Intro to Running Analysis and Runner's Rehab Flashcards
Define kinematics
- Describe motion without reference to forces involved
- Description of the way the parts of the body move in space
Define kinetics
- Describe the forces that cause motion
- Ground reaction forces
Define cadence
- Steps per minute
Define stride length/gait cycle
- From initial contact of reference limb to initial contact of same reference limb
Difference between walking and running
- Walking: the body vaults over a stiff stance limb
- Running: the body hops forward onto energy efficient springs
Describe the spring theory for running
- Energy absorbed in 1st half of stance & returned in 2nd half of stance
- Energy is absorbed & release via muscle-tendon units
Kinematics of running at initial contact
- STJ: 2º inverted
- Ankle: 0º DF
- Knee: 10-20º flexed
- Thigh to vertical: 25º
- Hip: 30º flexed, 7º anterior pelvic tilt
Muscle activity during running at initial contact
- STJ: Inv/Ev co-contract
- Ankle: pretibilvas isometric
- Knee: HS/Quads co-contract
- Hip: ext/ADD/ABD isometric
Describe a forefoot strike
- Ankle: Plantarflexed: Gastroc preactivated in terminal swing
- Tibia: Vertical
- Knee: Increased flexion
- Hip: Increased hip flexion
Describe rearfoot strike
- Ankle: Dorsiflexed: Anterior tib preactivated in terminal swing
- Tibia: Less Vertical
- Knee: Decreased flexion
- Hip: Decreased hip flexion
Kinematics of running during loading response (after heel strike)
- STJ: 4-6° EV; STJ is Pronating
- Ankle: 5° PF; Ankle is plantarflexing
- Knee: 30-42° Flex; Knee is flexing
- Hip: 20° Flex, 7° Anterior Tilt; Hip is extending and dropping
Muscle activation during running at loading response (after heel strike)
- STJ: Post tib, FDL, FHL, Soleus Eccentric
- Ankle: Pre-tibials Eccentric
- Knee: Quads Eccentric; HS Concentric
- Hip: Sagittal Plane: G. Max Concentric/Hip flexors – Eccentric; Frontal Plane: Hip ABD – Eccentric, Hip ADD Isometric; Transverse Plane: Hip ER/G.Max - Eccentric
Kinematics of running during loading response (after forefoot strike)
- STJ: Pronating
- Ankle: Dorsiflexes
- Knee: Flexing
- Hip: Frontal Plane: Adduction; Transverse Plane: Internal Rotation
Muscle activation during running at loading response (after forefoot strike)
- STJ: Post tib, plantar intrinsics Eccentric
- Ankle: Gastroc-Soleus Eccentric
- Knee: Quads Eccentric
- Hip: Eccentric; Frontal Plane: Glute Med; Transverse Plane: Glute Max, Hip ER
Kinematics of running during midstance
- STJ: 6-8° EV; STJ is at max pronation
- Ankle: 15-20° DF; Tibia is moving over foot
- Knee: up to 40° Flex
- Hip: 0-5° Flex; Frontal Plane – hip drop; Sagittal Plane – hip ext; Transverse Plane – femoral IR
Muscle activation of running during midstance
- STJ: Post tib – Eccentric
- Ankle: Gastroc-Soleus – Eccentric
- Knee: momentum from opposite limb in swing
- Hip: Eccentric; Frontal Plane: hip ABD; Sagittal Plane: hip flexors; Transverse Plane: Glute Max, hip ER
Kinematics of running during terminal stance
- No normative values currently
- STJ: Resupinating
- Ankle: Dorsiflexing
- Knee: Extending
- Hip: Frontal: Elevating; Sagittal: Extending; Transverse: Backwards rotation
Muscle activation of running during terminal stance
- STJ: Post tib/Ant tib – Concentric
- Ankle: Gastroc-Soleus – Eccentric
- Knee: Momentum
- Hip: Frontal: ABD – Concentric; Sagittal: Hip flexors – Eccentric; Transverse: Hip ER - Concentric
Kinematics of running during pre-swing
- STJ: No norms (Inverting)
- Ankle: 20° PF; Ankle is plantar flexing
- Knee: 10-20° Flexion; Knee is flexing
- Hip: 8-11° Extension; Hip is flexing
Muscle activation of running during pre-swing
- STJ: Invertors – Concentric
- Ankle: Gastroc-soleus – Concentric
- Knee: Knee flexes due to hip flexing
- Hip: Hip Flexors - Concentric
Kinematics of running during initial swing
- STJ: (no norms); inverting
- Ankle: 22-25° PF
- Knee: 20-40° Flex
- Hip: 3-8° Ext
Muscle activation of running during initial swing
- STJ: Ant tib – Concentric
- Ankle: Pretibials – Concentric
- Knee: Momentum from hip flexion; Rapid knee flexion occurring
- Hip: Hip flexors – Concentric; Rapid hip flexion
Kinematics of running during mid-swing
- STJ: No major activity
- Ankle: 0° DF (neutral)
- Knee: 90-110° Flex
- Hip: 0-10° Flex
Muscle activation of running during mid-swing
- STJ: No major activity
- Ankle: Pretibs – Concentric
- Knee: Quads – Concentric; Knee is extending
- Hip: Hip flexors – Concentric; Hip is flexing
Heel strikers muscle activation of running during terminal stance
- STJ: Ant-tib – Concentric
- Ankle: Pretibs – Concentric
- Knee: Hamstrings – Eccentric
- Hip: Hip extensors - Eccentric
