Common Sporting Injuries

It is now recognised that the majority of lower limb sporting injuries are a result of poor foot and leg position or function.
The best course of action is to prevent the injury in the first place.
With many sporting injures it is possible to determine the cause of the injury and by treating the cause it is possible to reduce the chance of recurring injuries.

Some of the more common causes include:
-----------------------1.
  
Training Errors
2.
Poor Biomechanics
3.
Incorrect Footwear
4.
Inadequate Flexibility
5.
Inadequate Strength

Injuries are rarely due to just one of these factors; more commonly it is a combination of two or three factors together that lead to a resultant injury.
A comprehensive treatment has to look at all of these factors and offer treatment or advice where necessary.
Some of the more common sporting injuries are:
 
 
click on one of the injuries above for a detailed explanation on causes and treatment
Achilles Tendonitis
 
This is an inflammation of the Achilles tendon (The large tendon that attaches the calf muscle to the heel)
The first symptom is a dull ache in the tendon after exercise and occasionally stiffness and aching in the tendon first thing in the morning.
If ignored the symptoms usually become worse to the point where pain is present as soon as exercise begins and becomes worse with increased activity.
If untreated the symptoms become present at all times and the person is unable to exercise due to pain (they may be unable to walk without pain).
Symptoms that persist for 8 or more weeks are often accompanied by a thickening and scarring of the Achilles tendon, making it weaker and at greater risk of rupture in the future.
 
Possible causes:
· tight calf muscles
· excessive shoe wear (uppers and soles), allowing for excessive pronation
· too much speed work too soon
· too much hill work too soon
· biomechanical faults
 
Treatment:
· small heel lift until symptoms subside, then stretch
· rest
· reduce speed work and hills
· Ice after training
· see a biomechanical specialist for comprehensive assessment, gait analysis and treatment

Iliotibial Band Syndrome
 
The Iliotibial band is a long band of tissue that runs from the outer hip area to the outside of the knee and attaches just below the knee joint.
It initially acts to decrease the inward rotation of the leg and flexion of the knee that occurs in response to pronation of the foot.
Iliotibial Band Syndrome is an inflammation of the Iliotibial Band.
The symptoms include discomfort in the lower outside thigh or knee area that are first present only when exercise. If left untreated the symptoms will gradually worsen to the point where they are present with most activity. One popular misconception is that only "supinators" get this problem. Nothing could be farther from the truth. It is much more commonly seen in runners with either poor biomechanics or poor flexibility (or both).
 
Possible Causes:
· poor Bbiomechanics - usually excessive pronation
· Inadequate flexibility - especially calf muscles and buttock muscles and outer thigh or buttock muscles
· training errors - always running the same slope of the road, excessive speed work
· excessive shoe wear, or inappropriate shoe choices
 
Treatment:
· address biomechanical Issues
· stretch tight calf muscles, hamstrings and hips
· decrease mileage and decrease speedwork
· replace worn out shoes

Metatarsal Stress Syndrome
 
The metatarsals are the bones in the foot that run from about the middle of the arch to the ball of the foot where they attach to the toes. They function first as a flexible platform to adapt to uneven terrain, then as a lever to propel the body forward. The joints of the midfoot (arch) and rearfoot (heel area) determine their function as either a flexible adapter or a rigid lever. One of the most common causes of metatarsal pain is poorly fitted shoes. If the toe box of the shoe is either too narrow or too short, it compresses the metatarsals and interferes with their natural actions.
The symptoms of metatarsal stress syndrome generally start as an aching sensation under the ball of the foot (where the toes join the foot). This is usually first felt only on long runs or during speedwork, but is also commonly felt in tighter shoes.
The symptoms are relieved by removing the shoes, only to return again the next time they are worn or during the next run. Some people describe the early sensation as feeling as if their socks have "wrinkled up" under the ball of the foot. The symptoms can become more frequent and intense, eventually causing discomfort with most activities.
 
Possible causes:
· poorly fitted shoes
· inadequate flexibility in calf muscles
· biomechanical - excessive or prolonged pronation
· excessive shoe wear
 
Treatment:
· ensure proper shoe fit and type
· stretch tight calf muscles
· replace worn shoes
· see a biomechanical specialist for analysis of biomechanical faults
 

Plantar Fasciitis

This is an inflammation ("itis") of the plantar (bottom of the foot) fascia. The most common symptom is pain in the bottom of the heel first thing in the morning or after sitting for a period of time. The pain usually reduces fairly quickly after moving around and in some cases may return later in the day after long periods of standing.
Many people describe the symptoms as feeling like a bruise on the bottom of the foot. If left untreated, these symptoms may become worse to the point where pain is present with nearly all activity.
The plantar fascia is much like a ligament that attaches to the heel bone at one end and to the ball of the foot at the other end. When the foot hits the ground the arch collapses to absorb shock and adapt to uneven terrain. As the arch drops the plantar fascia is stretched.
 
