DrRic Runners Knee, Common Problems with Knee Pain in Runners (slide share edition)
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Transcript of DrRic Runners Knee, Common Problems with Knee Pain in Runners (slide share edition)
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Runners Knee / Patello Femoral Syndrome
Enrique Saguil, MDSports and Family Medicine
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Wounded knee
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Knee Pain Iliotibial band syndrome Pes anserine bursitis Patellar tendinitis Meniscus tears Acl tears Osgood schlatter disease (gpi) Patellofemoral syndrome Referred pain (pinched nerve) Bone pain (tumor-fracture-growth plate)
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Patellofemoral syndrome
Irritation to the articular cartilage Sinding Larsen Johansson(osgood)
Irritation to the patellar tendon (mistaken)
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Reasons for irritation
Weekend warriors Running through the pain Attacking hills/incline “Steps”/open chain Two’s- fast, far, long, soft, tight Trauma (sticking it, dashboard, work) Overuse
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Angles that effect the knee Q angle Patellar glide Patellar tilt Pes planus Recurvatum of the knee
Muscular Imbalance
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Q angle
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Q angle
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High q angle “rubbing”
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High q angle rubbing
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Rubbing leads to friction
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Chronic friction = Edema/fracture
weeks
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Edema on edema rubbing =
Chondral fracture
Months
+ cutting
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Pes planus (pronation)
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Pes planus = “flat feet”
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Pes planus = “fallen arches”
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Pronation “fixes” alignment
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“Fixes” Low dye tape Endurance to
intrinsic foot muscles
Stabilizing running shoes
Orthotics
More next time…..
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Recurvatum Patellar instability No control to motion Patellar sledge hammer (outside straight)
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Muscular Imbalance Quads ITB hams
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Dominant muscle wins
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Sinding Larsen Johansson
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Osgood Schlatter Disease
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Osgood MRI
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Patellar Tendonitis
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Fixes Irritation to the articular cartilage Sinding Larsen Johansson Irritation to the patellar tendon (mistaken)
Px: It hurts when I do this……Doc: So don’t do this……. -Henny Youngman
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Acute fix “The Saguil Approach”
Ice 10 min/hour for 24-48 hrs Antiinflam Steroid Acupuncture Immobilization-”relative rest” Diet/supplement Aspiration/compression
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-Role of ICE
Vasoconstriction for 24-48 hours Blood vessel develops rebound vasodi Prevents influx of white blood cells Can “choke off” broken vessels WATCH FOR FROSTBITE!
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-Antiinflammatories
NSAIDS Stop the cascade of inflammation Help with decreasing prostaglandin Dull pain (relafen) WATCH FOR ULCER! WATCH FOR KIDNEY AND HEART DS!
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-Steroids
No, no roids! Catabolic Works fast for BIG suffering Oral or injectable WATCH FOR INSOMNIA AND SUGAR!
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-Acupuncture
3000 years old and still the same Can work on the opposite knee Uses meridia (chinese medicine) Uses trigger point and electric stim
(western medicine) CAN”T HURT, WATCH FOR FALLING
TREES
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-RICE
Rest Ice Compression Elevation
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-Diet
Dr Weil’s Antiinflammatory Diet Fruits and veggies Fish Omega 3 Turmeric Glucosamine sulfate Low GI carbs
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-Big Needle
Aspiration for pain relief and ROM Diagnostic and therapeutic Steroid injection Prolotherapy Trigger point therapy
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Long term fix
Muscle training Orthotic Shoe evaluation Training method/surface Soft tissue mobilization Flexibility surgery
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-Muscle Training Sports medicine ortho/primary Physical medicine and Rehab Podiatrist Chiropractor, ND Sport specific trainer “Gifted” physical therapist Experienced running guru On line, dvd,
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-Dr Robert Weil
Sports medicine podiatrist Ortho group with podiatric “Gifted” physical therapist Dick Ponds “guys” Buy and try
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-Soft tissue mob - flexibility
Yoga Massage therapy “Gifted” physical therapist Raike therapist Reflexologist acupuncture
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-”Heal with Steel”
Sports medicine orthopedic surgery
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Thanks www.herbal411.com