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Stressed Out

with Dr. Richard Beauchamp, M.D., FRCSC

 

Two words that can really stress out a runner: stress fracture. A stress fracture is a small crack in a bone brought on by repetitive loading and strain, resulting in pain and tenderness at the injury site. Stress fractures occur most frequently in the foot (metatarsals), the shin (tibia) and the hip (femur or pelvis). The condition can be accelerated by inadequate muscular support; therefore, maintaining balanced muscle and bone strength is the best way to avoid a stress fracture. Bones are the skeletal structures that provide attachment points for muscles, ligaments and tendons, which exert force in order to generate movement. The bones also receive their strength from the proper use of the adjacent muscles, so any situation where there is muscle weakness or misalignment can lead to the weakening of the bones, which may, in turn, lead to fractures. Continue reading “Stressed Out”

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Soft Tissue Causes of Back pain- Muscle, Fascia

by Dr. Richard Beauchamp, M.D., FRCSC

Soft tissue injuries are the most frequent causes of back pain. Many muscle units extending from the pelvis all the way up to the neck support the spine. These are the spinae erectae and the quadratus lumborum muscles. Injuries to these muscles can lead to dysfunction and the development of back pain. Injuries are most frequently a result of weak pelvic and abdominal muscles superimposed on a poor running technique. Initial treatment for a runner with a recent injury means resting the back for about a week to let the soft tissues heal (NO RUNNING). Application of ice is a good anti-inflammatory agent without the side effects of oral medication. Ice should be applied with a towel covering for 20 minutes three times a day. Pain that lasts more than two to three weeks could also be treated with oral anti-inflammatories. During all of these treatments, maintaining an activity level is important (active rest). Cycling, walking and general muscle strengthening exercises are to be encouraged. Continue reading “Soft Tissue Causes of Back pain- Muscle, Fascia”

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Arm Injuries in Runners

by Dr. Richard Beauchamp, M.D., FRCSC

Among runners and walkers, arm injuries are much less common than leg injuries. Even so, an injury to the arm or shoulder can be debilitating—anyone who has experienced the pain of inflammation around the shoulder knows what I mean. An athlete can cope with a leg injury by limping, using crutches, elevating, sitting, or lying down. In contrast, it is very difficult to “rest” an arm joint such as the shoulder or elbow. Even standing and sitting can require the arm musculature to contract, often resulting in pain. You just can’t “get away” from arm pain quite as easily.

Since runners pound the pavement so hard and so repetitively, it is a natural assumption that injuries would be confined to their legs. Runners’ legs have to contend with an inordinate amount of force—up to three or four times their body weight. These forces have to be absorbed by the body, thus injuries can occur in the legs, as well as up the skeletal structure to the back, neck and arms. Continue reading “Arm Injuries in Runners”

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Muscle Strains

The body has hundreds of muscles of  various types—slow twitch, fast twitch, skeletal, smooth and cardiac, to name a few. Muscles provide their power by contracting and relaxing, thereby generating a force that causes movement. Running muscles require a strong anchor (where one end of the muscle attaches to a bone or ligament) and the other end of the muscle connects to the flexible part of the limb. When that muscle contracts or shortens, movement of the joint is produced.

The science behind this muscle contraction and relaxation is very complex. It involves proteins called actin and myosin, along with various other elements including calcium, potassium, sodium and water. This is why it is so important to supply the fuel (water, electrolytes, etc.) for the muscles to work while you are training. Continue reading “Muscle Strains”

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Arthritis and Running

We’ve invited readers to send in topic suggestions for this column, and we received this question from David: “Is it possible to run or jog when one has a chronic and painful condition of the knee, like arthritis?”

