Injury & Prevention

If You Are Warm Now, What Are You Going To Do When It's Really Hot Outside?

I lost track of how many times my dad said those words to me.   As a kid, without fail, every late May I would start complaining about how hot it was outside.  It was inevitable since it was freakin' freezing cold all winter here in Iowa so when it hit about 60-70 degrees in May, I would turn into a sweaty gooey mess immediately.

And with one complaint, I would hear him say, "if you're warm now, what are you going to do when it's really hot outside?".   The smart ass response would always be, "Melt I guess"  or  "stay inside".  

But as a grown up runner, my response is different.  I usually freak out a bit and wonder, "What am I going to do when it is really hot outside?"

I am not a hot weather runner.  When it is above 80, my running suffers dramatically.   And I have been through one round of heat stroke and really don't care to live through that again.   So each year, about this time, I did through all the great advice offered in the Lounge around acclimating and running in hot weather.  

Here is a look back at some of the great tips on running in heat.   There are categories on Weather and Environment and Nutrition and Hydration if you want to page through the additional articles on your own.

Run Well! - Stress Fractures

We are excited to kick off a new series in partnership with Sports Injury Clinic.  www.sportsinjuryclinic.net   This site has been a well used site by me over the last year as I have worked through various injuries.  It provides the right amount of detail about the injury and tips on treatment as well.   And while we hope you don't have the need for the resources, we are pleased to offer articles in tips in the event you are dealing with a running injury.

 

Past articles can be found in the Injury and Recovery section in the Lounge.

 

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Stress fractures are microfractures which occur as a result of repetitive loading of the bone. They can occur due to increased stress at a focal point in the bone due to biomechanical issues, or through the action of a muscle pull across the bone.

 

In runners, stress fractures can occur in a number of locations, with the most common being:

 

Ø      The foot – Metatarsals or Calcaneus

Ø      The lower leg – Tibia

Ø      The thigh – Femur

 

Metatarsal stress fractures

There are 5 metatarsals in each foot, which are the ‘rays’ leading towards each toe. They can be fractured through an impact, as seen in sports such as soccer, or through repetitive impact, as is the case with a stress fracture. The 2nd, 3rd and 4th metatarsals are the most commonly injured.

 

Symptoms

 

Ø      Forefoot pain aggravated by running/walking etc

Ø      Pain gradually worsens with activity

Ø      Tenderness when applying pressure to the metatarsal

 

Calcaneal stess fractures

The calcaneus is the heel bone. Stress fractures most commonly occur at the back or inside of the bone.

 

Symptoms

 

Ø      Heel pain that comes on gradually

Ø      Pain aggravated by running or even weight bearing in more severe cases.

Ø      Pain when squeezing the sides of the heel together at the back

 

Tibial stress fractures

The Tibia is the larger of the two lower leg bones, and the only bone which is ‘weight-bearing’. The most common area for a tibial stress fracture is 2-3 inches above the medial malleolus (bony part on the inner ankle).

 

Symptoms

 

Ø      Gradual onset of leg pain

Ø      Pain is aggravated by activity

Ø      The Tibia may be tender when touched

Ø      Calf pain my be present

 

Femoral stress fracture

The Femur is the thigh bone and the largest bone in the body. Stress fractures can occur either in the mid-shaft of the bone, or at the neck of the femur, just below the hip joint.

 

Symptoms

 

Ø      A dull ache in the thigh

Ø      Poorly localised pain

Ø      Pain may refer to the knee

Ø      Pain may be exacerbated by sitting with the leg hanging over the edge of a bench/high chair, especially if a downward pressure is applied to the knee.

 

A stress fracture of the femoral neck may produce:

 

Ø      Pain in the groin which comes on gradually

Ø      The pain is poorly localised and aggravated by activity

Ø      Pain at the extremes of hip joint motion

 

Causes

Stress fractures are overuse injuries. In runners, this usually means, running too far or for too long, too soon, with insufficient rest! It is one of the main reasons behind the 10% increase rule.

Other issues can also contribute to the development of a stress fracture. Usually these are biomechanical issues which place extra stress on the bone. For example, the 2nd metatarsal is most commonly fractured in people who overpronate, and Tibial fractures can be caused by a leg-length discrepancy.

