Knee Medicine and Science: Running/Triathlon

Showing posts with label Running/Triathlon. Show all posts

BJSM Podcast: Running injuries.

In this BJSM podcast, Dr Andrew Franklyn - Miller gives his opinion on common running injuries.

BJSM Podcast: Dealing with shin pain.

In this BJSM podcast, Professor Phillip Newman from University of Canberra, addresses some of the key issues related to diagnosis, risk factors and treatment of Medial Tibia Stress Syndrome among running population. He also shares his views on barefoot running.

Listen here.

The knee most commonly affected in Ironman triathletes.

High prevalence of overuse injury among iron-distance triathletes.

Andersen C., Clarsen, B., Johansen, T. and Engebresten, L. British Journal of Sports Medicine, 2013; 47: 857 – 861.

http://www.ncbi.nlm.nih.gov/pubmed/23902775

Ironman distance triathlon has recently gained a lot of popularity in both professional and amateur athletes. Due to its endurance character, overuse injuries should occur. Nevertheless, lack of studies is present investigating injuries among Iron distance triathletes.

This was a 26-week prospective cohort study including 174 participants. Study found that the majority of injury cases in this group were overuse conditions. The most common sites of the injury were the knee, lower leg, lower back and shoulder. The average prevalence of overuse problems was 56%.

Study findings seem important for developing strategies to prevent and treat overuse injuries in triathletes. The knee and lower leg were most commonly affected body sites and this seems to be in agreement to what running athletes experience. Patellofemoral pain syndrome, “shin splints”, Iliotibial band syndrome , Achilles tendinopathy appears to be one of the most prevalent overuse conditions seen in runners and triathletes. Study results indicate that it would be advisable for Ironman triathletes to incorporate specific strategies into ther normal traing routine to prevent knee and lower leg overuse problems.

Do Minimalist Shoes Really Simulate Barefoot Running?

Running in a minimalist and lightweight shoe is not the same as running barefoot: a biomechanical study.
Bonacci, J., Saunders, P., Hicks, A., Rantalainen, T., Vicenzino, B. and Spratford, W. British Journal of Sports Medicine, 2013; 47: 387 – 392.
http://www.ncbi.nlm.nih.gov/pubmed/23314887

Minimalist shoes have been designed to mimic barefoot running due to its supposed efficacy in prevention of running related overuse injuries. Nevertheless, there is little evidence that running mechanics in minimalist shoes are similar to those observed during barefoot running. The study was conducted to compare running mechanics between barefoot running and running in a “minimalist” shoe (Nike Free 3.0), racing flat (Nike Lunaracer 2), and “regular” running shoes. Ground reaction force data and kinematics were collected from 22 highly trained runners.

Prevention and treatment of MTSS.

Excellent video presenting various stretches and exercises for those suffering from ‘Shin splints’ and for those wishing to avoid this common lower extremity overload condition. I would definitely recommend including this exercises to your normal workout routine.
All rights reserved to the WatchMojo.

BJSM Podcast: Biomechanical overload and lower limb injuries.

In this BJSM podcast, Andrew Franklin – Miller, PhD, talks about biomechanical issues associated with lower limb injuries among running athletes. Chronic exertional compartment syndrome, condition commonly mistaken with MTSS, is one of the overload injuries he specifically focuses on. Also, his shares his views in regards to relationship between running technique and lower extremity overload injuries which is followed by his recommendations on how you should correct your technique to lower the risk of sustaining some of the common leg overload conditions.

Listen here.(63)
All rights reserved to the British Journal of Sports Medicine.

Risk factors and prognostic indicators for Shin splints.

