Diagnosing running injuries using a runner's training & medical history

With the increase of running-related injuries, clinicians need to formulate running-specific assessment plans for their patients. Furthermore, we will be discussing a standardized approach that you can use to integrate as a part of your assessment process. A running assessment is a step by step process including 4 stages:
• Comprehensive medical review & training history.
• A Physician Examination.
• A running gait analysis, if the runner is symptomatic and,
• Physical therapy consultation to propose programs for correcting biomechanical aberrations of running motion.

Medical & training history

Medical, as well as training history documentation, is an excellent tool used by clinics for diagnosing running-related injuries in patients.
Here’s an effective ‘Runner intake questionnaire’ you can provide your patients at their first visit for assessing their running pattern & potential triggers for injury.

Clinical usage of the 'runner intake questionnaire'

A. RUNNING SURFACE & ROUTE CHARACTERISTICS

Undoubtedly, knowing about the running surface & route used by the patient can help you estimate the resulting joint and muscle loads, & identify aspects that may be associated with injury risk.

Surface	Injury
Beveled Roads	When the foot lands on the lateral side of the road, the lower extremity is subjected to strain.
Sand	Soft tissue injuries such as midportion Achilles tendinopathy
Hills	Eccentric loading to knee extensors

B. MILEAGE AND RUNS PER WEEK

Recreational runners with weekly volume <24 km/week or <3 years of training have a higher risk of developing leg pain.
Additionally, training for >7d/week (or >1 sessions/day) is considered as excessive. Also, Such high volumes don’t allow enough time for the soft and bony tissue recovery, moreover increasing the chances of injury. Studies have also shown that <2d/week of rest increases the risk of overuse injury by 5.2-fold!

C. SHOE MILEAGE & WEAR

A detailed evaluation of the runner’s footwear is extremely helpful in designing an effective rehab program for runners. An average running shoe begins to break down at 350-400 miles, leading to abnormal loading mechanics of the foot and lower extremity. Hence, assessing the mileage and wear pattern of the patient’s shoes is extremely important. As a matter of fact, any asymmetry in the wear pattern of the sole might promote indicate an asymmetric running motion. For example, a runner with a worn-out lateral heel of the shoe may have a tendency to land in excessive supination with each step, thus, increasing soft tissue stress in the midfoot. An ‘incorrect’ pair of shoes can lead to several injuries, even if there is no physical limitation in the body. A Clinical Assessment of the runner’s feet & shoe helps assess if the footwear needs to be replaced or while prescribing a new shoe. Here’s a comprehensive guide you can refer to for a shoe assessment of runners.

D. FOOT STRIKE PATTERN

Surprisingly, most patients are unable to determine their foot-strike patterns accurately. Hence, we recommend that you use a video-based tool to accurately assess this parameter in the clinic. As per recent studies, Fore-Foot Striking seems favorable for patients with unstable knee joints in the AP axis. As opposed to this, on the contrary, a Rear-Foot Strike pattern may be recommended for runners with unstable ankle joints. With that, Cushioned shoes encourage heel striking whereas shoes with minimal or no drop encourage mid to forefoot striking. Here’s a comprehensive article you can refer to understand the effect of foot strike pattern on running mechanics.

CONCLUSION

Although the documentation of medical and training history is very important, it is seldom used in isolation. Instead, it should act as a guiding criterion for subsequent examinations of the patient.

Once this step is complete, you can use this documentation for conducting a comprehensive physical and functional assessment of the patient.

At auptimo, we help clinicians introduce running analysis at their centers through GaitON, our motion analysis system. Its inbuilt running protocol assesses important biomechanical faults in running form and summaries all results in organised reports with normal values. For more information on GaitON’s running protocol, click here.

We, at auptimo help clinicians introduce running gait analysis at their centers through GaitON, our motion analysis system. For more information on GaitON’s running protocol, click here.

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Diagnosing running injuries using a runner’s training & medical history

Medical & training history

Clinical usage of the 'runner intake questionnaire'

A. RUNNING SURFACE & ROUTE CHARACTERISTICS

B. MILEAGE AND RUNS PER WEEK

C. SHOE MILEAGE & WEAR

D. FOOT STRIKE PATTERN

CONCLUSION

We, at auptimo help clinicians introduce running gait analysis at their centers through GaitON, our motion analysis system. For more information on GaitON’s running protocol, click here.

REFERENCES:

A-C

C-F

G-I

J-L

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Medical & training history

Clinical usage of the 'runner intake questionnaire'

A. RUNNING SURFACE & ROUTE CHARACTERISTICS

B. MILEAGE AND RUNS PER WEEK

C. SHOE MILEAGE & WEAR

D. FOOT STRIKE PATTERN

CONCLUSION

We, at auptimo help clinicians introduce running gait analysis at their centers through GaitON, our motion analysis system. For more information on GaitON’s running protocol, click here.​

REFERENCES:

A-C

C-F

G-I

J-L

Leave a Reply Cancel reply

We, at auptimo help clinicians introduce running gait analysis at their centers through GaitON, our motion analysis system. For more information on GaitON’s running protocol, click here.