46
Return to Sport: Running Injuries in Student-Athletes: Summary
COMMON RUNNING-RELATED INJURIES Anatomy
Incidence/Symptoms Risk Factors
Intervention
Return to Sport
Patellofemoral Pain Syndrome (PFPS)
• About 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 • “Shin splints” • Diffuse pain at posteromedial tibia with activity • Tenderness along posteromedial tibia • Weakness in tibialis posterior, soleus, flexor digitorum longus
• 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 • Training errors • Contralateral pelvic drop • Increased ground contact time (slow cadence) • Prolonged rearfoot eversion • Hip abduction weakness/evertor dominance • Increased BMI • Training errors • Contralateral pelvic drop • Increased ground contact time (slow cadence) • Rapid or excessive pronation • Increased BMI
• 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
Medial Tibial Stress Syndrome
• Hip strengthening • Foot strengthening (control eversion) • Footwear • Stretching gastrocnemius • Gait retraining** (increase cadence)
• 30% recover in 1 month
Achilles Tendinopathy
• Progressive Achilles pain/stiffness • Swelling/thickening at Achilles • Excessive pronation • Reduced dorsiflexion
• Hip strengthening • Intrinsic foot
strengthening • Cross training • Footwear—heel lift (limited evidence, avoid minimalist shoes • Gait retraining** (reduce forefoot strike, increase cadence)
• Weak/painful plantarflexion
• + arc sign or + Royal London Hospital test
Powered by FlippingBook