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DIAGNOSIS OF AN INJURY

5 tips for orthotics 8

DIAGNOSIS OF AN INJURY

By Steve Manning – Podiatrist and intraining Coaching Director

Injury is the greatest risk to achieving your running goals.  Around 60% of runners have injuries each year that require some time off running.  If you do become injured then the goal should be to get back to running ASAP so as not to disrupt your training plan.

 

To reduce your time off running you need to follow the best injury protocol for your problem.  The most important factor for injury resolution is an early accurate diagnosis.  Because different injuries require different treatment pathways and can occur within a similar region it can be difficult to make an accurate diagnosis.

 

This is where advice from an experienced running health professional is critical.  There are a variety of techniques that can be used to make a diagnosis:

1. Diagnose by History: 

A good history can often be enough to make an accurate diagnosis.  What is the nature of the injury?  How would you describe the pain?  Numbness and tingling and burning can be neural symptoms while sharp stabbing pains may be something ruptured.  Are you limping when running or do you only notice the pain after stopping?  How did the injury occur?  Was it a traumatic event or did it have a gradual onset?  When did the injury start and what were the contributing factors?  Has it been getting better or worse?  Is the pain easily localised or does it seem to move around?  What treatment or interventions affects the symptoms?  These are all important questions that will help us identify the cause of your injury.

2. Diagnose by Palpation

The next important technique is to find out where it hurts.  This means we need to reproduce the pain.  A complete understanding of the anatomy that exists under the skin is vital to knowing what structure is hurting and injured.  While pushing on each tissue is the most important thing some tissues can only be stressed with special mobility tests.  Sometimes athletes will need to hop or run to bring on the symptoms.

3. Diagnose from Imaging

Sometimes the clinical examination will be inadequate to differentiate an injury.  This will require imaging to identify.  X-rays are useful to identify fractures and some joint issues.  They are less useful for soft tissue injuries.  Ultrasounds are good to pick up superficial soft tissue injuries like ligament and tendon tears.  They are able to keep imaging while moving a joint through its range of motion to see if the connective tissue is incompetent.  MRI’s can create an image of a thin slice of anatomy.  This helps significantly in narrowing down the location of a problem.  An MRI shows up soft tissue problems and can identify subtle issues in bones like stress fractures and contusions.

4 . Treatment directed diagnosis

It is not always desirable to do imaging.  In this case it might be better to follow the treatment protocol from the most likely clinical diagnosis.  If the injury improves then the diagnosis was likely to be correct and if it fails then you can move on to the treatment protocol for the next likely injury.

5. Diagnose contributing factors not just injury

Making an accurate diagnosis is just the first factor in resolution of an injury.  You must also accurately diagnose the cause of an injury.  Sometimes it is obvious after having a fall and hurting something.  With chronic injuries there can be multiple contributing factors such as a training error, footwear, running technique and structural/biomechanical issues.  While it is important to heal an injury in the long term it is just important to make sure it does not occur again.

After a diagnosis is made we follow evidence-based medicine to create a treatment pathway for the resolution of an injury including short-term pain management, rehabilitation and then strengthening and conditioning for prevention.

 

If you have been struggling with a possible injury for more than 2 weeks or the injury is bad enough to stop you running then book in to see Steve at the intraining Running Centre, iHealth, Level 5 112 Coonan Street Indooroopilly.  Call 3870 2525 or book online.