BOOK
Running Injuries, An Issue of Physical Medicine and Rehabilitation Clinics of North America, E-Book
Michael Fredericson | Adam Tenforde
(2016)
Additional Information
Book Details
Abstract
Physical medicine and rehabilitation (PM&R) physicians across the country see injured runners every day. Running injuries may impact other areas of the body and PM&R physicians are trained to treat the body as a whole, as opposed to treating just the injury, they work to identify the true source of the problem and develop a training or rehabilitation program to solve it.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Running Injuries\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITORS | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Foreword: Supporting a Running Lifestyle\r | vii | ||
| Preface: Running Injuries\r | vii | ||
| Evaluation and Management of Hip and Pelvis Injuries\r | vii | ||
| Patellofemoral Pain\r | vii | ||
| Iliotibial Band Syndrome in Runners: Biomechanical Implications and Exercise Interventions\r | vii | ||
| Running Injuries: The Infrapatellar Fat Pad and Plica Injuries\r | vii | ||
| Exertional Leg Pain\r | viii | ||
| Foot and Ankle Injuries in Runners\r | viii | ||
| Bone Stress Injuries in Runners\r | viii | ||
| Health Considerations in Female Runners\r | viii | ||
| Running Injuries During Adolescence and Childhood\r | ix | ||
| Injuries and Health Considerations in Ultramarathon Runners\r | ix | ||
| An Evidence-Based Videotaped Running Biomechanics Analysis\r | ix | ||
| Malalignment Syndrome in Runners\r | ix | ||
| Core and Lumbopelvic Stabilization in Runners\r | x | ||
| Gait Retraining: Altering the Fingerprint of Gait\r | x | ||
| PHYSICAL MEDICINEANDREHABILITATION\rCLINICS OF NORTH AMERICA\r | xi | ||
| FORTHCOMING ISSUES | xi | ||
| May 2016 | xi | ||
| August 2016 | xi | ||
| November 2016 | xi | ||
| RECENT ISSUES | xi | ||
| November 2015 | xi | ||
| August 2015 | xi | ||
| May 2015 | xi | ||
| Foreword: Supporting a Running Lifestyle \r | xiii | ||
| Preface: Running Injuries | xv | ||
| Evaluation and Management of Hip and Pelvis Injuries | 1 | ||
| Key points | 1 | ||
| INTRODUCTION | 1 | ||
| INJURIES | 2 | ||
| Proximal Hamstring Tendinopathy | 2 | ||
| Presentation | 2 | ||
| Management | 4 | ||
| Greater Trochanteric Pain Syndrome | 9 | ||
| Presentation | 10 | ||
| Management | 11 | ||
| Piriformis Syndrome | 11 | ||
| Presentation | 13 | ||
| Management | 14 | ||
| Iliopsoas Syndrome | 14 | ||
| Patellofemoral Pain | 31 | ||
| Key points | 31 | ||
| INTRODUCTION | 31 | ||
| DISCUSSION | 31 | ||
| Epidemiology | 31 | ||
| Cause of Patellofemoral Pain | 32 | ||
| Risk Factors | 32 | ||
| Local joint impairments | 33 | ||
| Quadriceps muscle weakness | 33 | ||
| Delayed vastus medialis activation | 33 | ||
| Soft tissue inflexibility | 34 | ||
| Deficits in lower extremity biomechanics | 34 | ||
| Hip weakness | 34 | ||
| Foot pronation | 35 | ||
| Gait aberrations | 35 | ||
| Training errors | 35 | ||
| Other considerations: generalized laxity | 36 | ||
| Diagnosis | 36 | ||
| History | 36 | ||
| Physical examination | 36 | ||
| Imaging | 40 | ||
| Management | 41 | ||
| Quadriceps strengthening | 41 | ||
| Electromyography biofeedback | 42 | ||
| Taping | 42 | ||
| Bracing | 43 | ||
