Sports Medicine: Just the Facts

e. Proximal 5th metatarsal

i. Jones fracture (Fx) of proximal diaphysis:

Cast, non weight-bearing(NWB) 6–10 weeks

ii. Nonunion: Ortho.

SOME PRACTICAL GUIDELINES
FOR CLINICIANS

• Certain injuries require the runner to refrain from run-
  ning (stress fractures, radiculopathy). With most over-
  use injuries, however, some level of training may be
  permitted following the Relative Activity Modification
  Guidelines (Wilder RP: The Runners Clinics at UVa)
  
  
  1. Pain/discomfort should not exceed the mild level
     (≤3/10 on the 10-point pain scale).
     2.Pain that eases after a warm-up is generally
     benign, do not run if pain progressively worsens.
  
  
  2. Do not run if you are limping or changing your gait
     mechanics.
  
  
  
  


• Supplement lost run training with cross-training (aqua
  running, bike, elliptical).


• Do not increase mileage more rapidly than 10% per
  week.


• Long run of the week increases no more than 2 mi per
  week, and should not exceed 30% of one’s weekly
  mileage.


• Change shoes every 350–400 mi.

REFERENCES

Albertson K, Dammann G: The leg, in O’Connor F, Wilder R,
(eds.): The Textbook of Running Medicine, New York, NY,
McGraw-Hill, 2001, pp 647–654.
Andrish JT, Bergfeld JA, Walheim J: A prospective study on the
management of shin splints. J Bone Joint Surg Am56(8):
1697–1700, 1974.
Birnbaum J: Recurrent compartment syndrome in the posterior
thigh. Am J Sports Med11(1):48–49, 1983.
Birrer R, Buzermanis S, DellaCorte M, et al: Biomechanics of
running, in O’Connor F, Wilder R, (eds.): The Textbook of
Running Medicine. New York, NY, McGraw-Hill, 2001.
Briner WW, Jr: Shinsplints. Am Fam Physician37(2):155–160,
1988.
Detmer DE: Chronic shin splints. Classification and management
of medial tibial stress syndrome. Sports Med3(6):436–446,
1986.
Edwards P, Myerson M: Exertional compartment syndrome of
the leg: Steps for expedient return to activity. Phys Sportsmed
24:1996.
Epperly T, Fields K: Epidemiology of running injuries, in
O’Connor F, Wilder R, (eds.): The Textbook of Running
Medicine. New York, NY, McGraw-Hill, 2001.

Glorioso J, Wilckens H: Exertional leg pain, in O’Conner F,

Wilder R (eds.): The Textbook of Running Medicine. New York,

NY, McGraw-Hill, 2001, pp 181–198.

Gudas CJ: Patterns of lower-extremity injury in 224 runners.

Compr Ther6(9):50–59, 1980.

Inman VT: Functional aspects of the abductor muscles of the hip.

J Bone Joint Surg Am29:607, 1947.

Jacobs SJ, Berson BL: Injuries to runners: A study of entrants to

a 10,000 meter race. Am J Sports Med14(2):151–155, 1986.

James SL, Bates BT Osternig LR: Injuries to runners. Am J

Sports Med6(2):40–50, 1978.

Lysholm J, Wiklander J: Injuries in runners. Am J Sports Med

15(2):168–171, 1987.

Mann R: Biomechanics of running, in Nicholas J, Hershman E

(eds.) The Lower Extremity and Spine in Sports Medicine,C.V.

Mosby, St. Louis, 1986.

Mann RA, Hagy J: Biomechanics of walking, running, and

sprinting. Am J Sports Med8(5):345–350, 1980.

Mollica MB, Duyshart SC: Analysis of pre- and postexercise

compartment pressures in the medial compartment of the foot.

Am J Sports Med30(2):268–271, 2002.

Oonpuu S: The biomechanics of running: A kinematic and kinetic

analysis. Instr Course Lect39:305–318, 1990.

Oonpuu S: The biomechanics of walking and running. Clin

Sports Med13(4):843–863, 1994.

Padhiar N, King JB: Exercise induced leg pain-chronic compart-

ment syndrome. Is the increase in intra-compartment pressure

exercise specific? Br J Sports Med30(4):360–362, 1996.

Pinshaw R, Atlas V, Noakes TD: The nature and response to ther-

apy of 196 consecutive injuries seen at a runners’ clinic. S Afr

Med J65(8):291–298, 1984.

Raether PM, Lutter LD: Recurrent compartment syndrome in the

posterior thigh. Report of a case. Am J Sports Med10(1):

40–43, 1982.

Rodgers MM: Dynamic biomechanics of the normal foot and ankle

during walking and running. Phys Ther68(12):1822–1830,

1988.

Van Mechelen W: Running injuries. A review of the epidemio-

logical literature. Sports Med14(5):320–335, 1992.

Walter SD et al: The Ontario cohort study of running-related

injuries. Arch Intern Med149(11):2561–2564, 1989.

Wilder R, Sethi S: Overuse injuries: Tendinopathies, stress frac-

tures, compartment syndrome, and shin splints. Clin Sports

Med23:55–81, 2004.

89 SOCCER

Nicholas A Piantanida, MD

INTRODUCTION

• Soccer has a worldwide attraction to at least 40 million
  people and is the fastest growing sport in America (Hoy
  et al, 1992; Soccer Industry Counsel of America, 1996).

526 SECTION 6 • SPORTS-SPECIFIC CONSIDERATIONS