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- 1. RUNNING INJURIES: PREVENTION & TREATMENT By John Parr, PT, OCS, CMPT Therapeutic Associates Gresham Physical Therapy
- 2. COMMON INJURIES • Runner’s Knee • Plantar Fasciitis • Achillies Tendonitis • Shin Splints • Illiotibial Band Syndrome • Stress Fracture • Patellar Tendonitis • Ankle Sprain • Muscle Pulls • Low Back Pain • Blisters/Chaffing
- 3. • Pain behind the kneecap (patellofemoral syndrome) • Causal Factors • Overtraining • Downhill • Muscle imbalances (Weak hips) • First Steps • Cut your mileage & avoid hills • Ice & anti-inflammatories • Go to physical therapy • Treatment • Bracing or taping • Assessment of strength/flexibility • Hip strengthening & balance training RUNNER’S KNEE
- 4. • Pain in the Achilles Tendon • Causal Factors • Rapid mileage increase • Flat feet or improper footwear • Muscle imbalances (tight calves) • First Steps • Cut your mileage & avoid hills • Ice & anti-inflammatories • Stretch calves daily and after each run • New running shoes (proper fit) • PT if no resolution in 2 - 3 weeks • Treatment • Manual therapy (ASTYM) to calf muscles • Heel lifts, bracing or taping • Eccentric strength training ACHILLES TENDONITIS
- 5. PLANTAR FASCIITIS • Heel and/or arch pain • Usually worse in the morning, can last 9 – 12 months • Causal Factors • Overtraining • Poor footwear • Lack of flexibility • First Steps • Avoid Running for 2 weeks • Ice & anti-inflammatories • Roll tennis ball on bottom of foot daily • Get new shoes with extra cushioning • Treatment • Physical Therapy • Bracing or taping • Assessment of strength/flexibility • Manual Therapy (ASTYM) • Iontophoresis/Phonophoresis • Night Splint / Walking Boot • Injections • Surgery PLANTAR FASCIITIS
- 6. • Pain in lower leg • Front (tibilalis anterior) • Back (tibialis posterior) • Causal Factors • Improper footwear • Muscle imbalances • First Steps • Cut your mileage • Ice & anti-inflammatories • New shoes and/or cushioned insoles • Treatment • Physical Therapy • Bracing or taping • Assessment of strength/flexibility • Manual Therapy (ASTYM) SHIN SPLINTS
- 7. • Pain on the outside of the knee • Causal Factors • Increased mileage • Downhill running • Muscle imbalances (Weak hips) • First Steps • Cut your mileage & avoid hills • Ice & anti-inflammatories • Foam rolling IT band • Treatment • Physical Therapy • Bracing or taping • Assessment of strength/flexibility • Hip strengthening, specific stretching & balance training IT BAND SYNDROME
- 8. • Pain in foot, ankle or lower leg or thigh • Causal Factors • Overtraining • First Steps • See doctor or PT • May need x-rays • Stop running! • Crutches and/or boot • Cross training • Physical Therapy • Treatment • Address strength/flexibility/balance • Gradual return to weight bearing • Gradual return to running STRESS FRACTURE
- 9. • Pain just below the kneecap • Causal Factors • Overtraining • Overpronation • Too many hills • First Steps • Cut your mileage & avoid hills • Ice & anti-inflammatories • Strengthen hamstrings & quads • Treatment • Bracing or taping • Assessment of strength/flexibility • Hip strengthening & balance training PATELLAR TEDNONITIS
- 10. ANKLE SPRAINS • Ankle ligaments overstretched (rolling) • Causal Factors • Bad luck • Poor balance • Previous sprains • First Steps • Rest, Ice, Compression Elevation (RICE) • Treatment • Physical Therapy • Primary goal is to prevent the next sprain • Bracing or taping • Improve Strength • Balance / Proprioceptive training ANKLE SPRAINS
- 11. • Hamstrings, Quads, Calves, Hip Flexors • Causal Factors • Poor strength and/or flexibility • Lack of warm-up • First Steps • RICE • Treatment • PT is symptoms fail to resolve in 2 weeks • Manual Therapy • Assessment/Treatment of muscle imbalances • Gradual return to activity MUSCLE PULLS
- 12. • Pain in lumbar spine • Causal Factors • Facet, disc or muscle strain • Poor core stability • First Steps • Physical Therapy • MD if associated with leg symptoms • Treatment • Manual Therapy (manipulation) • Stretching & core strengthening • Proper body mechanics LOW BACK PAIN
- 13. • Blisters • Long runs • Improper footwear • No socks • Prevention: good socks & footwear • First Aid: band-aids, moleskin, gel • Chaffing • Long runs • Prevention: vaseline, body glide and/or tape • First Aid: lotion & rest BLISTERS/CHAFFING
- 14. • Mileage – no more than 10% increase per week • Rest – mix in rest days and/or cross training • Get fit by an expert…go to a running specialty store • Replace shoes after 600 miles • Change shoes (alternate), especially if they get wet • Add in strength training • Listen to your body PREVENTION IS YOUR BEST CURE!
- 15. • 3 x 30 daily AFTER running • Hamstrings • Quads • Hip Flexors • Glutes • Calves • Groin STRETCH
- 16. • 1 – 3 times a week, 3 sets of 8 - 15 • Leg Press or Squats • Calf Press • Leg Extensions • Hamstring Curls • Abduction • Hip Extension STRENGTH
- 17. • 3 – 7 minutes • No static stretching • Repeated active movements • Warm up muscles and elevate body temperature • All planes of movement • Front to back • Side to side • Twisting DYNAMIC WARM-UP
- 18. • Annual Prevention Visit • Health History Review • Full body assessment for Flexibility / Strength • Video analysis of running form • Personalized home exercise program • Personalized training recommendations • Prevent muscle imbalances & injuries BEFORE they happen! USE YOUR PHYSICAL THERAPIST FOR PREVENTION
- 19. • Questions? John Parr, PT, OCS, CMPT Therapeutic Associates 283 NW Miller Gresham, OR 97030 (503) 666-7644 jparr@taipt.com THANK YOU!