Common Running Injuries

Patellofemoral pain

Knee injuries are most common for runners

Patellofemoral pain

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• 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• 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• 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• 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

– 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)– Taping, orthoses or motion control shoe

• 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