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Physiotherapy


Running Injuries

Introduction

   Running is a sport of passion which is easy and most popular way to stay fit. During running, injuries are common and have hard impact on muscles and joints.

   Running injuries include hips, knees, ankle and foot. Hip and groin injuries are common during running with hurdles and sprinting.

Common Running Injuries

Hip Bursitis

    Inflammation of bursa which causes pain during hip movement.
    Snapping Hip syndrome
    In this injury, Iliotibial band is snaps outside the thigh, Hip flexor muscle also snaps in   front of the hip and the cartilage around the hip also cause snapping sensation.
    Snapping/Popping outside or in front of the hip is felt while moving the  hip which is not painful normally.
    Hip Stress Fractures
    Fractures occur due to high-pressure on the joint or bone.
    Hamstring pull/Tear/Strain
    Injury at the back of the thigh occurs ranging from minor to major rupture of the muscle.
    Groin pull
    Adductor pull or strain may occur when the thigh inside muscles get stretched beyond the limits.

Knee injuries

  Runner’s knee
    This is also known as Chondromalacia patella or Iliotibial band syndrome or Patellofemoral syndrome or Patellar tendinitis or Generalized knee pain etc.
    Most common running injury. Iliotibial band (IT band) is a thick, fibrous fascia from outside of the thigh to below the knee.
    IT band misalignment/tightening/rupture of cartilage on the back of the knee in its groove occur causing inflammation.
    Kneecap/patella helps in flexion and extension of the leg.

    Dislocated kneecap

Leg injuries

     Shin splints

    Leg pain occurs due to stress injury or overuse. Pain in the front of the lower leg along the tibia/shin bone.
    Compartmental syndrome
    In this condition, Pain occurs in front of the leg due to exercises or activity. In such cases, Fasciotomy surgery is done to relieve symptoms.
    Calf muscle pull/strain
    This occurs when lower leg muscles (Gastrocnemius and Soleus) are pulled from Achilles tendon. Pain in the back of the leg region.

Ankle injuries

    Achilles tendonitis
    It is chronic injury and occurs due to overuse.
    Ankle sprain

Foot injuries

    Plantar fasciitis
    Most common running injury causing pain and swelling at the bottom of the heel. Main symptom is pain in the heel during walking in the morning.
    This may lead to Heel spur.
    Over Pronation injury
    Pronation movement is moving the foot inwards to the body. Excessive pronation movement may lead to pain in the foot.
    Wearing shoes which limit over motion/Pronation of foot may help.
    Arch pain
    Inflammation and Burning sensation in the arch of foot area. Shoes which support the arch area reduce the arch pain.
    Heel spur
    Over growth of bone at the bottom of the heel causes

Muscle cramps

    Cramp is a sudden intense pain in the muscle which contracts involuntarily and forcibly which does not relax.

•    Stress fractures

    They are common in Hip, Knee, Ankle and Feet due to repetitive pressure, force and contraction of the muscles attached to them.
    Hip stress fractures seen mostly in long distance runners and women due to deficient nutrition and warm-up.

•    Tendinitis

    Inflammation of the tendon due to overuse syndrome, Forceful contraction of muscle fibers which cause injury.

•    Over training syndrome

    This occurs due to repeated training and overuse of the same muscles beyond their limit and capacity during competition/work-out lead to over training syndrome.

•    Sprains and Strains

     These are acute injuries causing Pain, Swelling, Bruising and Movement loss in the joint.
•    Blisters

    Fluid filled sacs on the skin surface of the feet due to Improper shoes, Running on bare feet, Running for longer periods etc

•    Runners toe/Turf toe

    This occurs due to running on hard and uneven surfaces which cause pain and swelling in the toe.

Physical Therapy Treatment

    Diet:

    Proper nutrition should be taken. Improper diet prevents from early recovery. A balanced diet includes:
    Carbohydrate intake which help in refueling muscles
    Proteins to rebuild muscles
    Drink plenty of water to keep hydrated.

    Vitamins and Minerals

Lower body strengthening exercises are more useful

    Ankle Sprain Treatment

    Rest for few days depending on the severity. Slow, Gentle movements. Then strengthening exercises of ankle.
    If the sprain is more severe, then surgery may be needed to repair the ligament. Physiotherapy treatment done after surgery.