Risk factors and prognostic indicators for medial tibial stress syndrome.
Moen, M., Bongers, T., Bakker, E., Zimmermann, W., Weir, A., Tol, J. and Backx, F.
Scandinavian Journal of Medicine & Science in Sports, 2012; 22: 34 – 39.
http://www.ncbi.nlm.nih.gov/pubmed/20561280

Medial tibial stress syndrome, so called ‘Shin Splints’, is a very common overuse lower leg injury observed in running population. MTSS was thought to be due to a traction induced periostitis, though recent evidence rather suggest bony overload. One of the keys to treat MTSS is to identify risk factors. Although several studies investigated risk factors for shin splints, findings seem somehow conflicting. Therefore, this study aimed at assessing risk factors for MTSS and identifying prognostic indicators to predict the duration of recovery.

'Shin Splints' by Sports Medicine Physician.

It took me some time to find really worth publishing video on MTSS and this one seems to be most reasonable choice. The video addresses basic issues in regards to anatomy, causes, differentiation and treatment of “Shin Splints”.

BJSM Podcast: Chronic Exertional Compartment Syndrome.

In this BJSM podcast, Prof Mark Hutchinson shares his views on leg pain among running athletes. He specifically focuses on examination and management of Chronic Exertional Compartment Syndrome, a condition frequently mistaken with 'Shin splints'.
Listen here.
All rights reserved to BMJ Group.

'Shin splints' - Medial tibial stress syndrome (MTSS)

Medial tibial stress syndrome (MTSS), commonly called ‘shin splints’, constitutes great number of overuse injuries seen in endurance sports, especially those involving long – distance running. It is one of the most common causes of exercise-induced leg pain. The post will cover current concepts in regards to the causes, history, risk factors, diagnosis and treatment of the MTSS.

Eccentric training for patellar tendinopathy: know how.

Here is the video presenting how to perform the decline board squat which represents most commonly used form of eccentric exercise for jumper’s knee. Eccentric training has been advocated by research findings to be most effective tool against patellar tendinopathy. Authors of the video, suggest performing the exercise three times daily, 15 reps each time. It would be advisable to add that most of the literature suggests continuing the training for the period of at least six weeks combined with relative rest and activity modifications. Finally little discomfort can be acceptable during the exercise.
All rights reserved to the PHYSIO4ALLsydney.

Eccentric training for 'jumper's knee'- is there one right protocol existing?

The evolution of eccentric training as treatment for patellar tendinopathy (jumper’s knee): a critical review of exercise programmes.
Visnes, H. and Bahr, R. British Journal of Sports Medicine, 2007; 41: 217 – 223.
http://www.ncbi.nlm.nih.gov/pubmed/17261559

Patellar tendinopathy occurs frequently in jumping (volleyball, basketball) and endurance (running, triathlon) athletes. Various treatment options are available. Eccentric exercises have been advocated to be very effective tool, with research finding proving that notion. Nevertheless, no consensus exists in regards to what specific prescription should be implemented for this kind of intervention. Therefore, authors conducted this review to help clinicians make appropriate choices regarding exact form of eccentric exercise to be used for patients.

Risk factors for the 'jumper's knee'.

Risk factors for patellar tendinopathy: a systematic review of the literature.
van der Worp,H., van Ark, M., Roerink, S., Pepping, G., van den Akker-Scheek, I. and Zwerver, J. British Journal of Sports Medicine, 2011; 45: 446 – 452.
http://www.ncbi.nlm.nih.gov/pubmed/21367808

Patellar tendinopathy, so called “jumper’s knee”, is a common complain among jumping athletes as well as in those participating in endurance events. Identifying risk factors for particular condition seems crucial for developing preventive and rehabilitation interventions. Nevertheless, there seems to be no consensus in these areas in regards to the jumper’s knee. Therefore, authors decided to put together this systematic review to investigate risk factors for patellar tendinopathy.

Jumper's knee by M.D.

Nice video by Nabil Ebraheim, M.D, summarizing everything you want to know about patellar tendinopathy, so called “Jumper’s knee”. It addresses key issues in regards to anatomy, biomechanics, causes, epidemiology, diagnosis and treatment of the Jumper’s knee.

Patellar tendinopathy (Jumper's knee).

