Prevention of common running injuries

Transcription

1 Prevention of common running injuries Lower limb and hip joint pain, along with soft tissue structures of the lower leg, can be extremely painful and frustrating injuries. Some of the most common running injuries can often start off as a twinge/niggle, progressing quickly to a debilitating injury that stops us for weeks. Some of these injuries include: - ITB friction syndrome (pain on outside of knee or hip) - patella-femoral knee pain (general pain around/behind knee cap) - Calf and achilles strain - Plantar fasciitis The iliotibial band (ITB) is a thick tendon-like (fascia) part of a muscle called the tensor fasciae latae (TFL). It passes down the outside of the thigh and inserts below the knee. When the TFL and ITB become tight, the knee joint can be pulled out of alignment and rub against the outside of the knee, which results in inflammation and pain. Tight plantar fascia, achilles and other muscles can also add to problems.. Weak medial structures (eg. Vastus medialis/vmo) can also contribute to this. Other weak muscles around the hip, namely gluteals (eg. medius and maximus), have been identified as common causes of lower limb injuries. CAUSES (of all the above injuries): Two main causes: (1) "overload ; (2) "biomechanical errors." (1) Overload can be caused by: Exercising on hard surfaces, like concrete; Exercising on uneven ground; Beginning an exercise program after a long lay-off period; Increasing exercise intensity or duration too quickly; Exercising in worn out or poor-fitting shoes; and, Excessive uphill or downhill running. (2) Biomechanical errors include: Leg length differences; Tight, stiff muscles in the leg (NB: Solution Stretching); Muscle imbalances (NB: Solution - Strengthening exercises); Foot structure problems such as flat feet (NB: Solution good, light but sturdy running shoe (support)); Gait, or running style problems such as pronation. TREATMENT: Initially, ICE the affected area after every run/activity, AND, every evening Stretch, strengthen and reduce volume! Identify the causes above that apply to you and remove/minimise these!

2 % of all lower leg injuries in runners (eg. knee pain, achilles) are caused by poor hip stability 2. During running & change of direction, muscles around the hip need to be strong enough to stop the hip rotating or dropping 3. Hip extensors eg. glut max Hip rotators eg. glut min, quadratus fem Hip abductors eg. TFL, glut med

3 GYM CONDITIONING PROGRAM (Stage 1) - PURPOSE The purpose of the program is to prepare and condition the lower body for sport training and competition long term. It also aims to develop mobility and general strength/stability around the hips/core. The program will be specifically tailored to the functional needs of running to assist in: (1) Developing strength of the hip abductors (TFL, glut medius) and hip extensors (glut maximus/hamstrings) (2) Developing strength of the VMO (vastus medialis) (3) Long-term welfare and longevity (reduce risk of injury due to lack of preparation or overload) injury prevention (4) Developing length/flexibility of ITB (priority), hip flexors, achilles/calf, lower back/hamstrings Hip stability: An initial focus will be on developing hip and gluteal stability. One of the main causes of lower leg pain/problems is poor hip stability or tight structures around the hip eg. Strength of the muscles around the hip joint, specifically the external rotators and extensors i.e. gluteus maximus, medius and minimus, TFL, quadratus femoris. EXERCISE PROGRAM: This should include some stretching and strengthening. Here are the key muscles to stretch and strengthen: Stretching: ITB/TFL Hip flexors/quads Lower back/hamstrings Calves/Achilles Functional strengthening: Hip abduction (gluteal medius, TFL) Hip extension (gluteus maximus) Quads (VMO) one-legged squat Summary: 70% of lower body injuries are preventable with strong control of the core, and, good mobility/flexibility.

4 PROGRAM 1 STRENGTHEN (Stage 1) Outcomes: Hip mobility. Core hip stability/gluts, abdominals.. NO EXERCISE SETS x REPS x INT 1a Glut max, hamstrings, lower back 1b Glut medius, TFL 2a Quads, hamstrings, calves 2b Lower back, rotational stabilisers, VMO 2c Abdominals Hip extension: double-leg glut extension Hip abduction (side-lying) leg raises (L then R) 3 x x 4secs 3 x x 4secs Single leg squat (90deg) 3 x 8-12 x 4secs Seated fitball leg extensions 3 x (each side) x 5secs Date/s: COMMENTS Slow. Controlled. Push hips up high. Squeeze/contract gluts. Hold 2 secs at top. Add barbell/weight to hips later Slow. Controlled. Keep hips square/vertical. Hold 2 secs at top. Add elastic later Knee to 120deg. (1) Hips square/parallel. (2) Keep knee in line with toes. (3) Focus on contracting VMO & keeping hips level. Add light DB s later Seated on edge, upright with both feet on ground, hip width apart. (1) With toes/knees slightly turned out, slowly raise one leg, contract VMO, and hold 3secs. Lower. (2) Repeat with other leg. Add elastic around ankles later. Plank 3 x 40-60secs Straight body position/good posture. (1) Squeeze belly button upwards/inwards. (2) Breathe normally. (3) Hold. Variations: (1) Rock gently forward and back on toes. (2) Slowly lift one leg (squeeze gluts) then other NO DATE

5 PROGRAM 2 - LENGTHEN Outcomes: Hip mobility. Core hip stability/gluts, abdominals.. NO EXERCISE SETS x REPS x INT 1a Calf, achilles, plantar fascia 1b ITB, TFL 2a Hip flexors 2b Hamstrings, lower back Calf wall stretch Standing ITB stretch Lunge Sit and reach (strap) 3 x 60secs 3 x 60secs 3 x 60secs 3 ITB roller 3 x 5 times Date/s: COMMENTS Place toes against wall. Slowly straighten body towards wall, bringing chest to wall. Place one leg behind, then step across. Keeping body upright/straight, push hip out Large lunge. Back knee on ground. Feel stretch in front of thigh/groin. Slowly straighten trunk to vertical to increase stretch. 3 x 60secs Seated. Both legs together. Hook strap over feet. Keeping upper body straight, pull lower back forwards. Start at hip. Slowly roll down towards knee. When at a lump/sore spot, hold roller on it for 10 secs. Continue. NO DATE

6 LEVEL (1) Hip extension (2) Hip abduction (3) Hip rotation 1 2 3

7 1. Achilles/calf stretch: Plantar fascia, achilles, calf, soleus 2. Standing ITB stretch 3. Lunge - Hip flexor stretch: Quads/hip flexors 4. Seated hamstring stretch: Hamstrings, lower back 5. ITB roller