 

Treatment

Generally, the treatment of a stress fracture involves plenty of rest (usually 4 weeks of partial or non-weight bearing), correction of any biomechanical factors, followed by a very gradual return to activity. This should only commence when walking is pain free and bone tenderness has cleared. Non-impact exercise should be introduced initially (e.g. cycling/cross-training, swimming), followed by a gradual return to running.

 

There is one major exception to this rule. A stress fracture to the femoral neck can be on either the superior (tension) side, or the inferior (compression) side. Those to the superior aspect should be treated as an emergency, with either surgical fixation or complete bed rest. The reasoning for this, is that due to the tension on the upper surface, there is a possibility of the stress fracture developing into a full fracture, which would stop the blood supply to the head of the femur, leading to a possible avascular necrosis – bone death.

 

Prevention

Stress fractures can be prevented by following these simple rules:

 

Ø      Don’t overtrain – increase mileage by no more than 10% per week.

Ø      Get a gait analysis to determine if you overpronate, oversupinate or have a neutral foot.

Ø      Make sure you are wearing the correct trainers for you

Ø      Change your trainers before they get worn out

Ø      Don’t run on hard surfaces (i.e. concrete) all the time

Ø      Try to mix it up and include grass, sand and tarmac running

 

For more information on metatarsal, calcaneal, tibial and femoral stress fractures, please visit:

http://www.sportsinjuryclinic.net/

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Run Well! : Piriformis Syndrome

We are excited to kick off a new series in partnership with Sports Injury Clinic.  www.sportsinjuryclinic.net   This site has been a well used site by me over the last year as I have worked through various injuries.  It provides the right amount of detail about the injury and tips on treatment as well.   And while we hope you don't have the need for the resources, we are pleased to offer articles in tips in the event you are dealing with a running injury.

 

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Piriformis is a small muscle located deep in the buttocks. It originates from the lateral aspect of the sacrum and crosses the buttock horizontally to insert into the greater trochanter of the femur. It is responsible for externally rotating and abducting the hip joint.

 

Piriformis syndrome is often the cause of sciatic pain in runners. The Sciatic nerve emerges from the vertebral column via the lumbar and sacral plexi at levels L4 –S3. From here it passes through the buttock and down the posterior thigh, before branching 180piriformis_syndrome out into several smaller nerves.  [Picture at right from SportsInjuryClinic.com]

 

The course of the sciatic nerve runs just below the piriformis muscle. If the piriformis muscle becomes tight then this can lead to the muscle impingeing on the nerve. Also, in up to 20% of the population, the sciatic nerve actually passes directly through the muscle belly. This predisposes the individual to developing this condition.

 

The symptoms of piriformis syndrome usually include:

 

Ø      Dull pain in the buttocks and (or) down the back of the leg

Ø      Pain gradually comes on over a period of time

Ø      It is often aggravated by running and sitting for long periods

Ø      The piriformis muscle is usually tender to palpate (touch)

Ø      Numbness or tingling may be felt in severe cases in the posterior thigh and calf

Ø      The range of motion at the hip may be limited, especially into internal rotation

 

What causes piriformis syndrome?

 

Piriformis syndrome results most regularly through muscle imbalances caused by repetitive movement with poor biomechanics. The most common scenario in runners is that the hip adductors (groin muscles) are very tight, and the hip abductors (including gluteus medius and piriformis itself) are not strong enough to counteract this problem. This causes them to become overworked and ‘tight’.

 

Treatment

 

The treatment of piriformis syndrome is usually quite striaghtforward and results can be seen relatively quickly.

 

Treatment should focus on:

 

Ø      Rest from the aggravating activity

Ø      Startching of the tight muscles – piriformis, adductors and sometimes hamstrings too

Ø      Self-massage using a foam roller or tennis ball to the piriformis muscle can be effective

Ø      Strengthening the hip abductors

 

In order to stretch the adductor (groin muscles) effectively, you should stretch both components – the short and long adductors. To stretch the long muscles, stand with a wide stance and bend the knee of the leg you DO NOT wish to stretch. Put your weight on this leg and tilt your hips to the side until you can feel a stretch on the inner thigh of the straight leg.

 

To stretch the shorter muscles, sit on the floor with the soles of the feet together (knees bent). Use the elbows to apply a gentle pressure on your knees (push down) until you can feel a stretch in the groin.

