Common Running Injuries

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

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

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

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

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

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

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

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

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

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 10-14 days.

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

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

5th MT Fractures Prevention Shoes Calf stretching Balance training Orthotics

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!

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??

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

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

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

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

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

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