Treatment of Lower Extremity Pain in Runners

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Treatment of Lower Extremity Pain in Runners

• Dick Evans PT, OCS
• 10-11-07

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60-65 of all runners are injured in an average
year

• Runners miss approximately 5-10 of their
  scheduled workouts due to injury
• 65 injury rate 10 absent rates could be
  significantly lowered if some simple adjustments
  were made in training schedules
• Possibly decreasing injury rates 25

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Five Anatomical Hot Spots

• Knee-25 to 30endurance runners
• Calf Shin20
• Iliotibial band10
• Achilles tendon8 to 10
• Foot ankle10 to 15

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25 of running injuries require medical care
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75 of those who seek medical care have good to
excellent recovery
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2 to 3 of running injuries have work absences
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65 of runners report they are running pain free
after 8 weeks of treatment
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Males females have the same injury rates per
hours of training

• Males tend to train longer so appear to have more
  injuries
• No direct correlations between
• Speed training
• Race speed
• Running surface or
• Body weight

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Warm Up, Cool Downs Stretching may not prevent
injuries

• First time runners had a higher injury rate
  compared to those who had trained many years

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Location of Injury

• Marathon runnersknee foot
• Middle distanceback hip
• Sprintershamstrings

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Spring Summer are high injury seasons For
example if May was a high mileage month you may
have potential break down in June
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Total training mileage is an excellent predictor
of injury. More miles you accrue per week, the
more time you spend running the higher the
risk of injury
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Injury risk is linked with inexperience runners
who have trained less than 3 years were more
likely to have an injury
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Significantly more injuries occur when training
more than 40 miles per weeknovice runners have
a harder time handling larger increases in
training volume
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2 best predictors of injury

• If you have a previous injury, you have a 50
  chance of recurrence importance of short term
  care rice and longer term care related to
  strength training and specific program related
  to return to running
• Number of consecutive days of training by
  reducing consecutive days of training, injury
  rates are lowered

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Run Monday through Friday5 consecutive days, 6
miles 5 x 6 30 run mon, wed, fri, sat ,
2 consecutive days 4 x 7.5 30
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The key is to develop training strategies which
promote healing of injured body parts

• Have fewer consecutive days of training
• Reduce mileage if problems occur
• Incorporate running specific strength and
  flexibility training
• Add intensity vs. mileage

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Common Injury Sites in Runners

• Hip Thigh Injuries
• Trochanteric bursitis
• Hip abductor pain syndrome
• Iliotibial band syndrome
• Quad Hamstring Pulls

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Knee Injuries

• Patellofemoral Pain Syndrome
• Meniscal Tears

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Leg Injuries

• Shin Splints
• Stress fractures
• Compartment Syndromes

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Ankle Injuries

• Ankle Sprains
• Achilles Tendonitis

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Foot injuries

• Plantar fasciitis
• Central heel pain
• Over pronation-arch pain
• Supination stress fractures
• Metatarsalgias, sesamoidittis,
• Post tib tendonitis
• Peroneal tendonitis
• Subungual hematoma nail bed bleeds

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Treatment of injuries in runners

• Acute phase rice , rom, pain control modalies,
  swelling control, activity modification, open
  chain strengthening when indicated
• Advance to closed chain strengthening
• Gradual return to impact monitor closely
• Balance agility drills
• Sports specific /running specific progressions.

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Avoiding injuries also include importance of
proper shoe wear, cross training considerations,
specific stretching and strengthening
considerations and good running form gait lab
evaluation
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Thanks for your time and attention.
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