Dr.Tompkins has
an extensive background and experience in reconstructive foot and ankle surgery
and is board certified by the American Board of Podiatric Surgery. He is also
a Diplomat of the American College of Foot and Ankle Surgeons (ACFAS), and previous
Division XII, ACFAS Vice President in Pittsburgh
, PA.
Dr.
Tompkins also specializes in sports related injuries, and preventative biomechanics.
He is a team physician for Incarnate Word University and Churchill High School
. In addition, he has worked extensively with area high school, college, and
professional athletes. |
Common
Foot and Lower Extremity Running Injuries
For
ease of presentation, conditions will be separated into seven distinct categories
representing individual organ systems. Subsequently, abbreviations regarding
the treatment and prevention of each condition will be listed. Abbreviations
are listed at the end with limited explanations.
The
treatments and preventions given are intended for general medical background
knowledge for the beginner or active runner. They are in no way considered thorough
and complete and should be utilized only to help the individual runner better
recognize various ailments, and their treatment and preventative measures. Persistent
or moderate to severe problems should be addressed by a medical specialist. |
|
Condition
|
Treatment
|
Prevention
|
I.
Muscles: |
| Overuse |
rest/ice-heat/stretching |
stretching/training |
| *Myositis |
rest/ice/stretching/straping |
stretching/terrain/support/shoe |
| Strains/mild
pulls |
rest/ice/nsaids/pt |
stretching/training/support/shoe |
| Severe
pulls/tears |
rest/ice/nsaids/immob/doctor |
stretching/training/support/shoe |
II.Ligaments: |
| *Sprain/partial
tears |
rest/ice/brace/ROM
exercises |
stretch/strengthen
(SS)/training/shoe |
| *Complete tears/ruptures |
rest/ice/immob./doctor |
SS/support/shoe/doctor |
| *Plantar fasciitis |
rest/ice/massage/support/doctor |
stretching/support/shoe/doctor |
III.
Tendons: |
| Tendonitis(mild) |
rest/ice-heat/nsaids/ROM |
stretching/training/terrain/support/shoe |
| *Tendonitis
(severe) |
rest/immob./nsaids/doctor |
stretching/training/terrain/support/shoe |
| Partial ruptures |
rest/immob/nsaids/doctor |
stretching/training/support/shoe |
| Complete ruptures |
rest/immob/doctor |
stretching/training/support/shoe |
| *ITB Syndrome
(runners knee) |
rest/ice-heat/support/SS/doctor |
SS/support/shoe/terrain/doctor |
IV.
Bones |
| *Periostitis
(bone bruise) |
rest/ice-heat/massage |
stretching/terrain/support/shoe |
| *Heel Spurs |
rest/ice-heat/nsaids/support/doctor |
stretching/support/shoe/doctor |
| *Bone Spurs-other |
rest/padding/support/doctor |
stretching/support/shoe/doctor |
| *Stress fractures |
immob/doctor |
stretching/training/support/shoe |
| Overt fractures |
immob/doctor |
stretching/training/support/shoe |
V.
Nerves |
| *Neuritis |
rest/nsaids/massage/pt/doctor |
stretching/training/support/shoe |
| *Neuroma |
rest/nsaids/support/doctor |
stretching/training/support/shoe |
| *Nerve entrapment |
rest/nsaids/support/doctor |
stretching/training/support/shoe |
| *Neuropraxia |
rest/massage/remove
source |
shoes/ padding/support/shoe |
VI.
Integument -(skin and related structures) |
| Blisters |
puncture/gentian
violet/cover |
socks(Thorlo®)/shoe/
training |
| Callous/corns |
pumice stone/Carmol
HC®/ doctor |
Thorlo®/shoes/pads/doctor |
| Ulcers |
antisepsis/ATB
cream/cover/doctor |
Thorlo®/support/shoes/doctor |
| *Hematomas |
puncture/ATB/cover/doctor |
Thorlo®/support/shoes/doctor |
| Nail conditions |
nail care/ATB/cover/doctor |
Thorlo®/nail
care/doctor |
| Athletes foot |
antisepsis/AF
med./air/doctor |
Thorlo®-clean/air/med./doctor |
| *Dermatoses |
antisepsis/ATB/doctor |
Thorlo®-clean/air/med./doctor |
| Xerosis/excoriations |
skin care/Carmol
HC®/pads |
Thorlo®/air/skin
care/pads |
VII.
