GOTS – Newsletter vom 10.05.2010
Sehr geehrte Damen und Herren,
mit steigenden Temperaturen schnüren auch immer mehr Freizeitsportler ihre Laufschuhe. Doch immer wieder klagen Läufer über Verletzungssorgen und Überlastungsbeschwerden. Ist Laufen eine gefährliche Sportart – und wenn ja: Wie kann man sich vor Verletzungen schützen? Mehr dazu finden Sie in diesem Newsletter.
Mit freundlichen Grüßen,
Frank Wechsel und Dr. Wolfgang Schillings, GOTS-Pressesprecher
GOTS-Pressekonferenz am 17. Juni 2010 um 11 Uhr in München
Der 25. Jahreskongress der Gesellschaft für Orthopädisch-Traumatologische Sportmedizin (GOTS) findet vom 18. bis 20. Juni 2010 im Klinikum Großhadern in München statt. Bereits am 17. Juni 2010 informiert Sie die GOTS auf einer Pressekonferenz um 11 Uhr im Hotel Arabella Sheraton am Westpark über das abwechslungsreiche Kongressprogramm und aktuelle Themen aus der Sportmedizin. Wie in jedem Jahr wird der Praxisbezug durch das Gespräch mit hochrangigen Spitzensportlern hergestellt.
Weitere Informationen zur Pressekonferenz erhalten Sie in den kommenden Tagen. Das Programm des 25. Jahreskongresses der GOTS finden Sie unter www.gots-kongress.org.
Verletzungen und Überlastungsschäden bei Läufern
Die steigenden Temperaturen locken mehr und mehr Läufer in die Parks und Wälder. Nun beginnt wieder die große Zeit der Frühjahrsmarathons. Dass Laufen vor allem für Herz und Kreislauf gesund ist, konnten mittlerweile zahlreiche Studien belegen – aber wie reagieren Muskeln, Bänder und Gelenke auf ein regelmäßiges Lauftraining?
80 Prozent der durchs Laufen verursachten Verletzungen und Beschwerden beruhen auf Fehl- und Überbelastungen und betreffen die untere Extremität. Es finden sich Muskel-Sehnen-Verletzungen (bei Langstreckenläufern vorwiegend im Bereich der Wadenmuskulatur), Sprunggelenksdistorsionen sowie Hautverletzungen, vornehmlich Schürfungen und Blasenbildungen. 80 Prozent der Beschwerden im Laufsport resultieren aus einem Missverhältnis zwischen der Belastbarkeit des Gewebes und der Belastung durch den Sport: Zu schnelle Steigerung der Laufbelastung, fehlendes Aufwärmen, ungenügende Regeneration nach Erkrankungen und Verletzungen, Belastung trotz Infekts, ungeeignetes Schuhwerk sowie stärkere Achsabweichung an der unteren Extremität sind die häufigsten Ursachen für Fehlbeanspruchungen. Als typische Fehlbelastungsfolgen finden sich:
- Achillessehnenerkrankungen (Tendinopathie, Peritendinitis, Schleimbeutelentzündung)
- Vorderer Knieschmerz (Patella-femoralis-Schmerzsyndrom)
- Schmerzen oberhalb des äußeren Kniegelenkspaltes (Tractus-iliotibialis-Syndrom)
- Schmerzen unterhalb des inneren Kniegelenkspaltes (Bursitis, Tendinose am Pes anserinus)
- Rückenschmerzen (ischalgieforme Beschwerden, ISG-Blockierung)
- Stressfrakturen (vorzugsweise am Mittelfußknochen 2 und 3, Fersenbein und Schienbein)
- Fasziitis plantaris
Anfänger aufgepasst
Ein erhöhtes Risiko, sich eine Verletzung beim Laufen zuzuziehen, besteht bei Anfängern in den ersten drei Jahren. Auch frühere nicht ausgeheilte Verletzungen sowie eine schnelle Steigerung von Umfang und Intensität – insbesondere nach der Winterpause im Frühjahr – erhöhen die Verletzungsquote.
