跑步受伤情况

jacky

Running Injury
Aka: Running Injury, Jogging Injury

• Epidemiology
  
  • Running is primary Exercise for 40-50 million in U.S.
  • Significant injury occurs in 50% of runners each year
    
    • Knee (42%)
    • Leg and Ankle (28%)
    • Foot (18%)
    • Hip (5%)
    • Low Back (4%)
    • Thigh (3%)
      
• Risk Factors
  
  • Prior lower extremity injury
  • Weekly mileage exceeds 20 to 40 miles (50 to 100 km)
    
• Causes: Running Injury
  
  • Training Error
    
    • High intensity Exercise without rest days
    • Sudden increase in mileage or intensity
    • Single intense training episode or competition
    • Overtraining related conditions
      
      • Tibial Stress Fracture or other Stress Fracture
      • Achilles Tendinitis
      • Patellar Tendinitis
      • Plantar Fasciitis
        
  • Anatomic Error
    
    • Overweight patient
    • Leg Length Discrepancy
    • Femoral neck anteversion
    • Weak or inflexible quadriceps or hamstrings
    • Genu Valgum or Genu Varum
    • Q Angle exceeds 15 degrees
    • Tibial torsion or tibia varum
    • Gastroc-soleus insufficiency
    • Patella alta
    • Pes cavus with high soft tissue arch >3.1 cm
    • Pes planus or flat feet (low injury risk)
      
  • Functional Error
    
    • Over pronation (most common cause)
    • Excess supination without compensatory pronation
      
      • Higher risk in pes cavus foot
      • Associated with Iliotibial Band Syndrome
        
  • Extrinsic Factors
    
    • Shoe Problem
      
      • Inadequate heel wedge or heel counters
      • Inflexible soles
      • Narrow toe boxes
      • Lateral heel wear
      • Old Running Shoes with lost shock absorption
        
        • Limit to 500-700 km (312-438 miles) per pair
          
    • Running surface or terrain
      
      • Arched track related conditions
        
        • Iliotibial Band Syndrome
          
      • Rigid or hard surface related conditions
        
        • Tibial Stress Fracture
        • Shin Splints
        • Patellofemoral Syndrome
          
      • Hill Running related conditions (esp. down hill)
        
        • Patellar tendinitis
        • Patellofemoral Syndrome
        • Iliotibial Band Syndrome
          
      • Loose surface Running (e.g. gravel)
        
        • Meniscus Injury
          
• Common Running Injuries
  
  • Patellofemoral Syndrome (26%)
  • Tendonitis (15%)
    
    • Achilles Tendinitis (30%)
    • Patellar Tendinitis
      
  • Medial Tibial Stress Syndrome or "Shin Splints" (13%)
  • Plantar Fasciitis (5%)
  • Iliotibial Band Syndrome (4%)
  • Stress Fracture (2-3%)
    
    • Tibial Stress Fracture (41%)
      
      • Similar presentation to Shin Splints
        
    • Metatarsal Stress Fracture, Freiberg's Disease (29%)
      
      • Consider for chronic Metatarsalgia in adolescent
        
    • Fibula Stress Fracture (18%)
    • Cuneiform Stress Fracture (6%)
    • Navicular Stress Fracture (6%)
      
      • Consider for persistent medial arch pain
        
  • Adductor Strain
  • Hamstring Strain
  • Iliac Apophysitis
  • Exertional Compartment Syndrome
  • Piriformis Syndrome
    
    • Consider for Sciatica in runner
      
• Management
  
  • Standard Injury Management
    
    • See injury specific therapy
    • See RICE-M Therapy
    • See Cold Therapy
    • Consider NSAIDs for 1 to 2 weeks
      
  • Modify training regimen
    
    • Reduce or eliminate pain triggering activities
    • Reduce speed and mileage
      
      • Week 1: Slow run, every other day for 1/3 distance
      • Week 2: Slow run, every other day for 2/3 distance
      • Week 3: Slow run, every other day for full distance
      • Week 4: Baseline pace every other day
        
    • Consider straight-away runs instead of curved track
    • Add rest days to training schedule
    • Move runs to a softer training surface
      
  • Cross-Train with other aerobic activities
    
    • Wet vest
    • Biking
    • Swimming
    • Stair climbing (Stairmaster)
    • Ski machine (Nordic Track)
      
  • Strengthen and rehabilitate involved muscle groups
    
    • Consider physical therapy or athletic trainer
    • Modalities
      
      • Education on stretches and Exercises
      • Ultrasound (and Phonophoresis and Iontophoresis)
      • Eccentric Exercises (tendon stretch while loaded)
        
• Prevention of Overuse Running Injuries
  
  • See Overtraining
  • Find the right Running Shoes
    
    • Change Shoes every 500 miles or every 6 months
      
  • Consider Orthotics
    
    • Flat foot (pes planus)
    • Over-pronation
      
  • Strengthen the quadriceps muscles
  • Maintain flexibility
    
    • Stretch before and after Exercise
    • Assess knee extension in clinic
      
      • Patient supine with hip flexed to 90 degrees
      • Expect knee extension within 15 degrees of full
        
• References
  
  • Fields (1997) Lecture: AAFP Sports Medicine, Dallas
  • [url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&db=PubMed&term=Ballas  [AU] AND 1997 [DP] AND  Am Fam Physician  [TA]]Ballas (1997) Am Fam Physician 55(7):2473-80[/url]
  • [url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&db=PubMed&term=Johnston  [AU] AND 2003 [DP] AND  Can Fam Physician  [TA]]Johnston (2003) Can Fam Physician 49:1101-9[/url]
  • [url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=search&db=PubMed&term=Wexler  [AU] AND 1995 [DP] AND  Postgrad Med  [TA]]Wexler (1995) Postgrad Med 98(4):185-93[/url]
    

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admin

是否标题为：跑步受伤情况？

jacky

admin 发表于 2011-11-1 04:44
是否标题为：跑步受伤情况？

是啊~~打错字了~~~

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