To begin, there are many causes for “arthritis.” I’m using quotation marks since the patient has to be satisfied that the diagnosis of arthritis is correct in the first place. Arthritis of the knee should definitely be confirmed before any alterations of activity or lifestyle are made. Continue reading “Arthritis and Running”

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Ankle Sprains

with Dr. Richard Beauchamp M.D., FRCSC

An ankle sprain refers to an acute or sudden injury that results in tearing of any of the ligaments of the ankle. Ligaments are strong tissues that attach to the adjacent bones of a joint, providing stability and limiting excessive movement. Sprains are usually graded according to the severity of the injury, as follows:

Classification: Grade 1
This refers to a mild stretch of some of the ligament fibres only. The individual is able to initially walk on the ankle without much discomfort. There may be some swelling, but recovery is usually complete in a few days. Continue reading “Ankle Sprains”

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Can I Return to Running After My Hip Replacement?

by Dr. Richard Beauchamp, M.D., FRCSC

Joint replacement surgery, particularly of the hip and knee, has become one of the most frequently performed operations around the world. According to the American Academy of Orthopedic Surgeons, over 300,000 total hip replacements (THR) are completed in the United States every year, and the number of knee replacements is even higher. Continue reading “Can I Return to Running After My Hip Replacement?”

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Ilio-Tibial Band (ITB) Friction Syndrome

by Dr. Richard Beauchamp, M.D., FRCSC

Ilio-tibial band (ITB) friction syndrome is a condition/irritation that causes pain along the outside of the leg due to inflammation related to the ilio-tibial band.

Anatomy :
The ilio-tibial tract is a condensation of muscle and tendon into a structure called the ITB. It runs from the outside of the pelvis (“Ilio”) above the hipbone and extends along the outside of the thigh, over the prominence of the hip and the knee and ends up just below the knee joint (“Tibial”) (Figure 1). This band begins as a muscle incorporating the hip and buttock muscles (flexors and abductors) but soon becomes a tendon with very little muscle function by the time it gets to the knee. It is meant to stabilize the knee primarily and the hip secondarily during walking and running. If your particular running style is abnormal, the ITB can be subjected to excessive pull or force that will make the muscle contract and cause resultant rubbing (hence the term “friction”) over the areas where it is close to the bone and other solid structures. (Figure 2) The ITB is a very important factor in the kinematics and kinetics of the leg during running. As this muscle-tendon complex spans two joints (hip and knee) it is very susceptible to forces from a multitude of causes. These can include leg length discrepancies, persistent running on uneven or canted surfaces, increased knee flexion from overstriding, which may include downhill running. Continue reading “Ilio-Tibial Band (ITB) Friction Syndrome”

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Stress Fractures

Two words that can really stress out a runner: stress fracture.

A stress fracture is a small crack in a bone brought on by repetitive loading and strain, resulting in pain and tenderness at the injury site. Stress fractures occur most frequently in the foot (metatarsals), the shin (tibia) and the hip (femur or pelvis). The condition can be accelerated by inadequate muscular support; therefore, maintaining balanced muscle and bone strength is the best way to avoid a stress fracture.

Bones are the skeletal structures that provide attachment points for muscles, ligaments and tendons, which exert force in order to generate movement. The bones also receive their strength from proper use of the adjacent muscles, so any situation where there is muscle weakness or misalignment can lead to weakening of the bones, which may in turn lead to fractures. Continue reading “Stress Fractures”

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What You Need to Know About Runner’s Knee

by Dr. Richard Beauchamp M.D., FRCSC

Have you experienced pain around the front of your knee(s) during or after a run? If so, you may have had a case of runner’s knee. Runner’s knee is actually a vague term used to describe the above symptom—pain in the knee. However, it is not necessarily a precursor of arthritis; in fact, it has been said that there is no correlation to hip and knee arthritis in active marathoners.1

Runner’s knee is a common condition, but the actual causes and effective treatments are not easily explained. Runner’s knee is a grab bag of other diagnoses and conditions often aggravated by the pounding of the legs on the ground during your sport. Your legs have to generate force in order to run, as well as absorb force in order to protect your bones and muscles from injuries. Runner’s knee can also occur in walkers, although not as frequently. Continue reading “What You Need to Know About Runner’s Knee”