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Return to Sport: Running Injuries in Student-Athletes: Summary
TABLE 4: RUNNING READINESS SCALE • Vertical jump (160 beats/minute) • Prone forearm plank • 6 inch step up (switch legs halfway, 80 beats/minute) • Single leg squat (to 45 degrees knee flexion; switch legs halfway) • Wall sit (90-90 position) Instructions : 1 minute per test, 30 second rest between Scoring : 1 point for each test completed correctly. </=3 higher risk of injury
RUNNING ANALYSIS Posterior View
Lateral View
• Base of support • Foot position (neutral, inverted, everted) • Knee angle (valgus/varus) • Knee window (space between knees) • Pelvic alignment • Trunk motion in frontal plane • Arm swing (cross over vs. in line with body)
• Foot strike at initial contact • Stride length/distance foot is in front of torso at initial contact • Knee angles throughout gait cycle • Trunk position • Vertical displacement
COMMON RUNNING-RELATED INJURIES Anatomy
Incidence/Symptoms Risk Factors
Intervention
Return to Sport
Patellofemoral Pain Syndrome (PFPS)
• ~40% of RRI • Vague anterior knee pain • Worse with sitting, running, after running • Due to overuse, weakness, motor control deficits, or mobility impairments • 20% of collegiate track and field athletes • Mild diffuse ache after specific time of running, at specific time in gait cycle • Pain does not “warm up” • Progresses to localized pain at rest • Localized bony tenderness • Femur: + fulcrum test
• Lack of forward trunk lean • Knee valgus • Contralateral pelvic drop • Tightness in gastrocnemius, quadriceps, hamstrings, or IT band • Prior BSI* • Menstrual changes* • Training errors* • Excessive rear foot eversion • Excessive hip adduction • Excessive dorsiflexion at initial contact (> 5 degrees) • High vertical loading • Downhill running
• Hip and knee strengthening* • Neuromuscular education/gait retraining • Improve flexibility/ mobility • Address training errors • Improve nutrition • Activity modification • Address strength/ neuromuscular control deficits • Optimize cadence (150–180 steps/minute) • Encourage midfoot strike High Risk BSI • Non weight bearing 6 weeks • More gradual return to running
Bone Stress Injury (BSI)
Low Risk BSI • 12–13 weeks High Risk BSI • Non WB x 6 weeks • 12–17 weeks Initiate running after can walk >30 minutes pain free x2 weeks
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