 

Hold both of these stretches for 20-30 seconds each and repeat them 2-3 times each. Try to go through this routine at least 3 times a day.

 

To stretch the piriformis muscle, lay on the floor on your back with the feet flat on the floor. Lift the foot of the leg you want to stretch and place the ankle on the other thigh. Hold this position as your grasp behind the non-stretching thigh, pulling the knee towards the chest until you can feel a stretch in the opposite buttock. Again hold this for 20-30 seconds and repeat 2-3 times, 3 times a day.

 

We always advise seeking professional treatment in order to return to fitness as soon as possible and free from pain! A professional sports injury specialist may also:

 

Ø      Use sports massage techniques on the piriformis, other hip abductors and groin muscles.

Ø      Use other treatment modalities such as ultrasound or intereferential.

Ø      Perform a gait analysis so that they can determine if there are any other factors which may be contributing to your injury.

Ø      Devise a full rehabilitation programme.

 

For more information on Piriformis Syndrome treatment and rehabilitation, including a sports massage demonstration, rehabilitation programme and further stretching and strengthening exercises, please visit:

www.sportsinjuryclinic.net

Run Well! : Compartment Syndrome

We are excited to kick off a new series in partnership with Sports Injury Clinic.  www.sportsinjuryclinic.net   This site has been a well used site by me over the last year as I have worked through various injuries.  It provides the right amount of detail about the injury and tips on treatment as well.   And while we hope you don't have the need for the resources, we are pleased to offer articles in tips in the event you are dealing with a running injury.

 

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Compartment syndrome can occur in several places in the body. The most common region to develop compartment syndrome, especially in runners, is the lower leg, and more specifically, the anterior compartment of the lower leg. 

‘Compartments’ are sections of the body, in this case the lower leg, which contain muscles, blood vessels, nerves and other tissues. Each compartment is separated by a kind of connective tissue known as fascia. In total, there are 4 compartments in the lower leg (anterior, lateral, posterior and deep posterior).  

The anterior compartment, the focus of this article, makes up the front part of the lower leg, just to the outside of the Tibia (shin bone). It contains the Tibialis anterior, Extensor digitorum longus, Extensor hallucis longus and Peroneus tertius muscles. The main function of these muscles is to dorsiflex the ankle and extend the toes (pull the foot  and toes up towards you).

Anterior compartment syndrome occurs when the muscles within the anterior compartment expand beyond the size of the fascia surrounding the compartment. Fascia is virtually non-elastic and so cannot expand with the muscles. This results in a decrease in space within the compartment and increased pressure on the nerves and blood vessels inside.

The symptoms of compartment syndrome include: 

  • Pain to the outside of the shin bone
  • Pain which increases during exercise until you have to stop
  • Pain is often described as achy pain
  • A feeling of tightness at the front of the leg
  • Pain eases gradually during rest
  • Weakness in dorsiflexing the ankle (pulling the foot up towards you)
  • Tingling or numbness may be present
  • The muscles at the front of the shin may feel tight, or even be visibly tight after exercise

 

What causes anterior compartment syndrome? 

Compartment syndrome can be either acute or chronic. Acute compartment syndrome is caused by a direct impact to the shin. Chronic compartment syndrome is an overuse injury, which comes on gradually over a period of time. This is the most common form in runners, although an acute case of compartment syndrome can develop into a chronic case if not treated appropriately. 

As already stated, compartment syndrome in runners is usually both in the anterior compartment and a chronic, overuse condition. The muscles in this compartment become overused through either overtraining or biomechanical abnormalities. This causes either the muscles to overdevelop and become too large for the compartment, or for minor swelling and inflammation to occur which reduces the space in the compartment. 

How is compartment syndrome diagnosed? 

The symptoms usually provide a pretty good indication of the condition, however the only way of determining that compartment syndrome is the cause of the pain is by measuring intercompartmental pressure. This is done by inserting a needle into the compartment after exercise. 

This is important as compartment syndrome can be misdiagnosed as a stress fracture, or sometimes even shin splints. 

How is compartment syndrome treated? 