Patellar tendinopathy, often reffered as the “jumper’s knee”, is a common knee overuse injury. Usually, affects athletes who jump frequently (volleyball, basketball), however is also very common in endurance athletes (triathletes, cyclists). The patellar tendon is the central portion of the common tendon of the quadriceps femoris, which is continued from the patella to the tibial tuberosity. As the quadriceps muscle directly controls its function and its macroscopic or microscopic appearance is similar to tendinous tissue, the term ‘patellar ligament’, should be avoided. The post will cover current concepts in regards to the causes, history, risk factors, diagnosis and treatment of the “Jumper’s knee”.

Functional anatomy of the iliotibial band and its implication for ITBS causation.

The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome.
Fairclough, J., Hayashi, K., Lyons, K., Bydder, G., Phillips, N., Best, T. and Benjamin, M. Journal of Anatomy, 2006; 208: 309 – 316.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2100245/

Iliotibial Band Syndrome (ITBS) is a very common overuse injury seen in endurance athletes, especially runners and cyclists. It is believed to be associated with excessive friction between the tract and the lateral femoral epicondyle-friction which ‘inflames’ the tract or a bursa. Authors conducted this study to challenge the view by evaluating clinical anatomy of the region. Gross anatomical and microscopical studies were conducted on the distal portion of the ITB in 15 cadavers. Additionally, magnetic resonance (MR) imaging of six asymptomatic volunteers and studies of two athletes with acute ITB syndrome were undertaken.

Step width during running and ITBS.

Step width alters iliotibial band strain during running.

Meardon, S., Campbell, S. and Derrick, T. Sports Biomechanics, 2012; 11: 464 – 472.

http://www.ncbi.nlm.nih.gov/pubmed/23259236

Iliotibial Band Syndrome (ITBS) is characterised by pain located in the area of lateral femoral condyle, occurring after substantial distance during running/cycling activity. ITBS is thought to occur as an inflammatory and/or degenerative response due to excessive ITB rubbing against lateral femoral condyle during repetitive knee flexion and extension while running/cycling. Others suggest that it is fat pad, located between ITB and lateral femoral condyle, excessive compression which creates pain symptoms. Much attention has been recently brought to biomechanical factors and ITBS. Some authors suggested that a narrower step width during running is likely to increase hip adduction and influence knee internal rotation resulting in greater ITB strains and strain rates. This study investigated this hypothesis.

ITBS examination: Ober's Test and Noble's Test

The Ober's test is a test used in physical examination in order to identify tightness of the iliotibial band and can be indicative for Iliotibial Band Friction Syndrome (ITBS).

The Noble’s test is a provocative test of the iliotibial band and is also commonly used as an indication for ITBS (click "read more" to watch).

Kinematic factors related to iliotibial band syndrome in runners.

Kinematic classification of iliotibial band syndrome in runners.
Grau, S., Krauss, I., Maiwald, C., Axmann, D., Horstmann, T. and Best, R. Scandynavian Journal of Medicine & Science in Sports, 2011; 21: 184 – 189.
http://www.ncbi.nlm.nih.gov/pubmed/19903313

Iliotibial Band Syndrome (ITBS) is one of the most common overuse injuries experienced by runners. It is generally thought to result from excessive rubbing of the distal iliotibial band across the lateral femoral condyle. Others think that fat pad compression beneath the tractus is a major causative factor in the development of ITBS. Several biomechanical risk factors have been suggested to contribute in the development of ITBS. Nevertheless, findings are somehow inconsistent and qualities of studies could be questioned. Thus, authors decided to conduct this study to investigate differences between healthy runners and runners suffering from ITBS with regard to kinematic characteristics.

Iliotibial Band Syndrome (ITBS), often called iliotibial band friction syndrome, is another common knee condition seen in endurance athletes (runners, triathletes, cyclists). The incidence is reported to be as high as 12% of all running-related, overuse injuries. Iliotibial band (ITB) is a sheet of connective tissue originating at the iliac crest and terminating at Gerdy’s tubercle and the fibular head. The post will cover current concepts in regards to the causes, history, risk factors, diagnosis and treatment of the ITBS.