Running Injuries from Kines

Question 1

What percent of runners experience PFPS?

Answer 1

25-40%

Question 2

In pt’s w/PFPS, what kinematic changes are commonly seen?

Answer 2

Incr Hip Adduction–>During running, jumping, & squatting

Incr Hip IR–>During running, jumping, & step-down tasks

Excessive Dynamic Knee Valgus

Excessive Eversion–>Causes bow string force on patella

Question 3

In pt’s w/PFPS, what strength deficits are commonly seen?

Answer 3

Hip Abduction
Hip ER
Hip Extension
Delayed & shorter glute med activation time
Maybe weak quads

Question 4

PFPS Interventions

Answer 4

Strengthening of hip ER's, abd's, & quads
PNF stretching
Orthoses
Proprioceptive (biofeedback) training
Taping
Gait Retraining

Question 5

What is the 2nd most common running injury & leading cause of lateral knee pain?

Answer 5

ITBS

Question 6

What contributes to ITBS in runners?

Answer 6

Slow training pace
Female
Short stature
High weekly mileage

Question 7

What are the 2 theories for why ITBS devos?

Answer 7

Compression & Friction Theories

Question 8

Explain the friction theory of ITBS

Answer 8

Knee flexion impinges the ITB, which causes friction on it

Question 9

Explain the compression theory of ITBS

Answer 9

Combined hip adduction & knee IR stretches the ITB

Question 10

What kinematic changes are commonly seen in pt’s w/ITBS?

Answer 10

IC: Decr hip add, tibial IR, & eversion

Stance: Incr hip add & tibial IR

Question 11

What is the main sx of plantar fasciitis?

Answer 11

Pain at the inside of the heel

Question 12

How long does it typically take for PF to resolve?

Answer 12

6-18mo

Question 13

What are the risk factors for PF in runners?

Answer 13

Older age
Higher Weight
Longer time running
High weekly mileage
Incr in intensity, frequency, & duration

Question 14

Why do the risk factors for PF cause PF?

Answer 14

They incr strain on the plantar fascia

Question 15

What does PF cause?

Answer 15

Incr stiffness & decr shock absorption of plantar fascia

Question 16

What kinematic changes are seen in pt’s w/PF?

Answer 16

Altered ankle ROM
Pes Cavus/Planus
Incr loading rate
Incr magnitude of impact

Question 17

Why does pes cavus contribute to PF?

Answer 17

Incr mechanical stress on fasica
Incr stiffness
Decr shock absorption

Question 18

Why does pes planus contribute to PF?

Answer 18

Causes incr loads on med calcaneus & plantar area

Question 19

Why does incr loading rate contribute to PF?

Answer 19

Faster loading rate means incr magnitude of impact

Question 20

How is PF tx’ed?

Answer 20

Manual Therapy
Jt & ST mobes

Stretching of Achilles & PF

Taping, Orthoses, & Night Splints

Question 21

What are the sx’s of MTSS?

Answer 21

Pain & tenderness along the posteromedial tibia

Question 22

What are the kinematic changes seen w/MTSS?

Answer 22

Decr hip ER
Decr PF
Navicular drop

Question 23

Explain the pathophysiology of MTSS

Answer 23

Incr pronation(Navicular drop) causes tibial rotation & bending, which leads to higher strains on the tibia

Question 24

Who is more likely to suffer from stress fx’s?

Answer 24

Females

Question 25

What are the kinematic changes seen w/tibial stress fx’s & what are the implications?

Answer 25

Incr peak rearfoot eversion–>Incr torsional load on tibia
Incr knee stiffness–>Can’t shock absorb as effectively
Incr hip adduction–>Pt absorbs in frontal plane
Incr vertical loading rate & peak tibial shock

Question 26

What is the tx for tibial stress fx’s?

Answer 26

Modified WB/Boot
Activity Restriction
Gait Retraining

Question 27

When doing gait retraining for a pt w/tibial stress fx’s what should be done?

Answer 27

Get pt to run quieter
Decr stride length
Incr cadence