  • Rest from aggracting activities
  • Apply ice after activity
  • Check biomechanical issues such as overpronation/oversupination
  • Ensure running shoes are replaced regularly
  • Improve flexibility of the calf and shin muscles
  • When returning to activity start very slowly and gradually increase

 

In some cases, if conservative treatment fails, surgery called a fasciotomy may be required to release the fascia and create more space in the compartment. 

To stretch the calf muscles, stand facing a wall with a wide stance and the leg to be stretched at the back. Keep the heel flat on the floor and the knee straight as you lean forwards using your hands on the wall to balance you. This stretches the Gastrocnemius muscle, the largest of the 2 muscles at the back of the lower leg. To stretch the smaller Soleus muscle, just bend the back knee slightly. You should then feel the stretch lower down the calf. 

We always advise seeking professional treatment in order to return to fitness as soon as possible and free from pain! A professional sports injury specialist may also: 

  • Perform sports massage techniques to the muscles of the lower leg
  • Use a taping tachnique to help take the strain off the muscles
  • Advise you on stretching and strengthening exercises
  • Undertake gait analysis to see if you overpronate or oversupinate and then prescribe custom orthotics

 

For more information on anterior compartment syndrome, including a sports massage demonstration, taping technique and further exercises, please visit:

www.sportsinjuryclinic.net

Run Well! PatelloFemoral Pain Syndrome

We are excited to kick off a new series in partnership with Sports Injury Clinic.  www.sportsinjuryclinic.net   This site has been a well used site by me over the last year as I have worked through various injuries.  It provides the right amount of detail about the injury and tips on treatment as well.   And while we hope you don't have the need for the resources, we are pleased to offer articles in tips in the event you are dealing with a running injury.

 

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Patellofemoral pain syndrome is also sometimes called anterior knee pain, or even runners knee. The reason for the variation in terms is due to the rather vague symptoms. This condition is basically an umbrella term, used to describe vague pain at the front of the knee.

Typically, the causes of this pain are also not clear. The general theory is that mal-tracking of the patella causes damage to the articular cartilage lining its underside. Although this damage may be associated with the injury, this cartilage is not innervated (supplied by a nerve) and so cannot cause pain. One possible theory is that the cartilage damage may lead to irritation of the synovial capsule of the joint.

Symptoms of Patellofemoral Pain Syndrome:

As already mentioned, patellofemoral pain syndrome is a very vague condition. However, there are some symptoms that are typically presented:

 Pain surrounding the knee cap at the front of the knee
 Pain is usually described as ‘aching pain’
 Pain comes on gradually
 Pain is often worst when walking down hills or stairs
 Pain often comes on after starting a new activity or increasing training
 There may be clicking or a locking feeling within the knee after longer periods of rest – especially with the knee bent

Mal-tracking of the patella is usually caused by muscle imbalances. Most commonly, the patella moves too far laterally (to the outside). This is usually caused by:

 Tight lateral structures such as the IT band, vastus lateralis muscle (outer quad muscle) and the lateral retinaculum (fibrous connective tissue).
 Weak medial structures – notably the vastus medialis oblique muscle.

Other causative factors include having weak hip abductor muscles (gluteus medius especially) which allows the knee to fall inwards, having particulaly wide hips (pfps is more prevalent in women!) or overpronation at the feet. All of these causes lead to an increased Q angle. This is an angle used to predict biomechanical abnormalities. It is the angle made by the line of the Rectus Femoris muscle and the Patella Tendon. A normal Q angle is between 18 and 22 degrees. An angle above this increases the chance of suffering PFPS. 

PFPS can also occur following knee surgery. This is less common now with the use of arthroscopic (key-hole) techniques for most procedures. However, following surgery, muscle inhibition due to incision of some of the fibres, or prolonged swelling, can cause long-term imbalances as discussed above. The VMO is particularly susceptible to inhibition, further exacerbating the problem.

Treatment

The treatment of patellofemoral pain syndrome focuses on correcting the biomechanical issues:

 Stretch the tight lateral structures
 Sports massage can help with loosening the ITB and lateral quads.
 Strengthen the medial quads with emphasis on VMO
 Strengthen the hip abductor muscles
 Correct overpronation if necessary

Whilst rehabilitating this injury, rest should be taken from any activities which cause pain. If pain is present during day-to-day duties, then a taping technique or knee brace  may be used to reduce lateral tracking of the knee cap.