Other |
| *Chrondromalacia
Patella |
rest/ice-heat/stretching/support/doctor |
stretching/strengthening/support |
| *Trochanteric
Bursitis |
rest/ice-heat/stretching/nsaids/doctor |
SS/terrain/support |
Descriptions
Myositis -
differs from overuse (sore muscles) in that it is not transient. More chronic-deep
quality type pain in the muscles of the arch or anterior/posterior/lateral leg.
Sprain/paritial
ligamentous tear - characterized by mild to moderate acute pain, swelling,
and stiffness which resides with limited rest/ice/compression/elevation (RICE).
Mild can be treated by self.
Complete
ligamentous tear/rupture - characterized by severe pain, swelling,
and stiffness which does NOT reside with intial rest/ice/compression/elevation
(RICE). Should be treated by a doctor.
Plantar
fasciitis - Not a true ligamentous injury, but a fascial strain characterized
by inside mid-arch pain. Usually more uncomfortable after periods of rest and
after increased activity. Different than heel spur syndrome (see below).
Tendonitis (severe)-
characterized by moderate to severe pain, swelling, difficulty walking. Not relieved
with limited rest, ice/heat, immobilization. Needs to be treated by a doctor;
usually a cast. Otherwise, may lead to a partial/complete rupture.
ITB
Syndrome - characterized by pain on the outside of the knee-usually
at the middle/end of activity.
Periostitis -
characterized by deep pain, which is exacerbated by activity and relieved with
rest. Most commonly affects the back portion of the heel. Different than heel
spur type pain (see heel spurs).
Heel
Spur Syndrome - characterized by pain at the bottom of the heel after
periods of rest (especially in the am and after increased activity). Usually
improves after some initial activity/stretching, then reoccurs.
Bone
spurs - characterized by chronic pain over bony protuberances exacerbated
with activity.
Stress
fractures - characterized by persistent pain and swelling, which gets
progressively worse. Constant pain with no improvement. Commonly occurs in the
forefoot region, but can also affect the heel or bones of the leg.
Neuritis -
characterized by burning sensation, or 'shooting' type pain exacerbated by activity
and relieved with rest, ice, and massage.
Neuroma -
characterized by burning sensation, or 'shooting' type pain which progresses
to intense pain and sometimes numbness. Most commonly between the 3rd and 4th
toes (Morton's neuroma).
Nerve
entrapement - characterized by chronic 'shooting' type pain distal
to the affected nerve. Most common is Tarsal Tunnel Syndrome which affects the
arch mid-foot.
Hematoma -
characterized by bleeding into tissues, which turns a blue-brown color. Most
common under nails or plantar blisters.
Dermatoses -
characterized by varying degrees of skin irritaion, itching, burning, exfoliation,
and sometimes infection.
Chondrmalacia
Patella - known as Runners Knee/characterized by pain under the knee
cap, more commonly on the medial (or inside) aspect of the knee and below. This
occurs with activity and often after periods of sitting or running downhill.
Trochanteric
Bursitis - characterized by pain in the outer hip joint which occurs
with increased running and extensive uphill/downhill training.
|
These
are the most common lower extremity injuries that occur with beginning, recreational,
and advanced levels of running. The most common causes of these injuries are:
- The
beginning runner-due to lack of preparation, knowledge, and training.
- The
recreational runner who is attempting to advance to higher levels- due to inappropriate
stretching/strengthening (S/S), lack of appropriate support, inappropriate training,
or physical limitations.
- The
advanced runner-due to inadequate stretching/strengthening, inappropriate training,
lack of appropriate support, or physical limitations.
The
best advice to prevent these injuries: Proper knowledge, preparation, training,
stretching and strengthening, shoes ( www.rogersoler.com ),
inserts/orthotics, and recognizing physical limitations.
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