Running Injuries

Question 1

how many foot strikes are there per mile?

Answer 1

1k - 1.7k

Question 2

what % of runners sustain an injury within a 1yr period?

Answer 2

70%

Question 3

what are the most common running injuries?

Answer 3

• patellar pain syndrome
• tibial stress syndrome
• achilles tendonitis
• plantar fasciitis
• ITB syndrome

Question 4

what is the most common site of LE injuries in runners?

Answer 4

• knee (7.2 - 50%)
• foot (5.7-39.3%)
• thigh (3.4-38.1%)
• lower leg (9.0-32.2%)

Question 5

what is the most common site of chronic running injury?

Answer 5

anterior knee pain // extensor mechanism of the knee

Question 6

what does the extensor mechanism of the knee do at IC?

Answer 6

absorbs 42% of energy
is up to 5x higher during running vs walking
places much greater stress on quads muscles/tendons and patellar ligament

Question 7

difference between Osgood-Schlatter’s and Sinding-Larsen-Johansson?

Answer 7

OGS: pain at tibial tuberosity
SLJ: pain at inferior pole of patella

Question 8

why is PFJP (patellofemoral joint pain) increased in female runners?

Answer 8

• increased hip width
• increased hip adduction
• increased femoral IR coupled w/ Add
• increased Q angle and TF valgus

Question 9

what does a medial heel whip look like?

Answer 9

• heel is pointed medially at toe off

Question 10

what does a lateral heel whip look like?

Answer 10

heel is pointed laterally at toe off

Question 11

what are causes of a medial heel whip?

Answer 11

• weak hip IRs
• tight hip ERs
• tight ITBs
• lacking DF to clear toes
• hamstring imbalance (weaker medial vs lateral)
• improper footwear

Question 12

what are causes of a lateral heel whip?

Answer 12

• weak hip ERs
• tight hip IRs
• tight add. magnus
• hamstring imbalance (weaker lateral vs medial)
• weak hip ext / lacking hip ext. ROM

Question 13

characteristics of a flat foot (pes planus)?

Answer 13

• tend to have foot hypermobility
• predisposed to over-pronation
• foot remainds pronated, unstable during toe off
• center of weight shifted to medial portion of foot
• ***increased medial foot, leg, and knee stress from excessive internal tibial rotation

Question 14

what is a flat foot more at risk for injury wise?

Answer 14

foot absorbs greater stress
- post. tib. tendonitis
- anterior knee pain
- shin splints
- achilles tendonitis
- metatarsal stress fx

Question 15

characteristics of a high-arch foot (pes cavus)?

Answer 15

• tend to have reduced forfoot mobility
• predisposed to under-pronation
• foot remainds in supinated, rigid, position during pronation phase
• center of weight remainds on lateral portion of foot
• reduced shock absorption

Question 16

what is a high-arch foot more at risk for injury wise?

Answer 16

foot may be more rigid
- tibial (shin) stress fx
- lateral hip, knee, and/or ankle pain
- ITB syndrome
- 5th metatarsal stress fx

Question 17

what causes ITB syndrome?

Answer 17

friction between ITB and lateral femoral condyle

Question 18

how does ITB syndrome present?

Answer 18

tenderness in region of distal ITB

Question 19

what does the ITB do in activity?

Answer 19

grf produces external varus movement, so ITB stabilizes knee against this w TFL/glut med and generates internal valgus movement to maintain upright position

Question 20

when is there peak valgus moment from the ITB in running?

Answer 20

peak valgus moment is 2.5x greater and when knee is at point of max stance-phase flexion (45°)

Question 21

what is the presenting symptom for achilles tendinopathy?

Answer 21

pain/tenderness along course of tendon

Question 22

what is the range of peak forces in the achilles tendon during MSt?

Answer 22

6-8x BW

Question 23

what causes achilles tendon injuries?

Answer 23

active muscle forces that occur during MSt rather than impact forces that occur at IC

Question 24

what is the most common presenting symptom of plantar fasciitis?

Answer 24

pain, especially on rising in morning
tenderness along course of plantar fascia or at origin on medial aspect of calcaneal tuberosity

Question 25

when is stress highest in plantar fascia?

Answer 25

can be as high as 3.5x BW during MSt when most of WB forces transferred from hindfoot to met heads

Question 26

what predisposes someone to increase risk of plantar fasciitis / stress or injury?

Answer 26

excessive pronation, which increases traction along medial plantar fascia

Question 27

what are some causative factors in running injuries?

Answer 27

- high mileage - previous running injury - change in running surface - sudden change in distance - foot type - biomechanics - type and age of running shoes

Question 28

what are some prevention factors in running injuries?

Answer 28

- surface - frequency - mileage modulation - speed work - shoes/orthotics

Question 29

how do orthotics help someone?

Answer 29

- reduce frequency of movement related disorders - correct skeletal alignment - increase cushioning - increase comfort