Runners knee Treatment

    Rest for some time.
    Isometric and strengthening exercises for quadriceps muscle.
    Stretching exercises, Range of motion exercises of the knee.
    Soft tissue massage – Stroking technique is used from upper thigh region to the knee. This stretches the muscle fibers and improves muscle contraction.
    Pain relievers like aspirin also help.
     Avoid full leg extensions with knee bent as this may rupture the kneecap making the condition worse.

Knee Injuries Treatment

    Rest the part. Slow, Gentle Passive and Active movements of the joint. Later Stretching and Strengthening exercises of the knee.
    Knees kept strong by leg lifts, strengthening exercises by machines.
    Wearing Ace bandage on knee help in preventing the injury to get worse.

Hip Injury Treatment

Hip Flexor Stretch

Kneel on one knee and place other foot in front, tighten your stomach muscles leaning forwards.
Another technique is Stand straight and pull one heel to your buttock and knee backwards keeping spine straight.

Calf stretch

Stand on a step and let the heels drop stretching the back muscles of the leg.
Stand on a step and drop the heel keeping the knee slightly bend which helps in stretching the calf muscle.

Prevention

    Injury prevention methods are similar to all most all the sports but slight variations regarding protective equipments and conditioning exercises should be taken care of.

Warm-up Program

    It should consist of 5 min Cardio/Pulse raising exercises like Jogging, Cycling, and Skipping etc.
    Stretching exercises
    Specific sports exercises.
    Jogging

Benefits

    Increasing temperature of muscles.
    Increases blood circulation and oxygen to muscles.
    Increase the speed of nerve impulses making the muscle action faster.
    Increase the range of motions of the joints.
    Improves the performance of the joint action.

Stretching Exercises

    All muscles and joints stretching to be done. This helps in preventing injuries.
    Good stretching program for upper and lower limb muscles is to be done.
    Stretches should be static without any bounce and held for at least 30 sec.

Cool-down Program

    It consists of gentle jogging followed by light stretching.
    Benefits
    Gradually lower your heart rate
    Restoration of blood and oxygen to muscles as they were before exercise program
    Removes toxic and waste products
    Reduces muscle soreness present after activity.

First Aid Kit

    Adhesive bandages, Adhesive tape, Ace bandages
    Ice packs
    Pain killers
    Sterile gauze pads,
    First aid cream/Disinfections cream/Analgesic cream
    Scissors
    Cloth swatches for making slings in case of emergency.

Sports Massage

    Regular sports massage help in flushing of toxic and waste products.
    Relaxes the muscle stress.
    Releases tight lumps and bumps in the muscles.
    Give more importance to Lower limbs.

Dress Appropriately

    Proper fitted equipments should be worn. They include
    Proper Shoes - Good running sneakers/Shoes with skid resistant soles. Always examine the shoe soles and if smooth areas are seen replace them as soon as possible.

    a.    Wear comfortable and appropriate shoes which absorb the force impact during jumping, hard running.

    b.    Shoes should also have ankle support.

    c.    Running shoes should have good cushioning effect and should provide support and stability to the arch of the foot.

    d.    Ankle support reduce ankle sprains

    Proper socks are also needed. The sock should not allow the foot to slide more inside the shoe. Cotton socks absorb perspiration and add support to the foot.
    Knee pads
    Padded shorts, in case if we fall.
    Braces and Supports help in stabilizing the injured area improving movement.
    Knee cap/Ankle brace gives support to the injured part relieving stress and inducing healing.

•    Minor injury should also be treated as early as possible as this may lead to severe injury in later stage.
•    Good fitness training and trainer are also necessary. During practice also wear good and protective shoes.
•    Better running techniques/actions are to be practiced and should avoid imitating other’s techniques which does not suit your body type.
•    Instead of practicing improperly for prolonged periods, practice with good running technique for shorter period to get good results
•    Practicing on grass is good for beginners and early recovering athletes to avoid injury and reduce stress.
•    Be careful while running in between hurdles and sprinting to avoid groin injury. Adequate rest between the sessions helps the body to recover and strengthen.
•    Use a sunscreen lotion in summer and moisturizer in winter season while running to protect the skin.
•    Take caution while running in extreme hot and cold weather, wet and uneven surfaces etc.

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