The IT band is usually tight in cases of PFPS. Stretching this structure can be difficult, but there are a number of stretching techniques which can be used, the difficulty comes in finding one which works for you! Here are two of our favorites:

 Place the leg you want to stretch behind the other one.
 Keep the knee straight and push the hips out towards the affected side.
 Hold for 30 seconds, repeat 3-5 times and do this at least three times a day.
 Never bounce when stretching, always ease into it gently and try to relax.

Alternatively:
 Sit on the floor with the uninvolved leg straight
 Bend the leg you wish the stretch and place the foot on the floor, the other side of the uninvolved knee
 Pull the knee of the involved leg across your body until your can feel a stretch on the outer thigh or hip

We always advise seeking professional treatment in order to return to fitness as soon as possible and free from pain! A professional sports injury specialist may also:

 Tape the knee for you
 Apply sports massage therapy
 Perform some partner stretches with you
 Provide a full rehabilitation program
 Prescribe orthotics or recommend someone who can

For more information on PatelloFemoral Pain Syndrome, including taping techniques, exercises and a sports massage demonstration, please visit:  www.sportsinjuryclinic.net

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Run Well: Achilles Tendinopathy

We are excited to kick off a new series in partnership with Sports Injury Clinic.  www.sportsinjuryclinic.net   This site has been a well used site by me over the last year as I have worked through various injuries.  It provides the right amount of detail about the injury and tips on treatment as well.   And while we hope you don't have the need for the resources, we are pleased to offer articles in tips in the event you are dealing with a running injury.

 

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Achilles tendinopathy is a common running injury. It is sometimes known by other names such as tendinitis, however this means inflamed tendon, and recent research has shown that there is no inflammation present in most cases.

The achilles tendon is the long thick tendon at the back of the ankle. It attaches both the Gastrocnemius muscle and its smaller, deeper neighbour the Soleus muscle, to the heel bone (calcaneus). Its job is to help provide the power in the push-off phase of the gait cycle.

Achilles tendinopathy generally is an overuse injury which comes on gradually over a period of time. It can however be quite a short period, only a few days. Usually in this time, strain through the tendon will have increased rapidly, for example increased training or lots of hill running.

Achilles teninopathy can either occur in the mid-portion of the tendon, around 4-5cm above the heel, or can be insertional, meaning right at the attachment point.

Symptoms of achilles tendinopathy:

Ø      Pain in the achilles tendon

Ø      Pain when pressing on the achilles tendon

Ø      Pain may initially fade after a warm-up but will become constant as the condition progresses

Ø      The tendon often feels very stiff in the mornings or after long periods of rest

Ø      You may feel nodules (small lumps) within the tendon

Ø      The tendon may appear thicker and redder than the other one

Ø      You may feel a creaking sensation within the tendon as you move the ankle

What causes achilles tendinopathy?

The most common causes are as follows:

Ø      Limited range of motion at the ankle – caused by tight calf muscles

Ø      A sudden increase in training or difficulty such as hill running

Ø      Overpronation (where the foot rolls inwards excessively as we run)

Ø      Inadequate rest time

Ø      Weak calf muscles

Ø      New or inappropriate footwear

Ø      Constantly wearing high heels and then changing to flat shoes

Treatment

Treatment of achilles tendinopathy should be centered around correcting the causative factors:

Ø      Rest from training and any other aggravating activities

Ø      Apply cold therapy to the tendon for 10 minutes at a time, up to 5 times a day

Ø      Wear a heel pad (in both shoes to avoid back problems!) to raise the heel slightly which will temporarily take the strain off the tendon.

Ø      If you overpronate, try some arch support insoles

Ø      Gently stretch the tendon and calf muscles to gradually increase the flexibility and range of ankle motion

Ø      Once pain-free, start to strengthen the calf muscles. Research has shown that eccentric training is most beneficial

To strengthen the calf muscles eccentrically, stand on a step with the heel just off the back. Lift the unaffected leg up so you are on one leg. Slowly lower the heel down as far as you can comfortably manage, making sure you maintain control throughout. When you are at the bottom, place the other foot back on the step and use this one to lift you up to the starting position again. Repeat this 10 times to start with, and if there are no adverse effects, then gradually increase the number you do.