| Stretching/flexibility | 43 | ||
| Hip strengthening | 43 | ||
| Foot orthoses | 44 | ||
| Gait retraining | 44 | ||
| Correcting training errors | 45 | ||
| SUMMARY | 45 | ||
| REFERENCES | 45 | ||
| Iliotibial Band Syndrome in Runners | 53 | ||
| Key points | 53 | ||
| INTRODUCTION | 53 | ||
| ANATOMY | 55 | ||
| KINEMATIC AND MUSCLE PERFORMANCE FACTORS | 58 | ||
| TREATMENT STRATEGY AND PRACTICE | 62 | ||
| Phases of Recovery in Iliotibial Band Syndrome | 62 | ||
| Orientation to gait and kinematics in iliotibial band syndrome in comparison with patellofemoral pain syndrome | 62 | ||
| Acute phase of iliotibial band syndrome | 62 | ||
| The subacute phase | 65 | ||
| The recovery strengthening phase | 66 | ||
| The return to running phase | 69 | ||
| CASE EXAMPLE USING RUNNING TECHNIQUE RETRAINING | 71 | ||
| SUMMARY | 74 | ||
| REFERENCES | 74 | ||
| Running Injuries | 79 | ||
| Key points | 79 | ||
| INTRODUCTION | 79 | ||
| ANATOMY | 80 | ||
| VASCULARIZATION | 81 | ||
| INNERVATION | 81 | ||
| BIOMECHANICS | 82 | ||
| Clinical Features | 82 | ||
| Treatment | 83 | ||
| MUSCLE TRAINING | 84 | ||
| Injections | 86 | ||
| Operative Treatment | 86 | ||
| SUMMARY | 87 | ||
| REFERENCES | 87 | ||
| Exertional Leg Pain | 91 | ||
| Key points | 91 | ||
| INTRODUCTION | 91 | ||
| MEDIAL TIBIAL STRESS SYNDROME | 92 | ||
| History and Physical Examination | 92 | ||
| Diagnostic Evaluation | 93 | ||
| Management | 95 | ||
| TIBIAL BONE STRESS INJURY | 96 | ||
| History and Physical Examination | 97 | ||
| Diagnostic Evaluation | 97 | ||
| Management | 97 | ||
| CHRONIC EXERTIONAL COMPARTMENT SYNDROME | 99 | ||
| History and Physical Examination | 99 | ||
| Diagnostic Evaluation | 101 | ||
| Management | 102 | ||
| EXTERNAL ILIAC ARTERY ENDOFIBROSIS | 103 | ||
| History and Physical Examination | 103 | ||
| Diagnostic Evaluation | 104 | ||
| Management | 105 | ||
| POPLITEAL ARTERY ENTRAPMENT SYNDROME | 105 | ||
| History and Physical Examination | 106 | ||
| Diagnostic Evaluation | 109 | ||
| Management | 109 | ||
| LOWER EXTREMITY NERVE ENTRAPMENT | 110 | ||
| History and Physical Examination | 111 | ||
| Diagnostic Evaluation | 112 | ||
| Management | 113 | ||
| SUMMARY | 115 | ||
| REFERENCES | 115 | ||
| Foot and Ankle Injuries in Runners | 121 | ||
| Key points | 121 | ||
| INTRODUCTION | 121 | ||
| ACHILLES TENDINOPATHY | 122 | ||
| Clinical Evaluation | 122 | ||
| Differential Diagnosis | 123 | ||
| Management | 123 | ||
| PLANTAR FASCIOPATHY | 124 | ||
| Clinical Evaluation | 124 | ||
| Differential Diagnosis | 125 | ||
| Management | 125 | ||
| ANKLE SPRAINS | 126 | ||
| Clinical Evaluation | 126 | ||
| Differential Diagnosis | 127 | ||
| Management | 127 | ||
| BONE STRESS INJURIES | 127 | ||
| Clinical Evaluation | 127 | ||
| Differential Diagnosis | 128 | ||
| Management | 128 | ||
| POSTERIOR TIBIAL TENDON DYSFUNCTION | 128 | ||
| Clinical Evaluation | 129 | ||
| Differential Diagnosis | 129 | ||
| Management | 129 | ||
| PERONEAL TENDINOPATHY | 130 | ||
| Clinical Evaluation | 130 | ||
| Differential Diagnosis | 131 | ||
| Management | 131 | ||
| OTHER TENDINOPATHIES | 131 | ||
| Flexor Hallucis Longus Tendinopathy | 131 | ||
| Anterior Tibial Tendinopathy | 131 | ||
| JOINT PATHOLOGIES | 131 | ||
| Osteochondral Lesions | 132 | ||
| NERVE CONDITIONS | 132 | ||
