1 / 60

OVERUSE INJURIES IN RUNNING

OVERUSE INJURIES IN RUNNING. CONTENTS. Overview; Basic biomechanics of running; Epidemiology of running injuries; Causative factors; Dose-response relationship; and Prevention strategies Evaluation strategies. OVERVIEW. Commonest type of sports in Hong Kong

kamali
Download Presentation

OVERUSE INJURIES IN RUNNING

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. OVERUSE INJURIES IN RUNNING

  2. CONTENTS • Overview; • Basic biomechanics of running; • Epidemiology of running injuries; • Causative factors; • Dose-response relationship; and • Prevention strategies • Evaluation strategies

  3. OVERVIEW • Commonest type of sports in Hong Kong • Mass entrants in the Tsing Ma Bridge Marathon and ‘98 New Airport International Marathon and 10 km. run

  4. BENEFITS OF RUNNING • Improve physical fitness level; • Positive feeling of good health; • Friendship and socialisation; • Enjoyment; and • Rewards

  5. Sequence of Prevention 2. Establishing aetiology & mechanism of injuries • 1. Establishing the extent of the sports injury problem • Incidence • Severity 3. Introducing preventive measures 4. Assessing their effectiveness by repeating step 1

  6. EPIDEMIOLOGY OF RUNNING INJURIES • Knutzen and Hart (1996) • A comprehensive review on running injuries • Retrospective studies (16) • Prospective studies (5) • Annual incidence 48-65% (P); 24-60% (R)

  7. EPIDEMIOLOGY OF RUNNING INJURIES • Retrospective studies • Marti et al. (1980) • Surveillance study of 4,358 runners in a road race • 1,994 injured (46%)

  8. PROSPECTIVE STUDY • Walter et al. (1989) • Ontario Cohort study • enrolled 1,680 runners at two races • prospective survey for 12 months. • 1,288 completed the follow-up data • 48% were injury.

  9. SITE OF INJURIES

  10. Case series studies • Clement et al. (1981) • Review 1,650 patients between 78-80.

  11. EPIDEMIOLOGY OF INJURIES • Data collection far from comprehensive • Subjects selection bias • Injuries ill-defined • True incidence of injuries yet to be determined (for details, refer to Caine et al., (1996) epidemiology of sports injuries. Human Kinetics. Chapter 22)

  12. ESTABLISHING AETIOLOGY & MECHANISM OF INJURIES

  13. RUNNING EVENTS • CHARACTERISTICS • NEURO-MUSCULAR PREDOMINANCE (SPRINT & HURDLES) • CARDIO-RESPIRATORY PREDOMINANCE (MIDDLE & LONG DISTANCE) • CAPACITY BASED ON STRENGTH & ENDURANCE (AEROBIC & ANAEROBIC) • PHYSIOLOGICAL ADAPTATION TAKING PRECEDENCE OVER TECHNIQUE

  14. RUNNING CYCLE • No double support phase • Stance (40%) • Float (30%) • Swing (30%) • Contact, midstance,propulsion • forward swing & foot descent

  15. Jogging: Stance > Swing • Distance: Stance = Swing • Sprinting: • Stance < Swing

  16. RUNNING BIOMECHANICS INITIAL GROUND REACTION FORCES • VERTICAL GROUND REACTION FORCES 2-3 TIMES BODY WEIGHT • ANTERIOR /POSTERIOR FORCES - 50% B.W. • MEDIAL /LATERAL SHEAR - 10% B.W. • DURATION - 200 - 600 ms. • PEAK IMPACT FORCES AT 20-30 ms.

  17. CAUSATIVE FACTORS IN RUNNING INJURIES EXTRINSIC • Training error • Running Terrain and Surfaces • Running shoes

  18. TRAINING ERROR • Clement et al. (1981) • Sudden increases in mileage or intensity • High intensity without rest • High level of competition

  19. Marti et al. (1980) • Increased association of injuries when mileage (>50 km./week) • Ontario Cohort study • > 40 km/week.

  20. RUNNING TERRAIN AND SURFACES • Clement et al. 1981 • Uneven, hardness, road camber • Uphill and downhill

  21. RUNNING SHOES • FOOT MUST BE STABLE • SHOCK ABSORBPTION – REDUCE THE INITIAL HEEL SPIKE • RIGID LEVER FOR THE THRUST OF FORWARD MOTION

  22. RUNNING SHOES SHOCK ABSORPTION EFFECT FACTS: • The Shock absorption effect will easily lost 40% after 400-800 Km. of running (After Cook et al 1985)

  23. CAUSATIVE FACTORS IN RUNNING INJURIES INTRINSIC • IMPERFECT MUSCULOSKELTAL ALIGNMENT • FLEXIBILITY

  24. INTRINSIC FACTORS • Cowan et al., 1996 • Investigate effects of anatomic variation on risk of overuse injuries • Prospective study • Subjects: 294 army infantry for 12/52 training • Risk of injury increase with Valgus knee (RR=1.9) and Q angle >15 degree (RR=5.4)

  25. INTRODUCING PREVENTIVE MEASURE

  26. PRINCIPLES OF TRAINING BIOLOGIC ADAPTATIONS TO IMPROVE PERFORMANCE IN SPECIFIC TASKS

  27. TRAINING PROGRAM • Yeung and Yeung 2001 • Investigate the characteristics and training profile of marathon finishers and non-finishers • Subjects: 113 runners from Standard Chartered Hong Kong Marathon 1998

  28. Personal and training profile

  29. TRAINING AND RECOVERY • Warm (Cool) down • Whirpools and Spas • Massage • Rest and Sleep • Psychological • Nutritional

  30. COOL DOWN • Lactate can be removed from blood and muscle more rapidly by light continuous aerobic exercise • Optimal rate of removal 30 - 45% VO2 max 50-65%

  31. OVER TRAINING • Sign of over training • Fatigue and poor performance • Increase resting heart rate • Weight loss • Irritability and sleep disturbance • Elevated Serum Creatine Phosphokinase (CPK)

  32. TRAINING TERRAIN • TRACK vs ROAD • CROSS TRAINING – UPHILL vs DOWNHILL • TREADMILL

  33. FUNCTIONAL ANATOMY OF FOOT • Normal Foot arch, flat foot and Pes Cavas • Effects of foot arch or weight bearing

  34. SELECTION OF RUNNING SHOE

  35. RUNNING SHOES • Be Comfortable • Protect the wearer from injury • Not be a source in injury • Facilitate athletic performance • Be durable and economical

  36. SHOE COMPONENTS

  37. Last • Straight / Curve Last • Slip Last • Board Last • Shoe Upper • Toe-box • Heel Counter • Achilles Tendon Pad • Sole • Outsole • Midsole • Insole

  38. PRONATOR • Needs stability and arch support • Features: • Straight last; • Supportive heel counter; • Extra support on medial side • Increased medial wedging on insole • Semirigid orthotic

  39. NEUTRAL • Need good fit, adequate arch and shock absorbing • Features: • Semicurved last; • Extra cushioning & • Medium heel counter

  40. SUPINATOR • Needs flexibility, maximum shock absorbing • Features: • Semicurved or curved last; • Slip last • Maximum cushioning

More Related