Running Injuries

Finding Root Cause

Staying healthy and injury free is a goal for all runners. Whether you are a competitive or a recreational runner, young or old, there are many variables involved in staying healthy and injury free. It is very much like a puzzle. We have been treating recreational to elite runners for over 30 years, and we have seen the science of running constantly evolve and frequently attend medical conferences to keep up with the latest knowledge. A key point in understanding running injuries is to look beyond the symptoms and pain, and truly understand the “Root Cause” of the condition in order to achieve true resolution of the issue. For example, plantar fasciitis is a medical diagnosis, but it is actually a symptom of over use and irritation of the plantar fascia of the bottom of the foot, which in some cases causes inflammation of the plantar fascia. To fully resolve this nagging recurrent problem one needs to understand ROOT CAUSE. Why is the plantar fasica being overused and/or irritated? Medications and orthotics manage the symptom (pain) and the source (the plantar fascia), but in many cases the problem persists because the root cause, that is, how the foot hits the ground is complicated. There is a lot going on there. The foot accepts weight from rear foot to forefoot, the ankle pronates to balance, then the toe pushes off, all in a second, automatically. If any part of that motion is off or misaligned a problem can develop.

The invisible force we know as gravity affects how the weight of your body and its center of gravity are transferred, through the foot, knee, hip, pelvis, and spine in a complicated kinetic chain. Ground Force Reaction (CFR) is always the root cause of all running injuries. Therefore several factors need to be evaluated including mechanical load, skeletal properties, and tissue injuries inclusive of bone and stress injury to fully assess a running injury. There are 5 major components to running form that impacts your exposure to injury while running. All should be assessed in a running analysis.

  • Stride length and shin position of landing position
  • Step rate
  • Step width
  • Foot position of foot strike
  • Bounce – vertical movement while running

In circling back to resolving plantar fasciitis, the source is the plantar fascia being over loaded, the root cause is figuring out why, which is what we do.

Structure, habit, reflexes are the invisible components to running, walking and function. Medications and orthotics are common approaches to addressing a nagging plantar fasciitis, but function and neuromuscular control answers the questions of root cause. This model approach is pertinent to all types of running injuries including hamstring strain, hip pain, IT band syndrome, meniscal tears, labral tear of the hip, and stress reaction fractures of the shin, hip or femur. As therapists, who specialize in treating runners, we are the experts to figure out “Root cause”, and teach you the patients treatment strategies to fully resolve the injury and to prevent future injuries.

WALK of LIFE

Bipedal walking is an important characteristic of humans. Gait is the manner, pattern or style of walking. The entire body moves during walking. A faulty movement or pattern in any segment of the body can have an effect on the gait pattern. The gait cycle is composed of the stance phase (60% of gait) when the foot is in contact with the ground from the heel strike to the toe-off of the same foot, and the swing phase (40% of gait) when the foot is not in contact with the ground, which is the normal weight bearing phase of gait. Proper body movement and timing are essential to normal gait. Physical Therapists are looking at symmetry of arm swings, stride length, weight shifting of hips, movement of the trunk and foot alignment, as well as other areas to fully assess the cause of a patient’s dysfunction.

Some of the abnormalities seen at the clinic which affect how a person walks are:

  • Forward flexed trunk position due to decreased spine mobility (spinal stenosis).
  • Trendelenburg gait due to weakness of hip abductor muscles causing the hip to drop towards the same side of the leg swinging forward.
  • Hip extensor weakness causes patient to compensate with an increased posterior trunk position to maintain alignment of pelvis in relation to trunk.
  • Quadriceps weakness or instability at the knee joint will cause the person to hyperextend the knee for stability.
  • Tight calf muscles will result in a compensated gait of toe walking.
  • Hallux rigidus results is a lack of big toe dorsiflexion, which will affect the gait pattern.
  • Leg length discrepancy can be a result of a pelvic asymmetry, or an uneven bone length of the tibia/shin or femur/thigh. This will cause an asymmetrical gait pattern of a pelvic dip or toe walk.
  • Get your groove back at NJPTA by letting us assess your gait.

NJPTA’s Kathryn Haskins Now Board Certified as Orthopedic Clinical Specialist (OCS)

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Kathryn Haskins, PT, DPT, OCS, CMTPT

The American Physical Therapy Association (APTA) represents more than 80,000 members throughout the United States, and established the specialist certification program in 1978. The specialist certification program was created to provide formal recognition for physical therapists with advanced clinical knowledge, experience, and skills in a special area of practice, and to assist consumers and the health care community in identifying these physical therapists.

The American Board of Physical Therapy Specialties (ABPTS) coordinates and oversees the specialist certification process. One such designation, received by North Jersey Physical Therapy Association’s (NJPTA’s) Kathryn Haskins, is the Orthopedic Clinical Specialist certification. It is important to note that as of June 2014, according to ABPTS, only about 10% of PTs in the U.S. are certified as Orthopedic Clinical Specialists.

As an Orthopedic Clinical Specialist (OCS), PTs strengthen their knowledge in the following body regions:

  • Cranial/Mandibular
  • Spine: Cervical
  • Spine: Thoracic spine/ribs
  • Spine: Lumbar
  • Upper Extremity: Shoulder/shoulder girdle
  • Upper Extremity: Arm/elbow
  • Upper Extremity: Wrist/hand
  • Pelvic Girdle/Sacroiliac/Coccyx/Abdomen
  • Lower Extremity: Hip
  • Lower Extremity: Thigh/knee
  • Lower Extremity: Leg/ankle/foot

Additionally, OCSs have increased their orthopedic practice dimensions in the following areas:

  • Examination
  • Evaluation
  • Diagnosis
  • Prognosis
  • Intervention
  • Outcomes

More focus and study is placed on knowledge areas and procedures that orthopedic clinical specialists use in their work, which are as follows:

  • Human Anatomy and Physiology
  • Movement Science
  • Pathophysiology
  • Orthopedic Medicine/Surgical Intervention
  • Evidence Based Orthopedic Theory and Practice
  • Critical Inquiry/Evidence Based Practice
  • Examination
  • Procedural Intervention

NJPTA’s Kathryn Haskins has her doctorate in Physical Therapy, is certified in Dry Needling, and now in Orthopedic Clinical Specialty. These unique credentials enable her to provide the upmost in services for those suffering from conditions that may include, but are not limited to sports injuries and spinal disorders, in addition to pre- and post-orthopedic surgeries. By using dry needling, myofascial release, neuromuscular reeducation, manual therapy techniques and laser as well as key exercises, Kathryn and NJPTA are dedicated to bringing patients sustained pain relief and pain-free function.

To schedule an appointment with Kathryn or our other well-qualified PTs, please Contact Us.