Current sports medicine reports
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Injuries of the foot are common among both elite and recreational runners. Overuse accounts for most of these injuries. Plantar fasciitis and tendinopathies of the midfoot and forefoot have a high incidence in running athletes. ⋯ Most running injuries are self-limited and pose little detriment if diagnosis is delayed. Navicular and sesamoid stress fractures may impart significant long-term consequences, and thus, a clinical suspicion of either fracture warrants definitive diagnosis and treatment. Barefoot running recently has garnered increased attention, but currently, there is a lack of prospective studies regarding its injury reduction.
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Running injuries are common. Recently the demographic has changed, in that most runners in road races are older and injuries now include those more common in master runners. In particular, Achilles/calf injuries, iliotibial band injury, meniscus injury, and muscle injuries to the hamstrings and quadriceps represent higher percentages of the overall injury mix in recent epidemiologic studies compared with earlier ones. ⋯ Evidence-based research now helps guide the treatment of iliotibial band, patellofemoral syndrome, and Achilles tendinopathy. The use of topical nitroglycerin in tendinopathy and orthotics for the treatment of patellofemoral syndrome has moderate to strong evidence. Thus, more current knowledge about the changing demographics of runners and the application of research to guide treatment and, eventually, prevent running injury offers hope that clinicians can help reduce the high morbidity associated with long-distance running.
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Patellar tendinopathy is a painful knee injury due to overuse common among jumping athletes. Because rest from sport is neither a feasible nor an effective treatment for patellar tendinopathy in elite athletes, active treatment options are needed. Treatment may be conservative, injection-based, or surgical. ⋯ Steroid injections are inferior to exercise interventions and are not recommended. Injections of autologous blood, platelet-rich plasma, and hyperosmolar dextrose are unproven and experimental. Clinicians need to have a comprehensive knowledge of the evidence in the literature, as well as training and experience, when treating patellar tendinopathy.