| INJURY PREVENTION AND MANAGEMENT | 133 | ||
| SUMMARY | 133 | ||
| REFERENCES | 133 | ||
| Bone Stress Injuries in Runners | 139 | ||
| Key points | 139 | ||
| INTRODUCTION | 139 | ||
| SUMMARY/DISCUSSION | 140 | ||
| Incidence and Distribution | 140 | ||
| RISK FACTORS | 140 | ||
| EVALUATION | 141 | ||
| Clinical Evaluation | 141 | ||
| Sacral/pelvic location | 141 | ||
| Femoral neck | 141 | ||
| Lesser trochanter | 141 | ||
| Femoral shaft | 141 | ||
| Calcaneus | 142 | ||
| ANATOMY AND IMAGING | 142 | ||
| MANAGEMENT | 142 | ||
| Activity Modification and Aerobic Activity | 142 | ||
| Ensure Adequate Intake of Calcium and Vitamin D | 142 | ||
| Female Runners: Screening and Management of the Triad | 143 | ||
| Evaluation of Bone Health in Male Runners | 143 | ||
| RECOMMENDATIONS BY ANATOMIC SITE | 144 | ||
| HIGH-RISK LOCATIONS | 144 | ||
| Femoral Neck and Lesser Trochanter | 144 | ||
| Anterior Tibial Cortex | 144 | ||
| Medial Malleolus | 144 | ||
| Base of Second Metatarsal | 144 | ||
| Fifth Metatarsal Diaphysis Fractures | 145 | ||
| Tarsal Navicular | 145 | ||
| Sesamoids | 145 | ||
| MODERATE RISK | 145 | ||
| Sacrum and Pelvis | 145 | ||
| Tarsals Cuboid and Cuneiform | 145 | ||
| Femoral Shaft | 145 | ||
| LOW RISK | 145 | ||
| Tibia | 145 | ||
| Fibula | 146 | ||
| Calcaneus | 146 | ||
| Metatarsals | 146 | ||
| PREVENTION | 146 | ||
| Participation in Ball Sports During Adolescence | 146 | ||
| Adequate Calcium and Vitamin D Intake | 146 | ||
| Preparticipation Physical Examination Screening | 146 | ||
| SUMMARY | 147 | ||
| REFERENCES | 147 | ||
| Health Considerations in Female Runners | 151 | ||
| Key points | 151 | ||
| INTRODUCTION | 151 | ||
| GROWTH AND DEVELOPMENT | 152 | ||
| Menarche | 152 | ||
| Adolescent Growth Spurt | 153 | ||
| Changes in Body Composition | 153 | ||
| Skeletal Maturity | 153 | ||
| Strength and Performance Measures | 153 | ||
| Preadolescence and Adolescence: A Vulnerable Period | 154 | ||
| NUTRITIONAL CONSIDERATIONS | 154 | ||
| Patterns of Intake in Female Runners | 154 | ||
| Defining Low Energy Availability | 155 | ||
| Intentional Versus Unintentional Underfueling | 155 | ||
| Performance Considerations | 156 | ||
| Micronutrient Intake | 156 | ||
| Iron | 156 | ||
| Calcium | 157 | ||
| Vitamin D | 158 | ||
| THE FEMALE ATHLETE TRIAD | 158 | ||
| Energy Availability | 158 | ||
| Menstrual Status | 159 | ||
| Effects on Bone | 159 | ||
| Relationship to Stress Fractures | 160 | ||
| Screening | 160 | ||
| Treatment | 161 | ||
| Consideration of Pharmacologic Treatment of Triad-related Medical Conditions | 162 | ||
| Clearance/Return to Running Considerations | 165 | ||
| IRON DEFICIENCY WITH AND WITHOUT ANEMIA | 165 | ||
| PREGNANCY | 165 | ||
| SUMMARY | 167 | ||
| REFERENCES | 167 | ||
| Running Injuries During Adolescence and Childhood | 179 | ||
| Key points | 179 | ||
| INTRODUCTION | 179 | ||
| EPIDEMIOLOGY | 180 | ||
| UNIQUE CONSIDERATIONS FOR THE GROWING ATHLETE | 180 | ||
| Bone Mineral Content | 181 | ||
| Endocrine | 181 | ||
| Peak Height Velocity | 181 | ||
| COMMON RUNNING INJURIES | 182 | ||
| Apophyseal Injuries | 182 | ||
| Lower Extremity Tendon Injuries | 183 | ||
| Bone | 183 | ||
| Medial tibial stress syndrome and stress fracture | 183 | ||
| Osteochondritis dissecans | 189 | ||
