Mechanism, diagnosis, and treatment of running injuries

Today running is an integral part of many people's lives. Despite an increased focus on the prevention of running injuries, overuse injuries are still rather frequent. It is important to identify the cause of the injury and treat the cause, not merely the symptoms. Of these injuries, 60% to 80% are associated with extrinsic factors, such as training errors and changes in running activities. Intrinsic factors are also common, especially malalignments, including excessive pronation and cavus foot. These changes are associated with common over-use injuries, but specific anatomic abnormalities and abnormal biomechanics of the lower extremity are not correlated with specific injuries on a predictable basis. Factors such as leg-length discrepancy, poor flexibility, muscle weakness and imbalance, deficit in neuromuscular coordination, and ligamentous laxity can also cause running injuries. Acquired or secondary factors, such as kinetic chain dysfunctions, are more common than previously acknowledged. Many running injuries, especially in patients with recurrent and previous injuries, are manifestations of a dysfunction of the kinetic chain. For this reason, it is important to examine the symmetry of stance and gait, and to look for abnormalities in both static and dynamic alignment and function. The whole kinetic chain must be carefully screened to rule out any underlying injuries or dysfunction. This process is difficult and requires experience and knowledge, especially because the cause of injury may be remote from the site of injury. The treatment of running injuries involves both a specific diagnosis, based on the primary problem, and the identification of kinetic chain dysfunctions. In order to be successful, treatment must be based on the specific diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)