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Rehabilitation Principles of the Injured Runner

Increasing running load is the foundation of every progressive training plan. Through this process of stressing the body, and then resting to allow the tissues to remodel and adapt, higher levels of fitness are achieved. At the same time, this process, when done incorrectly, can lead to injury. Runners become injured when the load capacity of a specific structure is exceeded during a running bout or…

Considerations in the Selection of a Running Shoe

Introduction The rapid growth in the participation of running for health and competition has contributed to the exponential demand for running shoe production and development. Over the past 50 years, running shoes have evolved from a minimal design to highly cushioned and supportive to light, partial minimalist shoes. Numerous athletic footwear companies have emerged to respond to the demand for the range of products that fit…

Influence of Step Rate on Running Mechanics

Introduction The number of runners in the United States has grown exponentially over the last several decades, now with over 35 million people running for exercise or sport. With the rise in the number of individuals running both recreationally and competitively, a corresponding rise in running-related injuries has occurred as well. Many running-related injuries are suggested to result from biomechanical faults in an individual's gait pattern.…

Running Gait Assessment

Introduction Musculoskeletal running-related injuries occur when there is an imbalance between tissue tolerance and applied loads experienced by the body. Reasons and risk factors for this imbalance are complex and multifaceted. However, a runner's mechanics significantly influence the extent of loading applied to the musculoskeletal system. This is evidenced by differences in the mechanics of runners with and without injuries or those with a history of…

Sport Psychology for the Runner: Injury, Rehabilitation, and Recovery

Introduction Injury, particularly in the context of sport and physical activity, is often viewed through a physical lens, centering on questions such as what is the physical injury, does the injury need to be repaired, or what physical or medical measures can be taken to expedite return to sport. While those factors are inarguably important, it is also the case that injury, recovery, and rehabilitation have…

Mass Participation Endurance Event Coverage

Introduction The mission of event medical coverage is to ensure a safe event for participants and event staff and to provide medical care when needed during the event. Secondarily, this coverage protects the community where the event is staged from undue stress to the emergency response system. Planning, organization, and execution are the most important factors in fulfilling this mission. The medical director is responsible for…

Exercise-Associated Collapse: On-the-Field and In-Office Assessment

Introduction Endurance events continue to be a popular athletic and social outlet for runners of all ages and abilities. In 2016, there were a total of 30,400 distance running events, and the estimated number of finishers of sanctioned running events that year was 16,957,100. It is estimated that approximately 25 of every 1000 finishers will seek medical attention during a marathon with fluctuations seen based on…

Evaluation of the Injured Runner

Introduction Running has become popular among the diverse population of recreational and competitive runners. As such, each runner who presents with injury has a unique set of circumstances that contribute to the problem. Evaluation of the injured runner should therefore include a systematic review of medical and training history, prior treatments, functional ability, pain symptom characteristics, shoewear, and running biomechanics to identify individual features that may…

Training Principles for the Runner

Establishing evidence-based training recommendations for runners is important to foster healthy training, optimize performance, and promote general well-being. Despite the seemingly innocuous nature of running, a relatively high incidence of running-related injuries (RRIs) has been documented in the literature. The vast majority of RRIs are nontraumatic in nature and primarily involve the soft tissues of the musculoskeletal system. Irrespective of whether one is running for general…

Incidence, Prevalence, and Risk Factors of Running-Related Injuries: An Epidemiologic Review

This chapter aimed to review the literature and identify studies that discuss the rate of injury and risk factors related to running-related injuries (RRIs). Only systematic review studies were used in this chapter. The decision to not use individual studies as references in this chapter was to decrease my inclination (bias) about the topic, and systematic review studies are classified with the highest level of evidence…

The Team in the Care of the Athlete

Acknowledgments The author would like to thank Bill Polian of ESPN and former General Manager/President of Indianapolis Colts, Carolina Panthers, and Buffalo Bills of the NFL; Dave Hammer, ATC, current Head Athletic Trainer Indianapolis Colts; Mark Bartelstein, owner and president of Priority Sports Agency Chicago, IL; Gordon Hayward, former Brownsburg, IN Bulldog, former Butler University Bulldog, former Utah Jazz, current Boston Celtic NBA basketball player; Robert…

Principles of Rehabilitation for the Foot and Ankle

Introduction This chapter provides an overview of the rehabilitation principles, appropriate progression of exercise, and return-to-play criteria when dealing with foot and ankle injuries. Rehabilitative protocols and progressions must be based primarily on the physiological responses of the tissues to injury and on an understanding of how various tissues heal. The foot and ankle often are injured during sporting events, recreational activities, and occupational accidents. Injuries…

Rehabilitation of Specific Foot and Ankle Issues

Introduction Injuries to the foot and ankle are some of the most common injuries in sport. These injuries can significantly affect the performance of an athlete and can often lead to disability and missed playing time. In a series of over 1600 athletic injuries, Garrick and Requa reported that more than 25% of the injuries occurred in the foot and ankle. More recently, Hunt et al. reported…

Orthobiologics in Foot and Ankle Applications

Introduction In recent years, as orthobiologic interventions for a variety of sports-related foot and ankle conditions have become more readily available, results are beginning to appear in the literature. The notion that we can affect the biology of the musculoskeletal tissues with these treatments and trigger a healing response is generally accepted. What conditions can be affected, how these orthobiologics are delivered, the mechanism of action,…

Unique Considerations for Foot and Ankle Injuries in the Female Athlete

Introduction The passage of Title IX is arguably the most important event in the timeline of women’s participation in US athletic endeavors. By almost any measure, the numbers of female athletes have exploded in multiple sports in the decades since 1972. “No person in the United States shall, on the basis of sex, be excluded from participation in, or denied the benefits of, or be subjected…

Pediatric Problems and Rehabilitation Geared to the Young Athlete

Introduction The number of young athletes participating in organized sports continues to expand in the United States, leading to an increasing number of both acute and overuse injuries of the foot and ankle in this age group. The recent trend toward early specialization in one sport poses additional risk for those children engaging in high-level activities. Foot and ankle pain in young athletes requires special consideration,…

The Military Athlete

Introduction While the military generally represents a young, athletic population, it is distinct in many ways. Functional outcomes are different when compared to the civilian population, largely because the definition of success and the functional demands of the soldier are unique. To better understand this, one must first recognize what the military does. Simply stated, the purpose of the military is to protect the nation and…

An International Perspective on the Foot and Ankle in Sports

Brazilian Foot and Ankle Injuries in Sports Epidemiological studies on sport injuries occurring at the foot and ankle are not consistent and lack uniformity in published outcomes in Brazil. Current literature on sports injuries in the country indicates that soccer is the most frequently investigated and the first source of injury. Research has shown that soccer players have a 1000-fold increased risk of injury compared to…

Foot and Ankle Injuries in Dancers

Videos 24.1 About Dance Smart 24.2 Balance – Airplane Test 24.3 Function – Battement Développé 24.4 Function – Over Turn Out 1st to 5th 24.5 Function – Dance and Street Shoe 24.6 Function – Petit Jeté 24.7 ROM – Neural Mobility: Straight Leg Raise with Dorsiflexion 24.8 Function – Yard Stick Test 24.9 Function – 4th Pirouette en Dehors 24.10 Balance – Plié, Relevé, Passé…