| TREATMENT | 190 | ||
| PREVENTION | 194 | ||
| SUMMARY | 196 | ||
| REFERENCES | 196 | ||
| Injuries and Health Considerations in Ultramarathon Runners | 203 | ||
| Key points | 203 | ||
| INTRODUCTION | 203 | ||
| CHARACTERISTICS OF ULTRAMARATHON RUNNERS | 204 | ||
| INJURIES IN ULTRAMARATHON RUNNERS | 205 | ||
| PREPARTICIPATION SCREENING FOR ULTRAMARATHONS | 207 | ||
| MEDICAL ISSUES DURING ULTRAMARATHONS | 208 | ||
| Blisters | 208 | ||
| Gastrointestinal Distress | 208 | ||
| Exercise-Associated Hyponatremia | 209 | ||
| Dehydration | 210 | ||
| Vision Impairment | 211 | ||
| POTENTIAL LONG-TERM HEALTH ISSUES | 211 | ||
| SUMMARY | 212 | ||
| REFERENCES | 212 | ||
| An Evidence-Based Videotaped Running Biomechanics Analysis | 217 | ||
| Key points | 217 | ||
| INTRODUCTION | 217 | ||
| ANALYSIS SETUP | 218 | ||
| Treadmill Setup | 218 | ||
| Cameras | 218 | ||
| Views | 219 | ||
| Markers | 219 | ||
| Warmup and Analysis Plan | 219 | ||
| Phases | 220 | ||
| SIDE VIEW | 220 | ||
| Foot Strike Pattern | 220 | ||
| Foot Inclination Angle at Initial Contact | 221 | ||
| Tibia Angle at Loading Response | 222 | ||
| Knee Flexion During Stance | 222 | ||
| Hip Extension During Late Stance | 222 | ||
| Trunk Lean | 224 | ||
| Overstriding | 225 | ||
| Vertical Displacement of the Center of Mass | 226 | ||
| Additional Variables | 227 | ||
| Auditory | 227 | ||
| Shaking of the treadmill | 227 | ||
| Cadence | 227 | ||
| POSTERIOR VIEW | 227 | ||
| Base of Support | 227 | ||
| Heel Eversion | 228 | ||
| Foot Progression Angle | 228 | ||
| Heel Whips | 229 | ||
| Knee Window | 230 | ||
| Pelvic Drop | 231 | ||
| SUMMARY | 232 | ||
| ACKNOWLEDGMENT | 233 | ||
| REFERENCES | 233 | ||
| Malalignment Syndrome in Runners | 237 | ||
| Key points | 237 | ||
| INTRODUCTION | 237 | ||
| THE PELVIC RING: NORMAL AND ABNORMAL MOBILITY AND FUNCTION | 238 | ||
| ASSESSING PELVIC MALALIGNMENT | 240 | ||
| PRESENTATIONS WITH THE PELVIS ALIGNED | 243 | ||
| Pelvis Aligned, Legs Length Equal | 244 | ||
| Pelvis Aligned, Right Anatomic (True) Leg Length Difference Present | 244 | ||
| COMMON PRESENTATIONS OF PELVIC MALALIGNMENT | 246 | ||
| OUTFLARE AND INFLARE | 246 | ||
| Examination Findings | 246 | ||
| Diagnosis and Corrective Procedures: Right Outflare, Left Inflare | 248 | ||
| Clinical Correlation for Runners | 250 | ||
| ROTATIONAL MALALIGNMENT | 251 | ||
| Examination Findings | 251 | ||
| Diagnosing Rotational Malalignment | 253 | ||
| Corrective Procedures for Rotational Malalignment | 256 | ||
| Clinical Correlation for Runners | 258 | ||
| UPSLIP | 259 | ||
| Examination Findings | 259 | ||
| Corrective Procedures for an Upslip | 261 | ||
| Clinical Correlation for Runners | 262 | ||
| THE MALALIGNMENT SYNDROME | 264 | ||
| Pelvic Ring Distortion | 264 | ||
| Clinical correlation for runners | 265 | ||
| Compensatory Curves of the Spine | 266 | ||
| Clinical correlation for runners | 266 | ||
| Asymmetrical Weight Bearing and Pattern of Shoe Wear | 268 | ||
| Clinical correlation for runners | 270 | ||
| Asymmetrical Muscle Tone | 273 | ||
| Clinical correlation for runners | 280 | ||
| Asymmetry of Muscle Strength and Bulk | 281 | ||
| Clinical correlation for runners | 283 | ||
| Asymmetrical Ligament Tension | 284 | ||
