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Return to Sport: Running Injuries in Student-Athletes: Summary
COMMON RUNNING-RELATED INJURIES Anatomy
Incidence/Symptoms Risk Factors
Intervention
Return to Sport
Iliotibial Band Syndrome (ITB)
• Due to friction of the ITB shifting over lateral femoral condyle • Lateral knee pain • + Noble compression test • Poor flexibility in ITB and hip flexors • Plantar pain when first standing • Improves with movement but worsens with prolonged weight bearing • Tender at proximal attachment • Osgood Schlatter— tibial tubercle tenderness • Sinding–Larsen– Johansson syndrome— inferior pole of patella tenderness • Bilateral 25% of the time • More common in track athletes • Hamstring strain most common in sprinters • Palpable fibrosis • + Windlass test
• Crossover running • Contralateral pelvic drop • Reduced knee flexion at initial contact • Excessive eversion
• Relative rest—avoid stairs, cycling • Hip/core strengthening • Stretching ITB
• Gait retraining** reduce transverse plane movement
Plantar Fasciopathy
• Training errors (too much, too fast)
• Foot intrinsic strengthening (toe yoga, doming) • Soft tissue mobilization • Stretching gastrocnemius, hamstrings, plantar fascia • Gait retraining** (increase cadence, soft landing) • Taping • Heel cup or lift (limited evidence) • Activity modification • Improve flexibility of quads • Strengthening of hips/ quads • Correct gait mechanics • Dynamic warm up prior to activity • Strengthening glutes/ hamstrings (deadlifts, kettlebell swings, front/ back squat, Nordic hamstring curls, ADD plank)
Apophysitis
• During time of a growth spurt • Youth 10–14 years old
• Self limiting, can continue with sport
Strains (Hamstring)
• Muscle weakness (hamstrings, glutes, core) • Ineffective warm up • Poor conditioning • Lack of rest • Overuse
• Pain free walking, jumping • Full ROM
• Strength 80% of uninvolved side
RRI—running-related injuries; RTS—return to sport * Best evidence ** Gait retraining is the use of visual, verbal, or auditory cues to change running for
REHABILITATION AND PREVENTION
8–10 months per year to promote safety and reduce risk of injury. One day per week should consist of a rest day where there is no running in addition to having variability in running volume and intensity (hill running, speed training) throughout the week. It can be helpful to only change one variable per week (mileage, speed, or intensity) to reduce risk of over stressing the body.
Reduce Training Errors In young athletes, it is important to discourage sports specialization and encourage multidirectional sport participation to improve bone health and reduce risk of injuries. Running, specifically, should be limited to
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