We always advise seeking professional treatment in order to return to fitness as soon as possible and free from pain! A professional sports injury specialist may also:

Ø      Use treatments such as ultrasound to ease pain and swelling and to promote healing

Ø      Apply sports massage techniques to the calf muscles to loosen them off and also to the tendon to increase blood flow which is associated with healing

Ø      Apply tape to the ankle to take the strain off the tendon

Ø      Advise you on a full rehabilitation program

 

For more information on achilles tendinopathy treatment and rehabilitation, including taping tachniques, exercises and a sports massage demonstration, please visit:

www.sportsinjuryclinic.net

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Run Well: Plantar Fasciitis

 

We are excited to kick off a new series in partnership with Sports Injury Clinic.  www.sportsinjuryclinic.net   This site has been a well used site by me over the last year as I have worked through various injuries.  It provides the right amount of detail about the injury and tips on treatment as well.   And while we hope you don't have the need for the resources, we are pleased to offer articles in tips in the event you are dealing with a running injury.

 

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Plantar fasciitis is a common running injury, resulting in pain under the heel and arch of the foot. The plantar fascia itself is a broad band of thick fibrous tissue (fascia) which runs from the heel bone (calcaneus) to the forefoot. Its function is to support the arch of the foot and to provide some rigidity to the foot for the propulsion phase of gait.

 

Plantar fasciitis is sometimes also known as a heel spur, although this is not strictly correct. A heel spur is a bony growth which forms under the heel, at the point where the plantar fascia attaches. A heel spur can be the cause of plantar fasciitis, although in many cases, there is not a heel spur present. Similarly, a heel spur can be symptom free.

 

The symptoms of plantar fasciitis include:

 

Ø      Pain under the heel which may radiate into the sole of the foot

Ø      Pain is usually worse first thing in the morning or upon standing after long periods of non-weight bearing

Ø      In the early stages pain usually fades as activity increases, although if the condition is left untreated pain may persist

Ø      Pain when pressing around the inside of the heel and sometimes along the arch

Ø      Stretching the fascia may be painful

 

What causes plantar fasciitis?

 

Plantar fasciitis is an overuse injury, meaning that it gradually comes on over a period of time. It is not caused by one sudden event. If this is the case, you are more likely to be suffering a plantar fascia strain.

 

The most common cause of plantar fasciitis is very tight calf muscles, which leads to prolonged, and / or high velocity pronation of the foot. This in turn produces repetitive over-stretching of the plantar fascia leading to possible inflammation and thickening of the tendon. As the fascia thickens it looses flexibility and strength.

 

Other causes include flat feet (pes cavus), high arches (pes planus), oversupination, or the wearing of unsuitable/unsupportive footwear.

 

Treatment

 

Treatment of plantar fasciitis can be difficult due to the near impossibility of completely resting the foot. However, relative rest from any excessive activities (i.e. running, long periods of walking etc) should be sufficient in all but the worst cases.

 

Ø      Apply cold therapy to the heel and arch of the foot 3-5 times a day for 10 minutes at a time

Ø      Apply a plantar fascia taping technique which will help take the strain off the fascia during day-to-day activities

Ø      Wear a plantar fasciitis night splint. This will help to stretch out the calf muscles and plantar fascia itself whilst you sleep. This is when the musles usually tighten up, causing pain first thing in the morning.

Ø      Take anti-inflammatory medication (always seek your Doctors advice first)

Ø      Gently stretch the fascia and calf muscles regularly throughout the day

Ø      Massage the fascia using a golf ball (or similar). Only do so if it is comfortable.

Ø      Purchase some insoles for your shoes. If you overpronate, get some with a medial arch support. If you oversupinate, get some shock absorbing ones

Ø      If you have a neutral foot (meaning you do neither of the above), consider using a heel pad (in both shoes so as to avoid a leg length difference!) as a temporary means of reducing pain in the heel.

Ø      Check your footwear isn’t worn out, and if it is....change it!

 

To stretch the calf muscles, stand facing a wall with a wide stance and the leg to be stretched at the back. Keep the heel flat on the floor and the knee straight as you lean forwards using your hands on the wall to balance you. This stretches the Gastrocnemius muscle, the largest of the 2 muscles at the back of the lower leg. To stretch the smaller Soleus muscle, just bend the back knee slightly. You should then feel the stretch lower down the calf.