| Clinical correlation for runners | 285 | ||
| Asymmetrical Lower Extremity Range of Motion | 286 | ||
| Clinical correlation for runners | 286 | ||
| Apparent or Functional Leg Length Difference | 290 | ||
| Clinical correlation for runners | 290 | ||
| Impaired Balance and Recovery | 291 | ||
| Clinical correlation for runners | 292 | ||
| Case Histories | 293 | ||
| Runner A: referred pain phenomenon presenting as heel pain | 293 | ||
| Analysis of case history of runner A | 294 | ||
| Runner B: biomechanical stresses on the left tensor fascia lata/iliotibial band complex | 295 | ||
| Analysis of case history of runner B | 298 | ||
| SORTING OUT COMBINATIONS OF THE 3 COMMON PRESENTATIONS | 298 | ||
| IMPLICATIONS FOR THE TREATING PHYSICIAN | 299 | ||
| Aggravation or Precipitation of Another Medical Disorder | 299 | ||
| Back pain arising from conditions of the pelvis or spine | 299 | ||
| Hip and knee joint osteoarthritis | 300 | ||
| Iliotibial band friction syndrome | 300 | ||
| Patellofemoral compartment syndrome | 300 | ||
| Plantar fasciitis and achilles tendonitis | 300 | ||
| Stress fracture | 301 | ||
| Compartment syndrome | 301 | ||
| Tibial stress syndrome/shin splints | 302 | ||
| Metatarsalgia, hallux valgus, and medial bunion formation | 302 | ||
| Peripheral nerve involvement | 302 | ||
| Pelvic floor dysfunction, coccydynia, and sacroccoccygeal junction pain | 304 | ||
| Mimicking Another Medical Disorder | 305 | ||
| Piriformis syndrome and sciatica | 305 | ||
| Mid back pain and thoracolumbar syndrome | 306 | ||
| Osteitis condensans ilii, sacroiliitis, spondyloarthropathy | 307 | ||
| Osteitis pubis | 307 | ||
| Post-realignment pain and paresthesias | 307 | ||
| Iliolumbar ligament pain | 307 | ||
| Overlap with Findings Attributable to a Coexisting Medical Disorder | 308 | ||
| Case history: runner C—central disc protrusion | 308 | ||
| Case history: runner D—radiculopathy | 308 | ||
| Comments on case histories C and D | 308 | ||
| TREATMENT | 309 | ||
| A Comprehensive Treatment Program | 309 | ||
| Shoes | 310 | ||
| Orthotics | 310 | ||
| Sacroiliac Belt and Compression Shorts | 310 | ||
| Injections | 311 | ||
| Prolotherapy | 311 | ||
| Cortisone | 311 | ||
| Surgery | 311 | ||
| When Malalignment Fails to Respond to a Course of Treatment | 312 | ||
| Summary | 312 | ||
| REFERENCES | 313 | ||
| Core and Lumbopelvic Stabilization in Runners | 319 | ||
| Key points | 319 | ||
| WHAT IS THE CORE? | 319 | ||
| ANATOMY | 320 | ||
| LOCAL SYSTEM | 320 | ||
| GLOBAL SYSTEM | 320 | ||
| PHYSIOLOGY/BIOMECHANICS | 320 | ||
| BASIC RUNNING BIOMECHANICS | 322 | ||
| EVALUATION | 324 | ||
| REHABILITATION | 326 | ||
| SUMMARY | 335 | ||
| REFERENCES | 336 | ||
| Gait Retraining | 339 | ||
| Key points | 339 | ||
| INTRODUCTION | 339 | ||
| FACTORS ASSOCIATED WITH RUNNING INJURIES | 340 | ||
| STRENGTHENING ALONE IS NOT ENOUGH | 342 | ||
| BRIEF HISTORY OF GAIT RETRAINING | 343 | ||
| COMPONENTS OF A RETRAINING PROGRAM | 344 | ||
| ALTERING MOVEMENT PATTERNS IN RUNNERS | 344 | ||
| ALTERING LOADING PATTERNS AND FOOT STRIKE PATTERNS IN RUNNERS | 346 | ||
| CASE STUDY OF TRANSITIONING INTERVENTION WITH LONG-TERM FOLLOW-UP | 349 | ||
| MONITORING RUNNERS IN THEIR NATURAL ENVIRONMENTS | 351 | ||
| SUMMARY | 352 | ||
| REFERENCES | 352 | ||
| Index | 357 |