Please enable JavaScript.

Coggle requires JavaScript to display documents.

Running Injury Management (Load and Injury (Internal Forces (Tendon Forces…

- - - - Tibial Stress #
      - MTSS
      - Achilles tendinopathy
      - Plantar fasciitis
        
        Local pain at insertion of plantar fascia on calcaneus. Collagen breakdown, fibrocyte breakdown, matrix degradation, vascular ingrowth
        
        Progressive loading program. 3x12 every second day for 12 weeks. Improvement in pain and function
    - - Patellofemoral syndrome
      - Patella tendinopathy
      - ITBS
  - - - Muscle activation changes
        
        Reduced patellofemoral joint forces
        
        Improved hip and knee kinematics
        
        Decrease vertical GRF
        
        Decrease in heel to COM distance
        
        Reduced lower extremity loading
        
        Reduced knee and hip joint loading
      - Increase in step rate - 10%
      - Decrease in stride length
      - Change in foot strike – heel to mid foot
      - Decreased COM vertical oscillation
      - Reduced knee and hip joint loading
- - - - Insertional at greater trochanter.Tendons of glute med and min and associated bursa. Avoid positions with greater ranges of hip flexion and adduction - increases tension on ITB and increases compression
      - Running - reduced step width, increased hip adduction style
      - Management - Training modifications, reduce volume, hills and speed. Gait re-education.
      - Progressive loading - Bridging, single leg bridge, side laying hip abduction, crab walks, step ups, side planks, single leg squat
      - Muscle Pain
        
        Due to muscle overload. Potential causes: fatigue, training factors, increase in volume, intensity, frequency, change in terrain, associated with previous injury.
        
        Mostly affects - calfs, hamstrings, glutes. ?associated with bio-mechanics
        
        Patellofemoral Pain
        
        Anterior knee pain, patellofemoral pain syndrome, patella maltracking.
        
        Associated with changes in volume
        
        Biomechanical factors: Greater hip add during stance in female runners who developed PFP. Greater hip add and IR during stance in females with PFP. Greater pelvic obliquity in males with PFP. Delayed onset and shorter activation of glute med during running in female runners with PFP
        
        Proximal rehab (hip and trunk) -> Local trunk (strengthen knee) ->Movement control/ Plyometrics (restore control of single leg balance and loading tasks-> Performance (progressive plyometrics to restore power to hip and knee
        
        Illiotibial Band Syndrome (ITBS)
        
        Lateral knee pain. Dense connective tissue - unlikely to stretch. Provides insertion to glute max and TFL. Inflammation is primary concern.
        
        Associated with changes in training. Biomechanical factors: greater knee add and IR in males. Increased hip add and knee IR in stance in females. Hip drop, increase hip add and increased knee flex during stance.
        
        Flexibility - Reduced Obers test. Strengths: Weak hip ex rot. Weak hip abductors
        
        Acute Management: Reduce inflammation, NSAIDS, Ice, Rest/ relative rest- consider reducing activities with repetitive knee flex/ext.
        
        Sub Acute phase: Regain flexibility of ITB, STM and stretching of glute max and TFL, also consider VL and hamstring (attachments to ITB)
        
        Bone Stress injuries
        
        Half of BSIs occur in tibial diaphysis: majority of others: Femur, Fibular, Calcaneus, metatarsals.
        
        Bio-mechanical: Higher GRF magnitudes and rates, greater peak acceleration, greater peak adduction, knee internal rot and peak rearfoot eversion.
        
        Influenced by training factors and weak fatigued muscles or altered activation patterns
        
        Phase 1: activity modification, painless during ADLs, identification and initial management of potential risk factors, maintenance of physical condition. Phase 2: Graduated return to running, painfree walk, strat a jog/walk, progress gradually - determined by no immediate or latent symptoms, gait re-education, education training factors.