Disclaimer: Note that stretching is not warming-up. It is a common misconception that warming-up equates to stretching. ‘Warming-up’ literally means raising your core body temperature. It is advised that before you begin on your stretches and run, a general warm-up such as brisk walking between five to ten minutes be performed to prevent injury to your ‘cold’ muscles. (see To stretch or not to stretch before an event?

Top 5 stretches:

Hamstrings Stretch

click for larger view	Start off with your body close to your thigh and your knee about 90 degree
click for larger view	Straighten the knee gently while keeping your body close to your thigh Hold for 15 seconds and repeat 3-5 repetitions

Calf Stretch

click for larger view	Upper Calf stretch Place hands on front thigh, with one leg to rear Keep the rear leg straight and foot flat with toes pointing forwards Bend the front leg and feel the stretch through the rear leg Hold the stretch for 15 seconds and repeat 3-5 repetitions.
click for larger view	Lower Calf Stretch Place hands on front thigh, putting your weight on your rear leg Keep the rear foot flat with toes pointing forwards Bend rear knee forward over rear foot and feel for the stretch over the lower calf Hold the stretch for 15seconds and repeat 3-5 repetitions

Quadriceps Stretch

click for larger view	In standing, bend your knee and take your heel towards your bottom, keeping your back straight until you feel a stretch in the front of your thigh
click for larger view	To further stretch the front of your thigh, extend your thigh and bring your heel closer towards your bottom Feel for the stretch at the front of your thigh Hold the stretch for 15seconds and repeat 3-5 repetitions

Iliotibial Band (ITB) Stretch

click for larger view	To stretch the IT band of your right leg, stand with your right leg crossed behind your left.
click for larger view	Put your weight on the right leg and lean your body towards the left. You should be able to feel the stretch in your hip and down the IT band along the right side of your right thigh Hold for 15 seconds and repeat 3-5 repetitions

Glueteus (Buttock) Stretch

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Sitting on the floor with one leg straight out, bend the other knee and place the foot over the straight leg Using your hands, gently bring the bent knee up towards the opposite shoulder. Feel for the stretch in the buttock Hold the stretch for 15 seconds and repeat 3-5 repetitions.

Stretches For New Runners is a post from: Musculoskeletal Consumer Review

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What is Pes Anserinus Tendinitis?

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Is it often mis-diagnosed as MCL or  medial-menicus strain because of the close location of the pes anserinus tendon to the MCL and medial menicus.

What strains the Pes Anserinus Tendon?

Things that strain the pes anserinus tendon are

1. Severe pronation of the feet – this causes the tibia (one of the lower leg bones) to rotate inwards which strains the tendons
2. Weak hamstring muscles – when combined with an intense running programme, the hamstrings may not be able to cope with the high workload. This is often an overlooked areas in a runner's strength training regime.
3. Tight thigh muscles (quadriceps) – weakens the opposing hamstring muscle. Muscles tightness here is further encouraged if you have a deskbound job that requires you to sit at the your desk all day long.
4. Sudden change on the volume and intensity of training

Diagnosing Pes Anserinus Tendinitis

Patients typically complain about pain climbing stairs, squatting, running and in severe cases, standing from a seated position.The pain would also appear gradually and for runners, following an increase in their training volume and intensity (uphill, or running faster).

However, even if your symptoms match those listed above, it is advisable to ensure that it is not other possible condition such as Patellar-Femoral Pain (PFP), MCL strain and medial-menicus strain

Treating Pes Anserinus

During the initial inflamed painful stage, your doctor may prescribe NSAIDs to help reduce the swelling and inflammation and recommend rest for the first 24-48 hours. Ice or cyrotherapy can help speed up the recovery by reducing the inflammation.

Once less painful, your therapist may suggest the following treatment depending on your cause of the tendinitis as list above.

1. For severe foot pronation – orthotics can help correct over pronation of your foot
2. To strengthen the weak hamstrings – see Hamstring Exercises for Long Distance Runners
3. Release tight thigh muscles with sports massage and a stretching programme.
4. A training programme that appropriately increases your training volume and intensity.

¹ Ed note. The Sartorius is the longest muscle in the human body

Why is my MCL strain not getting better? Because it is Pes Ancerinus Tendinitis. is a post from: Musculoskeletal Consumer Review

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The quick, strong pull on the tibial tubercle has an avulsion-fracture like effect (when a small bone fragment breaks away from the main bone mass) that would cause an inflammation of the periostium. However, with the child being actively involved with the sport, this effect is magnified as the action is repeated. The frequency and repetitive nature of the sport doesn’t allow the periostium to recover and thus causes a chronic inflammation on prominence of the tubercle. This leads to a constant, persistent pain, especially on impact. This pain will not only limit the child’s performance in the sport, preventing them from excelling, it would also cause a lot of inconveniences later on in their growing years.

Management

• RICER regime (Rest, Ice, Compression, Elevation, and Referral).

• Oral NSAIDs or injection of NSAIDs directly over the painful area
• Ultrasound guided Extracorporeal Shock Wave Therapy (ESWT) by a sports physician to break down scarred tissues and allow for the tubercle to heal
• Stretches and improving muscle control through physiotherapy
• Assessing for biomechanical factors that may cause OSD by sports physiotherapists to prevent recurrence of pain and to maximise the child’s performance in their sport

Prevention

The best way to prevent the onset of OSD is to ensure adequate stretching and good control of the quadriceps. Adequate prehab should thus be a key before starting any form of sport.   | MCR

Osgood-Schlatter Disease (OSD) is a post from: Musculoskeletal Consumer Review

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