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Травмы при беге   10.09.2014

Травмы при беге обусловлены пере­напряжением мышц (постоянно повторяющимися движениями), чему способствуют нарушение мы­шечного тонуса, небольшие деформации скелета, недостаточные эластичность, сила и выносливость мышц, а также сенсорная невропатия.

При беге на стопы всякий раз приходится 3-8-кратная масса тела спортсмена. Большинство травм при беге возникает на длинных дистанциях или с высо­кой скоростью. Небольшой анатомический дефект костей ног, который в покое не имеет значения, во время бега может приводить к явным поврежде­ниям (хондромаляция надколенника, чрезмерная пронация). Важную роль играют также степень мышечного утомления, окружающая температу­ра и беговая поверхность (например, трава или твердый бетон). Увеличение эластичности и си­лы мышц после травмы при беге путем соответствующих упражнений, езды на велосипеде и плавания позво­ляет избежать последующих повреждений. Прежде всего необходимо позаботиться о соответствующей обуви. Например, у девочек пятки уже, чем у маль­чиков. При выраженной пронации стоп используют амортизирующие вставки и специальные стельки, в менее тяжелых случаях — обувь с мягкой про­кладкой, стабилизирующей средний отдел ступни. Супинация стоп также требует обуви с упругими прокладками, амортизирующими нагрузку на сред­нюю часть ступни, и колодкой с большим изгибом и лишь минимальной поддержкой свода стопы.

У бегунов возможны такие травмы при беге, как усталостные переломы любых костей нижних конечностей (шейки бе­дра, нижних ветвей лобковых костей, подвертельных участков, проксимального отдела бедренных, мало- и большеберцовых костей, ладьевидных, плюсневых, сесамовидных и пяточных костей). Чаще всего страдают кости плюсны, а также мало- и большеберцовые кости. Риск несращения осо­бенно высок при переломе большеберцовой кости в проксимальном отделе, шейки бедра и таранной кости. Растяжению наиболее часто подвергают­ся подколенные мышцы, затем — четырехглавые и приводящие мышцы бедра, камбаловидные и икроножные мышцы. Тендинит обычно развивается в ахилловом сухожилии; менее часто поражаются сзади сухожилия большеберцовых, малоберцовых, подвздошно-поясничных и проксимальное сухо­жилие подколенных мышц. В начале хроническо­го ахиллова тендинита бег может даже уменьшать . В острых случаях такой травмы при беге при пальпации по ходу су­хожилия ощущается болезненность и крепитация, а в хронических — узловатость. Ахиллов тендинит следует отличать от ахиллобурсита. Прежде всего необходимо установить причину боли и на время отстранить спортсмена от занятий бегом (разре­шив ему занятия другими видами спорта без на­грузки на поврежденную область). Используют подпяточники (толщиной 1,0-1,5 см), вытяжение пятки и НПВС. Инъекции кортикостероидов не показаны.

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