Flying Pig Flying Pig Marathon Injury Marathon Injury Prevention and Prevention and ManagementManagement

Presented by:Presented by:Sachin Patel and Brian NashSachin Patel and Brian Nash

PURPOSEPURPOSE

The purpose of today’s lecture is to The purpose of today’s lecture is to educate you about injuries that are educate you about injuries that are related to running and how to related to running and how to prevent them. It is not intended to prevent them. It is not intended to treat, diagnose or cure any injury treat, diagnose or cure any injury you may have. Only a trained you may have. Only a trained provider can make a definitive provider can make a definitive diagnosis and treatment plan.diagnosis and treatment plan.

PurposePurpose

This one hour lecture will focus on common This one hour lecture will focus on common running injuries with a special interest paid running injuries with a special interest paid to injuries most commonly found amongst to injuries most commonly found amongst those who have run and trained for the those who have run and trained for the Flying Pig. Flying Pig.

Cincinnati's unique topography plays a Cincinnati's unique topography plays a huge role in certain running related injuries huge role in certain running related injuries and we wish to touch upon that tonight.and we wish to touch upon that tonight.

Sachin Patel DCSachin Patel DC

Board Certified Chiropractic PhysicianBoard Certified Chiropractic Physician Fully Certified ART providerFully Certified ART provider Certified Functional Medicine PractitionerCertified Functional Medicine Practitioner Certified KinesiologistCertified Kinesiologist Additional training in:Additional training in:

Nutritional supplementationNutritional supplementation Functional Diagnostic MedicineFunctional Diagnostic Medicine Environmental and Household ToxinsEnvironmental and Household Toxins Gait and Biomechanical analysisGait and Biomechanical analysis Assessment and Management of shoulder injuriesAssessment and Management of shoulder injuries

Brian NashBrian Nash

Avid runner and marathonerAvid runner and marathoner One of the assistant coaches for the One of the assistant coaches for the

Pig training groupPig training group Flying Pig Streaker – Training for Flying Pig Streaker – Training for

#10#10

History and overview of History and overview of the Flying Pig Marathon the Flying Pig Marathon

CourseCourse

http://www.flyingpigmarathon.com/race_information/cohttp://www.flyingpigmarathon.com/race_information/course/urse/

Common Runner’s Common Runner’s ComplaintsComplaints

Shin SplintsShin Splints Plantar Fascitis/Heel SpursPlantar Fascitis/Heel Spurs Achilles TendonitisAchilles Tendonitis Pulled Hamstring(s)Pulled Hamstring(s) Low back painLow back pain Calf PainCalf Pain IT Band syndromeIT Band syndrome Hip painHip pain Stress fracturesStress fractures

Flying Pig DataFlying Pig DataRaw data collected from the 2007 Flying Pig Marathon Raw data collected from the 2007 Flying Pig Marathon

(Cincinnati, Ohio) lists the top 7 complaints reported by (Cincinnati, Ohio) lists the top 7 complaints reported by marathon runners of variable age and skill level. This data marathon runners of variable age and skill level. This data only represents those that sought help post completion of the only represents those that sought help post completion of the race. Data was collected based on subjective complaint(s).race. Data was collected based on subjective complaint(s).

11 CalvesCalves 24.4%24.4%

22 HamstringHamstring 13.5%13.5%

33 KneeKnee 11.5%11.5%

44 HipsHips 10.3%10.3%

55 FeetFeet 7.1%7.1%

66 IT BandIT Band 5.8%5.8%

77 ShinsShins 4.5%4.5%

Achilles TendonitisAchilles Tendonitis Second most common reported running Second most common reported running

injuryinjury Strongest tendon in the body (steel Strongest tendon in the body (steel

cable)cable) Pain 1.5 inches above the heelPain 1.5 inches above the heel May be torn or inflammedMay be torn or inflammed Can be painful when running/walkingCan be painful when running/walking Better with rest and iceBetter with rest and ice Occur in runners with a floppy or rigid Occur in runners with a floppy or rigid

footfoot

Causes of Achilles Causes of Achilles TendonitisTendonitis

Rigid Foot (high arch)Rigid Foot (high arch) Use the foot as a strong lever, stressing the Use the foot as a strong lever, stressing the

tendon throughout the movementtendon throughout the movement

Sloppy Foot (Flat foot)Sloppy Foot (Flat foot) Runners who pronate will overstress the inside of Runners who pronate will overstress the inside of

the tendonthe tendon Hills, speedwork, and negative heel shoes all Hills, speedwork, and negative heel shoes all

put more pressure on the achilles tensdonput more pressure on the achilles tensdon Tight calves, hamstrings, plantar fascia and Tight calves, hamstrings, plantar fascia and

poor footwear are common causespoor footwear are common causes

Calf PainCalf Pain Pain in the back of the lower legPain in the back of the lower leg Often linked to hamstring and achilles Often linked to hamstring and achilles

injuries or dysfunctioninjuries or dysfunction Fascial adhesions between gastroc, soleus, Fascial adhesions between gastroc, soleus,

flexor digitorum or flexor halicus can result flexor digitorum or flexor halicus can result in slow recoveryin slow recovery