Forefoot strikers muscle activation of running during terminal stance
- STJ: Inversion; Post tib – Concentric
- Ankle: Plantarflexing; Gastroc-Soleus – Concentric
- Knee: Flexing; HS – Eccentric
- Hip: Flexing; Hip extensor - Eccentric
Describe running gait as a whole versus walking gait
- Stance phase decreased, swing increased: Double float phase
- Forces higher and occur quicker
- Lower extremity strength demands and neuro-motor control higher
- Shock attenuation more important vs. walking
- Base of Support more narrow; BOS narrows with increasing speed; Higher strain on ITB
- Mechanics vary by speed, age, gender, terrain and individual
Overuse injuries account for ____% of running injuries
- 90%
Risk factors for a running injury
- No prior running experience = 2.5-3x more likely to be injured
- Mileage exceeding 10 miles per week 3x more likely to be injured
- Increase in mileage too rapidly – best plan 10% progression per week
- Sudden change in terrain
- Not enough rest days – less than 2 per week higher incidence of injury
- Hx of previous running injury
- Poor LE biomechanical profile
- Selection/condition of running shoes
- Women with low bone density (osteopenia or osteoporosis)
Prevalence of running injuries
- Knee 42%: Patellofemoral pain, Iliotibial band syndrome, Infrapatellar pain
- Foot/Ankle 36%: Plantar fasciosis, Medial tibial stress syndrome, Achilles tendinosis
- Stress Fracture 20%: Tibia, Metatarsals, Femur
Signs and symptoms of patellofemoral pain syndrome “Runners Knee”
- Pain after longer runs
- Pain after extended periods of sitting
- Pain with descending hills or stairs
- Pain with squatting
Risk factors for patellofemoral pain syndrome
- Lower extremity biomechanical deficits ie overpronation
- Weakness in quads or hips – specifically gluteals
- Females > Males
Treatment for patellofemoral pain syndrome
- Avoid running downhill
- Cross train with cycling (build quads), elliptical or swimming
- Strengthen gluteals especially hip abductors and deep hip external rotators
- Shorten stride length to land with slight bend in knee
When should you stop running, use caution, or go for patellofemoral pain syndrome
- Stop: Pain on inside/outside of knee upon waking up (>3-4/10) and Pain that doesn’t decrease throughout the day
- Caution: Minimal pain early in run, can run it off but sore following run (<3/10) and Mild pain with prolonged sitting (<3/10)
- Go run: Pain free after sitting through a two hour movie and Pain free after a long hilly run
Signs and symptoms of achilles tendinitis (osis)
- Tenderness to touch at the back of the heel
- Swelling at the back of the heel where the tendon meets the bone
- Pain with heel raises
- Pain at the heel during and after running
- Pain in the back of the heel when getting out of bed
Risk factors for achilles tendinitis (osis)
- Middle age/older runners due to reduced vascularization of tendon
- Sudden increases in training
- Poor calf flexibility
Treatment for achilles tendinitis (osis)
- Ice massage/anti-inflammtories during acute stage
- Eccentric strengthening (following acute stage)
- Daily calf stretches to improve flexibility (following acute stage)
- Cross train with pool running, elliptical
When should you stop running, use caution, or go for achilles tendinitis (osis)
- Stop: Severe pain and swelling above the back of the heel, despite rest from running and Pain with heel raises (>4/10)
- Caution: Dull pain following a run that lingers for up to 24 hrs post run but relieved with icing and Mild tenderness to touch the back of the heel
- Go run: No tenderness to touch the back of the heel and No pain/swelling following running
Signs and symptoms of stress fracture
- Localized pain at the shin, foot, groin/front of hip
- Pain with running that goes away at rest
- Progresses to persistent pain
Risk factors for stress fractures
- Women > Men
- Low BMI
- Low bone mass
- Quickly increasing mileage
- Poor LE biomechanics
Treatment for stress fractures
- Depends on severity and location
- Moonboot with crutches 4-6 weeks
- Progressive weight-bearing under guidance of PT/MD
- Cross train with biking or swimming or pool jogging
When should you stop running, use caution, or go for stress fractures
- Stop: Pain increases with running, but then starts to linger with just standing/walking afterward and Get diagnosis via weight-bearing x-ray or tuning fork test
- Caution: No middle ground with this – if it hurts you need to stop or you will make it worse
- Go run: Walking without a limp, Pain free standing for prolonged periods, and Pain free walk/jog with no lingering pain following