 

To stretch the plantar fascia, gently pull the toes back towards you until you feel a pull in the arch of the foot.

 

With both of these stretching exercises you should hold the stretch for 20-30 seconds and repeat two or three times. Do this 3-5 times a day to get the most benefit.

 

We always advise seeking professional treatment in order to return to fitness as soon as possible and free from pain! A professional sports injury specialist may also:

 

Ø      Perform treatments such as ultrasound to aid healing

Ø      Use sports massage techniques to stretch out the calf muscles and plantar fascia

Ø      Undertake gait analysis to see if you overpronate or oversupinate and then prescribe custom orthotics

Ø      Shock wave therapy

Ø      Devise a full rehabilitation program

 

More extreme treatments include a corticosteroid injection, or surgery, although these tend to be last resort treatments, and should only be used after a lengthy period of thorough, conservative treatment.

 

For more information on plantar fasciitis treatment and rehabilitation, including a sports massage demonstration, taping technique and further exercises, please visit:

www.sportsinjuryclinic.net

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Running Well: Shin Splints

We are excited to kick off a new series in partnership with Sports Injury Clinic.  www.sportsinjuryclinic.net   This site has been a well used site by me over the last year as I have worked through various injuries.  It provides the right amount of detail about the injury and tips on treatment as well.   And while we hope you don't have the need for the resources, we are pleased to offer articles in tips in the event you are dealing with a running injury.

 

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Shin splints is possibly the most common, and certainly the most well known ‘running injury’. However, the symptoms of shin splints are often confused with those of other lower leg injuries, such as compartment syndrome  [picture on right  compliments of sportsinjuryclicinic.net]

 

The symptoms of shin splints usually include:

Ø      Diffuse pain at the front of the lower leg, to the inside of the shin bone (pain on the outside of the bone is more Shin splints likely a compartment syndrome)

Ø      Pain which is worst at the start of the exercise and often eases throughout

Ø      Pain may then return after exercise or the next morning

Ø      As the condition becomes worse, pain will become more constant

Ø      The area to the inside of the shin bone may be tender to touch

Ø      You may also feel small lumps within the muscles

Ø      Pain may be present when you stretch the shin muscles (i.e. point the toes away from you)

Ø      There may be mild swelling or redness

Shin splints pain is thought to be caused by inflammation of the periostium of the tibia (sheath surrounding the bone). Traction forces on the periosteum from the muscles of the lower leg cause shin pain and inflammation.

Causes

Shin splints is an overuse injury. The symptoms develop over a period of time and gradually increase in severity if treatment is not sought. Overuse injuries can be caused by a number of factors, which are usually biomechanical issues, or training errors such as:

Ø      Overpronation

Ø      Oversupination

Ø      Increasing training too quickly

Ø      Running on pavements or other hard surfaces

Ø      Old trainers which have lost their cushioning

Ø      Tight calf muscles – limted ankle flexibility

Treatment

The treatment of shin splints should begin as soon as possible after the injury has been detected:

Ø      Rest from any activity which causes pain

Ø      Apply ice to the area for 10 minutes at a time, up to every 2 hours

Ø      Take anti-inflammatory medication (always seek the advice of your Doctor first)

Ø      Once you can do so pain free, stretch the calf and shin muscles

Ø      Wear shock absorbing insoles if you oversupinate, or arch support insoles if you overpronate

Ø      Wear a compression support to help improve blood flow to aid healing

Ø      Buy new trainers if yours are very old!

To stretch your calf and shin muscles, always start with a gentle stretch and move further into the position as the stretching feeling fades. Hold stretches for at least 20 seconds and always repeat them 2-3 times and do this several times a day.

To stretch the calf muscles, stand facing a wall with a wide stance and the leg to be stretched at the back. Keep the heel flat on the floor and the knee straight as you lean forwards using your hands on the wall to balance you. This stretches the Gastrocnemius muscle, the largest of the 2 muscles at the bck of the lower leg. To stretch the smaller Soleus muscle, just bend the back knee slightly. You should then feel the stretch lower down the calf.

To stretch the shin muscles, kneel with the shins on the floor, sitting on your heels. Lean back to increase the stretch, or alternatively, use the hands to lift the knee just off the floor.