Pain worse when running up hillsPain worse when running up hills Tightness and cramping, sometimes severeTightness and cramping, sometimes severe Stretching may only helps temporarily if Stretching may only helps temporarily if

root cause is not addressedroot cause is not addressed

Causes of Calf PainCauses of Calf Pain Uphill runningUphill running Lack of stretchingLack of stretching Increased mileageIncreased mileage Over pronationOver pronation Poor hydrationPoor hydration Poor footwearPoor footwear Short legShort leg Inadequate flexibilityInadequate flexibility FatigueFatigue DVTDVT Varicose veinsVaricose veins

Hamstring InjuriesHamstring Injuries Pain usually near the proximal attachment Pain usually near the proximal attachment

(pain in the butt) or in the middle of the back (pain in the butt) or in the middle of the back of the thighof the thigh

Pain may throb during and after runningPain may throb during and after running Often caused when muscle is “cold”Often caused when muscle is “cold” Continuous or intermittent pain when runningContinuous or intermittent pain when running Symptoms tend to worsen with speed work Symptoms tend to worsen with speed work

and uphill runsand uphill runs Will affect running mechanics and lead to Will affect running mechanics and lead to

further injuriesfurther injuries Can mimic nerve pain (sciatica)Can mimic nerve pain (sciatica)

Causes of Hamstring Causes of Hamstring InjuriesInjuries Insufficient stretching pre and post exerciseInsufficient stretching pre and post exercise

Overworking a weak muscleOverworking a weak muscle Excessive hill or speed work (up or down Excessive hill or speed work (up or down

hill)hill) Running on sloped roads (over stretches)Running on sloped roads (over stretches) Tight hip flexors (muscle imbalance)Tight hip flexors (muscle imbalance) Over pronationOver pronation Muscle fatigueMuscle fatigue Re-current injuryRe-current injury KGJ – Torn hamstring in 2001, 2002, 2004KGJ – Torn hamstring in 2001, 2002, 2004

Pelvic dysfunctionPelvic dysfunction

Hip PainHip Pain Pain in femuro-Pain in femuro-

acetabular jointacetabular joint Pain may refer to groin Pain may refer to groin

or down legor down leg Pain worse with loading Pain worse with loading

or laying on the hipor laying on the hip Better with rest, worse Better with rest, worse

with activitywith activity Pain may be sharp, dull, Pain may be sharp, dull,

stabbing or achystabbing or achy Pain deep in hip jointPain deep in hip joint

Causes of Hip PainCauses of Hip Pain

ArthritisArthritis Muscular imbalancesMuscular imbalances OvertrainingOvertraining CapsulitisCapsulitis Muscular sprain/strainMuscular sprain/strain Stress fractureStress fracture Pinched nervePinched nerve Short legShort leg Bursitis Bursitis

Plantar FascitisPlantar Fascitis

Pain in the front of the heel and archPain in the front of the heel and arch ““12 steps of death”12 steps of death” Can be very painful Can be very painful Can be uni or bi-lateralCan be uni or bi-lateral

Causes of Plantar Causes of Plantar FascitisFascitis

Poor FootwearPoor Footwear Flat foot/fallen archFlat foot/fallen arch High archHigh arch OveruseOveruse Bone spurBone spur Tight calvesTight calves Tight hamstringsTight hamstrings Poor mechanicsPoor mechanics Weak intrinsic foot musclesWeak intrinsic foot muscles Running up-hillRunning up-hill

Shin SplintsShin Splints Very common in new runners Very common in new runners

or seasonal runnersor seasonal runners Pain along the front of the Pain along the front of the

shin, typically comes on a few shin, typically comes on a few minutes into the runminutes into the run

Can go away shortly after Can go away shortly after runningrunning

Can cause numbness in the Can cause numbness in the leg if severe enoughleg if severe enough

Can be very, very painful and Can be very, very painful and tender along front of shintender along front of shin

Need to address root cause of Need to address root cause of the problemthe problem

Causes of Shin SplintsCauses of Shin Splints Pes planus (flat feet)Pes planus (flat feet) High Arch High Arch Over pronationOver pronation Weak Tibialis Anterior/posteriorWeak Tibialis Anterior/posterior Tight hamstringsTight hamstrings Tight calf musclesTight calf muscles Poor/worn out footwearPoor/worn out footwear Running PitchRunning Pitch Downhill runningDownhill running Running DownhillRunning Downhill

ITB SyndromeITB Syndrome

Pain in outside of knee(s) or Pain in outside of knee(s) or hip(s)hip(s)

Tightness in tendon will Tightness in tendon will cause friction at knee or hip cause friction at knee or hip irritating the surrounding irritating the surrounding tissuetissue

Snapping at hip or knee is Snapping at hip or knee is sometimes presentsometimes present

Pain can come on during run Pain can come on during run and alleviated by rest in mild and alleviated by rest in mild casescases

Causes of ITB SyndromeCauses of ITB Syndrome Poor footwearPoor footwear Pitch in roadPitch in road Weak abductors, Weak abductors,

weak glut max and weak glut max and med.med.