Possible causes:
· tight calf muscles (other leg muscles may also be involved)
· inadequate support from the running shoe
· training errors (too many hills, too much speed too soon)
· biomechanical problems (excessive or prolonged pronation)
 
Treatment:
· stretch calf muscles
· examine shoes for wear & replace frequently
· Ice
· adjust training schedule (decrease speedwork & hills)
· see a biomechanical specialist for a full assessment, gait analysis and treatment.

Runner's Knee
 
This refers to pain in and around the knee cap or "patella."
The patella rests in a groove on the femur (thigh bone) and acts to improve the angle of pull of the quadriceps muscle, which attaches to the lower leg bone (tibia) through a thick tendon called the patellar tendon. The early symptoms are usually a dull aching in and around the patella after running.
The pain may be localised to one area or another of the patella. If the pain is localised to the patellar tendon it is often referred to as Patellar Tendonitis.
If the biomechanics of the runner are such that the patella does not sit properly in its femoral groove, the underside of the patella will over time wear down and become rough and deteriorated. This condition is known as Chondromalacia Patella.
As in most cases of inflammatory processes, left untreated the symptoms generally get worse and with time deterioration and /or scarring of the involved tissues takes place.
 
Possible causes:
· tight quadriceps muscles
· tight calf muscles (hamstrings may also be tight)
· biomechanical faults (usually excessive or prolonged pronation)
· worn or improper shoes
· training errors (too much hill work too soon)
 
Treatment:
· stretch tight muscles (quadriceps and calf muscles)
· examine shoes for wear and replace frequently
· Ice
· rest, and reduce hill work and speed work
· see a biomechanical specialist for comprehensive assessment, gait analysis, and treatment

Stress Fractures
 
Stress fractures are partial or complete cracks in the outer layers of the bone that occur as a result of repetitive stress.
In runners the common sites for stress fractures include: tibia (shin bone), metatarsals (long bones of the foot), femur (thigh bone), and occasionally the pelvis. The symptoms of a stress fracture include pain that is worst when exercising but may also be present at rest. The pain is generally quite localised to a specific bony area and is noticeable when the area is pressed or tapped.
The physical causes are usually related to training errors and biomechanical factors. Other factors to be considered are a low bone mineral content caused by insufficient dietary calcium, and hormonal insufficiencies (low blood oestrogen in women and low blood testosterone in men). True diagnosis must often be made through the use of a bone scan.
 
Possible causes:
· training errors: abrupt changes in training, mileage intensity, duration, or equipment.
· biomechanical faults: excessive pronation or supination
Treatment:
· rest
· Biomechanical evaluation and gait analysis with orthotic intervention as needed
· address training errors
· supplemental calcium as directed by doctor or specialist and avoidance of diet soft drinks
(they often inhibit the body's ability to absorb calcium)

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Tibial Stress Syndrome
 
This term covers several more specific diagnoses including posterior shin splints, anterior shin splints, and could include compartment syndromes.
The two most common are: posterior and anterior shin splints.
Anterior shin splints is the term given to an inflammation of the tendons that attach to the front of the shin bone along the outer edge. One large muscle, the Tibialis Anterior, is primarily responsible for keeping the toes from scuffing the ground when the leg swings through to take a step. It also functions to help reduce the pronation of the foot that occurs shortly after heel strike.
Early symptoms usually consist of aching in the muscle on the front outer part of the shin during running, and gradually becoming worse until there is a sharp pain along the front outer edge of the tibia (shin bone) even with walking.
Posterior shin splints is the term given to an inflammation of the tendons that attach to the inner side of the shin bone.
A common muscle involved is the Tibialis Posterior. The main function of this muscle is to slow down the pronation (inward rolling) motion of the foot.
Symptoms usually consist of an aching that occurs along the inner border of the shin bone and may progress down to the arch of the foot. Generally the pain occurs at the start of a run, and may subside later in the run only to return later. As the inflammation worsens, the symptoms are present with walking and may also present as a tenderness and stiffness first thing in the morning. With either of these syndromes, there may be localised tenderness to the touch and there may also be some swelling.
The most common cause for both of these syndromes is faulty biomechanics.
If rest, ice and stretching don't reduce the symptoms fairly quickly the advice of a biomechanical specialist is required.
 
Possible causes:
· tight calf muscles
· biomechanical faults (excessive or prolonged pronation)
· increasing mileage too fast
· excessive shoe wear
· training errors (too much hill work or speed work too soon)
 
Treatment:
· stretch tight calf muscles
· decrease mileage and hill work / speedwork
· assess shoe wear and replace frequently
· see a biomechanical specialist for full gait analysis and treatment as needed

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