We always advise seeking professional treatment in order to return to your sport as soon as possible and free from pain! A professional sports injury specialist may also:

Ø      Use sports massage techniques to relax the muscles of the shin and calf

Ø      Tape the shin to take the strain off the muscles

Ø      Use ultrasound to ease pain and inflammation and promote healing

Ø      Devise a full rehabilitation program

For more information on Shin Splints treatment, including a rehabilitation programme, exercise pictures and videos as well as massage demonstrations, please visit:

www.sportsinjuryclinic.net

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Run Well! - Iliotibial Band Syndrome (Runners knee)

We are excited to kick off a new series in partnership with Sports Injury Clinic.  www.sportsinjuryclinic.net   This site has been a well used site for me over the last year as I have worked through various injuries.  It provides the right amount of detail about the injury and tips on treatment as well.   And while we hope you don't have the need for the resources, we are pleased to offer articles in tips in the event you are dealing with a running injury.

 

Run well logo The Iliotibial band is a thick band of fascia which runs from the outer hip, down the outside of the thigh, and attaches on the outside lower part of the knee. At the top of this band, is the small muscle known as Tensor Fascia Latae, which attaches the fascia to the iliac crest (pelvis).

As the ITB passes over the lateral epicondyle of the femur (bony bit on the outside of the knee) it is prone to friction. This friction is at its worst when the knee is bent at an angle of approximately 20-30 degrees. This is the approximate angle of the knee at foot strike when running. Think of it as a tight rubber band flicking back and forwards over the bone. This repetitive friction results in the pain and inflammation associated with runners knee.

Causative factors, which can lead to the development of IT band syndrome (Picture: Copyright Peter Gardiner for www.sportsinjuryclinic.net), include:Itband picture

Ø      A tight or naturally wide IT band

Ø      Trigger points within the IT band and gluteal muscles

Ø      Overpronation

Ø      Overuse (i.e. too much too soon)

Ø      Excessive hill running

Ø      Running on a cambered surface (where one side is lower than the other)

Ø      Leg length discrepancy

Ø      Weak hip muscles.

Symptoms include:

Ø      Pain on the outside of the knee

Ø      Tightness in the iliotibial band

Ø      Pain is often made worse by running downhill

Ø       Bending and straightening the knee whilst applying pressure to the IT band attachment on the outside is often painful

 

What treatments can be used?

There is no substitute for professional treatment, however, in mild cases, and certainly in an attempt to prevent IT band syndrome, self-treatment can be effective.

Ø      Rest – rest from any aggravating activities; don’t attempt to run on, as it will only get worse!

Ø      Ice – applying ice to the area on the outside of the knee will help to decrease pain and inflammation

Ø      Stretch – Once it is pain-free to do so, start to stretch the muscles of the leg, paying particular attention to the IT band itself.

Ø      Strengthen the muscles on the outside of the hip such as gluteus medius

Ø      Correct any biomechanical abnormalities or training errors

Stretching the IT band can be tricky. The easiest method we have found is as follows:

Ø      Stand leaning forwards, with your hands on a table for balance.

Ø      To stretch the right leg, take the right foot behind the left and as far to the left as possible, keeping the knee straight.

Ø      Push the hips out to the right to increase the stretch.

Ø      Hold this position for 30 seconds.

To strengthen Gluteus Medius, the side-lying clam is the best exercise:

Ø      Lay on your side with the side you want to work on top.

Ø      Have the knees bent and together and feet together, in line with the spine.

Ø      Make sure your hips are stacked one on top of the other.

Ø      Lift the top knee away from the bottom one, keeping the feet together.

Ø      Ensure you keep your back straight and still throughout.

Ø      It may only be a small movement initially but should increase as your strength improves.

Ø      Start off performing 2 sets of 10 reps and gradually build to 3 sets of 20!

If you were to visit a professional sports injury therapist, other treatments may include sports massage, acupuncture, electrotherapy such as ultrasound and a full rehabilitation programme.

Persistent cases can be treated with a corticosteroid injection, although this should be a last resort, after consistent and thorough conservative treatment has failed.

For more information on Iliotibial band syndrome (runners knee) including a rehabilitation programme, exercise pictures and videos as well as massage demonstrations, please visit:

www.sportsinjuryclinic.net

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