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Treatment of Lower Extremity
Pain in Runners
Dick Evans PT, OCS10-11-07
60-65% of all runners are injured in an average year
Runners miss approximately 5-10% of their scheduled workouts due to injury
65% injury rate & 10% absent rates could be significantly lowered if some simple adjustments were made in training schedules
Possibly decreasing injury rates 25%
Five Anatomical Hot Spots
Knee-25 to 30%~endurance runners
Calf & Shin~20% Iliotibial band~10% Achilles tendon~8 to 10% Foot & ankle~10 to 15%
25% of running injuries require medical care
75% of those who seek medical care have good to excellent recovery
2 to 3% of running injuries have work absences
65% of runners report they are running pain free after 8 weeks of treatment
Males & females have the same injury rates per hours of training
Males tend to train longer so appear to have more injuries
No direct correlations between Speed training Race speed Running surface or Body weight
Warm Up, Cool Downs & Stretching may not prevent injuries
First time runners had a higher injury rate compared
to those who had trained many years
Location of Injury Marathon runners~knee & foot Middle distance~back & hip Sprinters~hamstrings
Spring & Summer are high injury seasons For example if May was a high mileage month you may have potential break down in June
Total training mileage is an excellent predictor of injury.
More miles you accrue per week, the more time you spend running & the higher the risk of injury
Injury risk is linked with inexperience
runners who have trained less than 3 years were more likely to have an injury
Significantly more injuries occur when training more than 40 miles per week
novice runners have a harder time handling larger increases in training volume
2 best predictors of injury If you have a previous injury, you have a
50% chance of recurrenceimportance of short term care –riceand longer term care related to
strength training and specific program related to return to running
Number of consecutive days of training;by reducing consecutive days of training,
injury rates are lowered
Run Monday through Friday5 consecutive days, 6 miles 5 x 6 = 30
run mon, wed, fri, sat , 2 consecutive days
4 x 7.5 = 30
The key is to develop training strategies which promote healing of injured body parts
Have fewer consecutive days of training
Reduce mileage if problems occur Incorporate running specific
strength and flexibility training Add intensity vs. mileage
Common Injury Sites in Runners
Hip & Thigh Injuries Trochanteric bursitis Hip abductor pain syndrome Iliotibial band syndrome Quad & Hamstring Pulls
Knee Injuries
Patellofemoral Pain Syndrome Meniscal Tears
Leg Injuries
Shin Splints Stress fractures Compartment Syndromes
Ankle Injuries
Ankle Sprains
Achilles Tendonitis
Foot injuries Plantar fasciitis Central heel pain Over pronation-arch pain Supination –stress fractures Metatarsalgias, sesamoidittis, Post tib tendonitis Peroneal tendonitis Subungual hematoma – nail bed bleeds
Treatment of injuries in runners
Acute phase – rice , rom, pain control modalies, swelling control, activity modification, open chain strengthening when indicated
Advance to closed chain strengthening Gradual return to impact –monitor closely Balance – agility drills Sports specific /running specific
progressions.
Avoiding injuries also include importance of proper shoe wear, cross training considerations, specific stretching and strengthening considerations and good running form – gait lab evaluation
Thanks for your time and attention.