Transcript Treatment of Lower Extremity Pain in Runners

Treatment of Lower Extremity
Pain in Runners
Dick Evans PT, OCS
10-11-07
60-65% of all runners are
injured in an average year
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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
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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
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Males tend to train longer so appear to
have more injuries
No direct correlations between
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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
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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
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If you have a previous injury, you have a
50% chance of recurrence
importance of short term care –rice
and 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 Friday
5 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
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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
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Hip & Thigh Injuries
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Trochanteric bursitis
Hip abductor pain syndrome
Iliotibial band syndrome
Quad & Hamstring Pulls
Knee Injuries
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Patellofemoral Pain Syndrome
Meniscal Tears
Leg Injuries
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Shin Splints
Stress fractures
Compartment Syndromes
Ankle Injuries
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Ankle Sprains
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Achilles Tendonitis
Foot injuries
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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
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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.