Sports
Running is a popular activity that can help maintain or improve your cardiovascular fitness and in some cases help you lose weight. There are many different reasons to run but often there is a goal set that may include 5Km, 10Km, half marathon, or full marathon.
When training for longer runs including 10km, half and full marathons it is important to remember that the training schedule should take place over long periods of time to allow your muscles and joints to accommodate for the increased strain that will be placed on them during the long run. As a physiotherapist, I treat many runners with all sorts of injuries. Some of the most common injuries include plantar fasciitis, achilles tendonitis, muscle strains, and Iliotibial band friction syndrome (IT band syndrome).
IT band syndrome is a repetitive stress injury that occurs when the iliotibial band glides over the lateral femoral condyle on the outside part of the knee. The iliotibial band is the thick band that runs from the outside of the hip down to the outside of the knee. It is a common injury for long distance runners (20-40 miles/week) but is not limited to only long distance runners. Running on various terrains can increase the risk of developing this condition. Up and down hills, graded slopes, and cambered roads have all been shown to increase the risk. This syndrome may also be found in other athletes or weekend warriors such as cyclists, weight lifters, and participants in jumping sports.
With IT band syndrome there is rarely a history of trauma. Patients will often complain of knee pain that may be difficult to localize and usually increases with repetitive motions like running. The symptoms usually get worse with changes in training surfaces, increasing mileage, or training on crowned roads.
Studies have found that long distance runners with IT band syndrome have weaker hip abductor and glut muscles on the involved leg compared to the uninvolved leg. The hip abductor muscles are located on the outside part of the hip and help prevent the leg from moving towards the centre of the body. It is also noted that fatigued runners are more prone to having their hip adduct (move towards the centre) and internally rotate (leg turns inwards) which causes more friction on the iliotibial band and therefore the symptoms get worse.
The management of IT band syndrome usually includes: 1) activity modification (usually decreasing mileage). 2) New running shoes. Shoes should be replaced about every 500km. 3) Heat or ice. 4) Stretching the IT band. 5) Strengthening the hip abductors and glut muscles.
If you are interested in pursuing long distance running you should: 1) follow a certified training schedule. 2) Make sure the shoes you are wearing are the right shoes for you. 3) Increase your mileage slowly to allow your body to accommodate for the increased strain. 4) Hit the gym – muscle weakness can cause problems down the road. 5) Go in for an assessment with a health care professional if you start to experience aches and pains that aren’t going away.
Sports
The sun is shining. Birds are singing. Blossoms are blooming… and the soccer balls are flying! Soccer is the most commonly played sport in the world enjoyed by all ages. In 2005, about 20% of children younger than 14 years of age participated in soccer, a number which is likely higher now.
Training in organized sports during the younger years has been shown to, improve general health, have psychological benefits, and enhance performance in physical activities. However, children and adolescents are at risk of injury with sports, and special considerations need to be kept with regards to their growing bodies. Studies have shown higher risk in younger age groups, particularly those under 15.
The leg joints and muscles are commonly hurt, with strains, sprains, and bone or cartilage damage. Injuries can occur due to a traumatic event, or overuse, in either a game or in practice. While some aches and pains are relatively minor, the sprain receiving the most attention in soccer is the ACL tear. The risk of this season-ender is high due to the nature of the sport with quick changes of directions, cutting manoeuvres, sudden stops with a foot planted on the ground, and collisions with other players.
The good news? Injuries can be prevented! Training programs exist specifically for soccer players and have been shown to reduce the risk of injuries, including the ACL tear. These programs are based on well designed studies, and can be carried out by an individual experienced with this kind of training: this could be, for example, a coach or a physiotherapist.
The programs decrease injury risk by:
Decreasing muscle fatigue
Improving stability of the trunk, pelvis and joints of the leg
Optimizing balance between muscle groups
Increasing balance
Improving body technique and body mechanics.
Special training programs for young soccer players often involve a cardiovascular warm-up, strength building, stretching, agility drills, and exercises with fast, powerful movements (plyometrics).
Note to any young athletes reading: remember all those dreaded drills of burpees, hopping over cones, and jumping on/off high steps? Try to smile through them, and think of how much you’re lowering your risk of being kept out of the game.
Having a history of previous injury increases the chances of getting hurt again. The high rate of re-injury suggests players often return to sport with incomplete healing or rehab. Factors to preventing recurrence of an injury include: completing a rehab program specific to the individual, gradual return to training and competing, use of bracing and taping if appropriate, and consulting a professional to ensure the young athlete is ready before returning to sport.
Another injury risk factor that can get overlooked in the young is the occurrence of a ‘burn out’, which can happen with over training. Some signs to watch for include:
Sleep changes
Persistent aches and pains
Decreased physical performance
Changes to mood and attention
Decreased academic performance
If you note these signs, consider if over-training is a factor. Consulting your coach or health professional is important for recognizing burn-out and preventing injury. An appropriate training program will be intense enough to obtain desirable goals, without resulting symptoms of overtraining.
Participating in organized sports has many benefits for children and adolescents. To prevent injuries to stay in the game: consider incorporating a special supervised training program, give time for injuries to heal, and be aware of signs of overtraining. As the temperatures soar into the double-digits, the clouds give us reprieve, and the spring sports recommence, I hope you and your young athletes stay injury-free… and have a ball!
Sports
With the start of a new year, you may have made New Year resolutions to start running, or to take your running to the next level by completing your first marathon or half marathon. There are many factors to consider when you start to run or train for longer races. One major consideration is to avoid injuries. Shin splints are a common injury that physiotherapists see in clinic.
Shin splints are an umbrella term used to describe pain and discomfort in either the front or back portion of your shin. It usually presents in the lower 1/3 of the leg in the muscles around the tibia (shin bone). It typically has a dull ache but can be sharp and severe pain. Shin splints often start at the beginning of the workout, it may or may not disappear during the workout, and then returns after you finish your workout. Patients may also complain of soreness to touch and swelling.
Shin splints are often associated with running injuries, especially for long distance runners, novice runners, overzealous fitness fanatics, and for those just increasing hill training. You may also see it with dancers, tennis players, basketball players, or high divers, but it is not exclusive to these athletes.
Some of the major causes of shin splints include: changes in running surface and terrain, changes in training regimes, poor foot or ankle biomechanics, poor running mechanics, muscle imbalances, being overweight, or unconditioned athletes doing too much, too fast.
Typically your healthcare professional will want to rule out several conditions with the most serious being stress fractures and compartment syndrome. Once a diagnosis is made, treatment usually starts out conservatively with ice, ultrasound, and interferential current to control pain and swelling. Your doctor may also try to control inflammation with the use of some medications. There will be discussions about activity modifications such as no hill running. There may be other treatments to try such as taping or orthotics, and your physiotherapist may focus on some stretching and strengthening exercises. If conservative treatment does not appear to be helping, aggressive treatment may be considered. This may include a cessation of activity altogether, immobilization, or in some cases, surgery.
Recovery from this injury can be long and frustrating and it can really impede your goals – whether that includes getting back in shape or completing your first marathon. So remember to progress your training at a reasonable rate and make changes in your routine slowly. Happy running!
