ISSN:0112-1642    

DOI:10.2165/00007256-198502050-00001

出版商:Springer International Publishing    

年代:2012

数据来源: ADIS

摘要:

SummaryBecause knowledge of overuse syndromes is limited, the diagnosis and treatment of these conditions are a challenge to sports medicine physicians. Trial and error methods of treatment and too little attention to basic research have resulted in less than optimum solutions. We do know that these maladies most frequently result from overload or repetitive microtrauma stemming from extrinsic factors such as training errors, poor performance, poor techniques and inappropriate surfaces or intrinsic factors including malalignment and muscle imbalance. Overuse injuries involving the muscles include compartment syndromes and muscle soreness; while those involving the tendons result from a variety of degenerative and inflammatory processes. Overstress of bone results in stress fractures, apophysitis and periostitis. Bursitis and joint overstress problems are also discussed briefly. General guidelines for establishing the appropriate diagnosis are: the initial stages of therapy require rest, often a modification or scaled down exposure to the athlete’s usual performance rather than complete abstinence; in acutely symptomatic cases pain medications and various measures to control inflammation may be necessary; an exercise programme should start early with range of motion exercises and isometric muscle contractions; when pain allows, dynamic muscle and flexibility exercises can resume together with a conditioning programme; if possible, eccentric exercises should be performed. The treatment may also include other conservative treatment modalities and surgery in special cases.Overuse injuries constitute a great diagnostic and therapeutic problem because the symptoms are often diffuse and uncharacteristic. An appropriate diagnosis followed by adequate treatment can improve or eliminate most of these conditions, but perhaps even more importantly a proper understanding of overuse syndromes should allow physicians to assist athletes, trainers, and coaches in preventing them.

ISSN:0112-1642    

DOI:10.2165/00007256-198502050-00002

出版商:Springer International Publishing    

年代:2012

数据来源: ADIS

摘要:

SummaryRunning is the most visible expression of the continued interest in regular physical activities. Unfortunately injuries are common, primarily due to overuse, and a number of aetiological factors have been recognised. Of these, training errors can be responsible for up to 60% of injuries. The training surface, a lack of flexibility and strength, the stage of growth and development, poor footwear and abnormal biomechanical features have all been implicated in the development of running injuries. A thorough understanding of the biomechanics of running is a necessary prerequisite for individuals who treat or advise runners.Clinically, the configuration of the longitudinal arch is a valuable method of classifying feet and has direct implications on the development and management of running problems. The runner with excessively pronated feet has features which predispose him/her to injuries that most frequently occur at the medial aspect of the lower extremity: tibial stress syndrome; patellofemoral pain syndrome; and posterior tibialis tendinitis. These problems occur because of excessive motion at the subtalar joint and control of this movement can be made through the selection of appropriate footwear, plus orthotic foot control. The runner with cavusfeet often has a rigid foot and concomitant problems of decreased ability to absorb the force of ground contact. These athletes have unique injuries found most commonly on the lateral aspect of the lower extremity; iliotibial band friction syndrome; peroneus tendinitis; stress fractures; trochanteric bursitis; and plantar fasciitis. Appropriate footwear advice and the use of energy-absorbing materials to help dissipate shock will benefit these individuals. Running shoes for the pronated runner should control the excessive motion. The shoes should be board-lasted, straight-lasted, have a stable heel counter, extra medial support, and a wider flare than the shoes for the cavusfoot. For these athletes a slip-lasted, curve-lasted shoe with softer ethylene vinyl acetate (EVA) and a narrow flare is appropriate. Orthotic devices are useful in selected runners with demonstrated biomechanical abnormalities that contribute to the injury. Soft orthotics made of a commercial insole laminated with EVA are comfortable, easily adjusted, inexpensive, and more forgiving than the semirigid orthotics which are useful in cases where the soft orthotic does not provide adequate foot control.A review of injury data shows an alarming rise in the incidence of knee pain in runners — from 18% to 50% of injuries in 13 years. Errors in training judgement, with excessive loading, particularly in runners with compromised biomechanical features, represent the primary aetiological factors. These errors cannot be accommodated by running shoe design. Similarly, orthotic devices alone will not control the injury pattern of most runners. Although footwear and biomechanical control may represent a significant therapeutic intervention in some individuals, they must remain part of a comprehensive rehabilitation programme that considers the other aetiological factors that contribute to running injuries.

ISSN:0112-1642    

DOI:10.2165/00007256-198502050-00003

出版商:Springer International Publishing    

年代:2012

数据来源: ADIS

摘要:

SummaryThe sports physician faces major practical problems in stimulating the activity of sedentary patients, and also ensuring their subsequent adherence to a prescribed exercise regimen. Both the individual and society bear some responsibility for poor exercise compliance. Patients are most likely to persist with programmes which are well-adapted to their physical, physiological, psychological and socioeconomic characteristics. The quality of leadership is also an important variable. Open-ended and structured questionnaires suggest that motivations to exercise include the improvement of health, the development of fitness, the control of bodyweight as well as an improvement in personal appearance, socialising, and simply a wish to ‘feel better’. The main perceived reason why people ‘drop out’ of formal exercise classes is through lack of time, although often the individuals making this complaint appear to have substantial free time. Personality characteristics of the adherent depend on the type of programme that is offered and the degree of social support that is provided; extraversion, a high self-esteem and self-motivation are common findings. Modelling of exercise behaviour has drawn upon the concepts of Skinner, Becker and most recently Fishbein. Beliefs and their evaluation seem more influential than subjective norms, although exercise behaviour is also heavily influenced by past experience of physical activity. Programmes should be designed to maximise external reinforcement of the exercise habit until the early discomforts of training are overcome, and the patient discovers the internal rewards of a more active lifestyle.

ISSN:0112-1642    

DOI:10.2165/00007256-198502050-00004

出版商:Springer International Publishing    

年代:2012

数据来源: ADIS

摘要:

SummaryThe study of sports injuries has grown with the increase in importance of sport as a leisure-time activity. The origin of many sports injuries is assumed to be mechanical, with the forces and/or stresses acting on one element of the human locomotor system exceeding the critical limits. This article presents some biomechanical considerations on the mechanical aspect of the aetiology, reduction and treatment of sport injuries with special emphasis on the lower extremities.Forces acting on the locomotor system have a magnitude, a point of application and a direction. Both magnitude and geometry (point of application and direction) are important in load analysis. However, the geometrical aspect of externally acting forces is an extremely important aspect, especially with respect to reduction of load in practical situations. Load analysis is usually performed with force transducers and optical instruments in order to quantify magnitude and geometry. Two possible approaches to load analysis are discussed. One approach works with the critical limits of biomaterials. This approach shows that the local stresses for cartilage, tendon and bone are in the order of 10 to 20% of the critical limit for normal daily activities, such as walking. The second approach deals with strategies to reduce load, assuming that it is usually too high in sports activities. The nature of playing surfaces and shoes are revealed as important possibilities for load reduction.

ISSN:0112-1642    

DOI:10.2165/00007256-198502050-00005

出版商:Springer International Publishing    

年代:2012

数据来源: ADIS

ISSN:0112-1642    

DOI:10.2165/00007256-198502050-00006

出版商:Springer International Publishing    

年代:2012

数据来源: ADIS