OveruseOveruse Overcorrection of Overcorrection of

pronation issuespronation issues Flat feetFlat feet Tight lateral Tight lateral

compartment of compartment of thighthigh

Poor pelvic functionPoor pelvic function Short leg Short leg

Low Back PainLow Back Pain Low back pain may Low back pain may

occur during or after occur during or after a runa run

Multi-factorial in Multi-factorial in etiologyetiology

Pain may shoot into Pain may shoot into legs, buttock, foot, legs, buttock, foot, shoulder or groinshoulder or groin

Pain may be sharp, Pain may be sharp, dull, achy, burningdull, achy, burning

Low back may be a Low back may be a victim of dysfunction victim of dysfunction of hips, knees or of hips, knees or anklesankles

Causes of Low Back PainCauses of Low Back Pain Multitude of causesMultitude of causes Short legShort leg Lack of stabilityLack of stability Lack of mobilityLack of mobility Lack of pelvic rotationLack of pelvic rotation PathologicalPathological ScoliosisScoliosis MechanicalMechanical Muscular imbalanceMuscular imbalance Structural predispositionStructural predisposition ArthritisArthritis Lumbar disc Lumbar disc

PreventionPrevention Prevention is easier and more cost effective then interventionPrevention is easier and more cost effective then intervention Use appropriate training techniqueUse appropriate training technique Get a god pair of shoes that suit your foot mechanicsGet a god pair of shoes that suit your foot mechanics Be sure to stretch and warm up prior to and during run Be sure to stretch and warm up prior to and during run Run on soft even surfaces when possibleRun on soft even surfaces when possible Stretch and ice post running (regardless of pain)Stretch and ice post running (regardless of pain) NSAIDS will inhibit healing, avoid taking prior to runningNSAIDS will inhibit healing, avoid taking prior to running Proteolytic enzymes to reduce inflammation while allowing healing Proteolytic enzymes to reduce inflammation while allowing healing

to occurto occur Glucosamine HCl as a dietary supplement to proactively maintain Glucosamine HCl as a dietary supplement to proactively maintain

jointsjoints Rest – allow your body to healRest – allow your body to heal Sleep – 6-8 hours to allow body to repairSleep – 6-8 hours to allow body to repair Fish oil to reduce imflammation – 1-2 capsules with each mealFish oil to reduce imflammation – 1-2 capsules with each meal Ensure your footwear is appropriate for your foot mechanicsEnsure your footwear is appropriate for your foot mechanics Ensure proper spinal and extremity mobility Ensure proper spinal and extremity mobility Hydration and minerals….0.5 oz per pound of body weightHydration and minerals….0.5 oz per pound of body weight

TreatmentTreatment

Chiropractic manipulation and ART to restore Chiropractic manipulation and ART to restore function of spine, hip, knee and ankle joints as function of spine, hip, knee and ankle joints as well as their surrounding soft tissuewell as their surrounding soft tissue

Address any issues with footwearAddress any issues with footwear Orthotics or insoles to address foot mechanicsOrthotics or insoles to address foot mechanics PT to strengthen the weak musclesPT to strengthen the weak muscles Stretch tight muscles and capsulesStretch tight muscles and capsules Rest, ice, compression, elevationRest, ice, compression, elevation Proper dietary and supplementary nutritionProper dietary and supplementary nutrition

Injury SummaryInjury Summary

Uphill InjuriesUphill Injuries GlutsGluts HamstringsHamstrings CalvesCalves Achilles TendonAchilles Tendon Plantar FasciaPlantar Fascia

Downhill InjuriesDownhill Injuries Shin SplintsShin Splints IT Band IT Band Knee and QuadKnee and Quad

Course AnalysisCourse Analysis

ContactsContacts

Sachin Patel – Norwood Chiropractic Sachin Patel – Norwood Chiropractic 513 531 2277513 531 2277patelchiropractic@yahoo.comwww.norwoodchiropractic.comwww.norwoodchiropractic.com

www.ilovebeinghealthy.blogspot.comwww.ilovebeinghealthy.blogspot.com Brian Nash - Brian Nash - “echoguy” on the Flying Pig “echoguy” on the Flying Pig

forum, forum, www.flyingpigmarathon.com. .

  Bob Roenker’s Running SpotBob Roenker’s Running Spot513 321 3006513 321 3006