brachialis

29 2006 年 ING 國際超級馬拉松行前訓練 Rhabdomyolysis 肌纖維溶解症 occurrence: downhill running S/S: –muscle pain, low-grade fever, and dark urine after racing –muscle swelling, tenderness, and weakness are rare laboratory examinaiton –serum CK with a level > 5X of normal value –2 ~ 12 hr after injury and peak in 1 ~ 3 day Rx –close monitoring for renal, cardiac, and metabolic complications coupled with early and aggressive hydration

30 2006 年 ING 國際超級馬拉松行前訓練 PT of Marathon Runners’ Injuries -- Assessment and Treatment Biomechanical concerns of running injuries Physical therapy assessment Skills required for a PT on race day

31 2006 年 ING 國際超級馬拉松行前訓練 Eccentric Exercises 離心運動訓練效果快 但易造成肌肉痠痛 向心 離心 向心運動動作與重力反向,收縮肌肉縮短 離心運動動作與重力同向,收縮肌肉拉長

32 2006 年 ING 國際超級馬拉松行前訓練 開放鍊運動閉鎖鍊運動 open kinematic chain exerciseclosed kinematic chain exercise distal end free in the airdistal end fixed on a point for mobilityfor stability

33 2006 年 ING 國際超級馬拉松行前訓練 Embedded Padding in Shoe Insert heel pad metatarsal pad medial wedge lateral wedge


Download ppt "2006 年 ING 國際超級馬拉松行前訓練 Physical Therapy of Marathon Runners’ Injuries -- Assessment, Judgment, and Consultation 2006 年 ING 國際超級馬拉松行前訓練 柴惠敏 台灣大學物理治療學系 951216."

Similar presentations


Ads by Google