A mistaken case of peroneal dislocation.
ABSTRACT This article is centred around the similarities and highlights some differences between a sports injury compared with any other injury profile. The authors use a musculoskeletal assessment, diagnosis and management of an injury based on a particular case study. The intention is to highlight how problems may be masqueraded in the history and perception of the injured athlete and how this perception may have complicated the injury and the rehabilitation process. This issue generates a renewed awareness for all primary care nurses and health practitioners who may be involved in treatment pathways for associated injuries related to sports medicine problems. The article gives an insight into peroneal dislocation/subluxation, but primarily focuses on peroneal tendonitis/tendonosis. The management of the injury briefly touches on the associated benefits (and risks) of barefoot running and its role in the prevention of sporting injuries. This article illustrates how the frustration of a chronic injury can lead to the athlete making ill-informed decisions and highlights the need for a thorough assessment and an evidence-based management plan that is negotiated with the athlete.
- SourceAvailable from: Irene S Davis[Show abstract] [Hide abstract]
ABSTRACT: Humans have engaged in endurance running for millions of years, but the modern running shoe was not invented until the 1970s. For most of human evolutionary history, runners were either barefoot or wore minimal footwear such as sandals or moccasins with smaller heels and little cushioning relative to modern running shoes. We wondered how runners coped with the impact caused by the foot colliding with the ground before the invention of the modern shoe. Here we show that habitually barefoot endurance runners often land on the fore-foot (fore-foot strike) before bringing down the heel, but they sometimes land with a flat foot (mid-foot strike) or, less often, on the heel (rear-foot strike). In contrast, habitually shod runners mostly rear-foot strike, facilitated by the elevated and cushioned heel of the modern running shoe. Kinematic and kinetic analyses show that even on hard surfaces, barefoot runners who fore-foot strike generate smaller collision forces than shod rear-foot strikers. This difference results primarily from a more plantarflexed foot at landing and more ankle compliance during impact, decreasing the effective mass of the body that collides with the ground. Fore-foot- and mid-foot-strike gaits were probably more common when humans ran barefoot or in minimal shoes, and may protect the feet and lower limbs from some of the impact-related injuries now experienced by a high percentage of runners.Nature 01/2010; 463(7280):531-5. DOI:10.1038/nature08723 · 42.35 Impact Factor
Article: Clinical sports medicine[Show abstract] [Hide abstract]
ABSTRACT: Clinical Sports Medicine has been fully updated from the popular 2nd edition (2000). It is even more practical, now superbly illustrated, easy-to-read and packed with substantially updated and new material. There are samples of several chapters online including the whole "Pain in the Achilles region" chapter. This book describes a completely symptom-oriented approach to treating clinical problems.
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ABSTRACT: Barefoot running kinematics has been described to vary considerably from shod running. However, previous investigations were typically based on externally mounted shoe and/or skin markers, which have been shown to overestimate skeletal movements. Thus, the purpose of this study was to compare calcaneal and tibial movements of barefoot versus shod running using skeletal markers. Intracortical bone pins with reflective marker triads were inserted under standard local anesthetic into the calcaneus and tibia of five healthy male subjects. The subjects ran barefoot, with a normal shoe, with three shoe soles and two orthotic modifications. The three-dimensional tibiocalcaneal rotations were determined using a joint coordinate system approach. Test variables were defined for eversion and tibial rotation. The results showed that the differences in bone movements between barefoot and shod running were small and unsystematic (mean effects being less than 2 degrees ) compared with the differences between the subjects (up to 10 degrees ). However, differences may occur during midstance when extreme shoe modifications (i.e. posterior orthosis) are used. It is concluded that calcaneal and tibial movement patterns do not differ substantially between barefoot and shod running, and that the effects of these interventions are subject specific. The result of this in vivo study contrasts with previous investigations using skin and shoe mounted markers and suggests that these discrepancies may be the result of the overestimation with externally mounted markers.Journal of Biomechanics 12/2000; 33(11):1387-95. DOI:10.1016/S0021-9290(00)00116-0 · 2.50 Impact Factor