Zu den allgemeinen konservativen therapeutischen Optionen einer Laufverletzung gehören:
- Laufpause
- Training in einer anderen Sportart wie Radfahren, Aqua-Jogging, Skilanglauf oder Schwimmen
- Maßnahmen der physikalischen Therapie
- Physiotherapie mit Muskelaufbautraining, Ausgleich von Muskeldysbalancen, exzentrischem Krafttraining bei Achillessehnentendinose
- Stoßwellentherapie
- Akupunktur
- funktionelle Stützverbände
- Einlagen
- Schuhzurichtungen
- Röntgen-Reizbestrahlung
Als operative Maßnahmen kann bei Ansatztendinopathien der Heilungsprozess durch Bohrungen am Sehnenknochenübergang stimuliert werden. Auch die Ausschneidung von degeneriertem Gewebe, das Entfernen eines entzündlich veränderten Schleimbeutels sowie Achskorrekturen können hilfreich sein.
Vorgehen bei Muskelverletzungen
Die Behandlung von Muskelverletzungen beruht meist auf Erfahrung. Hochlagerung und Entlastung der betroffenen Extremität in Verbindung mit Kühlung und Kompression sind empfehlenswerte Erstbehandlungsmaßnahmen. Ziel dabei ist, die Größe des Blutergusses so gering wie möglich zu halten, wozu auch eine Punktion oder eine Ausräumung des Blutergusses beitragen kann. Ist eine operative Behandlung indiziert, wie zum Beispiel bei großen Blutergüssen im Muskel, kompletten Muskelrissen oder Teilrissen von über 50 Prozent des Muskelbauchs, sollte diese ohne Verzögerung durchgeführt werden. Jede muskuläre Verletzung sollte in Abhängigkeit vom betroffenen Muskel, der Lokalisation und der Schwere der Verletzung individuell behandelt werden. Dies betrifft insbesondere auch die Nachbehandlung. Die biologischen Heilungsvorgänge lassen sich nur bedingt beschleunigen und benötigen in der Regel mindestens 21 Tage bis zur Ausbildung einer einigermaßen stabilen Narbe.
Voraussetzungen für gesundes Laufen
Die Verletzungsanfälligkeit eines Läufers kann durch ein allgemeines athletisches Training, ein Flexibilitätstraining und durch den Ausgleich von muskulären Dysbalancen herabgesetzt werden. Dabei sollten Läufer insbesondere auf die Stärkung der Bauch-, Rücken- und Glutealmuskulatur sowie die Dehnung des Musculus rectus femoris achten. Das Bewegungsausmaß der Gelenke kann durch aktive und passive Mobilisation verbessert werden. Besonders zu berücksichtigen sind das Sprunggelenk mit der Neigung zur eingeschränkten Fußhebung und das Hüftgelenk mit eingeschränkter Hüftstreckung. Eine Laufschulung mit Training verschiedener Laufvarianten trägt zur Muskelkräftigung bei und verbessert die Reaktionsfähigkeit auf unebenem Boden. Die Trainingsplanung sollte den notwendigen Wechsel von Be- und Entlastung berücksichtigen, genügend Zeit zur Regeneration geben und ein abwechslungsreiches Training ermöglichen. Lockeres Auslaufen fördert die Regeneration und ist allen anderen Maßnahmen einschließlich Stretching überlegen. Bei Infekten sollte kein Training erfolgen. Eine gesunde Ernährung, ausreichendes Trinken – insbesondere bei langen Läufen und hohen Außentemperaturen sowie hoher Luftfeuchtigkeit –, angemessene Kohlenhydratzufuhr bei langen Läufen sowie ausreichender Schlaf sind Basisvoraussetzungen zur Erhaltung der Gesundheit.
Autor: Priv.-Doz. Dr. Martin Engelhardt, Chefarzt der Klinik für Orthopädie, Unfall- und Handchirurgie des Klinikums Osnabrück, ist Schriftführer der Gesellschaft für Orthopädisch-Traumatologische Sportmedizin (GOTS)
In eigener Sache: Sind Ihre Kontaktdaten aktuell?
Liebe GOTS-Mitglieder,
sind wir auf dem aktuellen Stand? Bitte prüfen Sie Ihre persönlichen Daten, die in der GOTS-Datei auf der Website www.gots.org hinterlegt sind. Mit Ihrer E-Mail-Adresse haben Sie den Zugang.
Herzlichen Dank,
Ihre GOTS-Geschäftsstelle
Petra Enderlein
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