A***u
发帖数: 3714 | 1 距离上次全马14个月了,这期间我几乎就没跑过. 那次Race结束后,我就发现右膝盖外侧
痛,尤其是下楼痛. 这2周以来,我加强了拉伸, 左腿已经彻底没感觉了. 倒是原来不痛
的右膝盖内侧开始痛了,我想多拉伸会好,但是跑了30迈了,还不见得好.就是前2迈,尤其
是速度慢到3.89mph, 15min/mi,这种非常慢的跑时痛, 速度到达5.31MPH 的时候,倒不
痛,但是跑结束静息状态上下楼的时候会痛.
这种状态有10天了,我担心要不要看医生? 请大家分析一下..
谢谢 | d******0
发帖数: 22800 | | A***u
发帖数: 3714 | 3 14天统计的.
【在 d******0 的大作中提到】
: 14个月没跑后，你是一口气跑了30迈吗？
| d******0
发帖数: 22800 | 4 要不试试路程长点，你全麻都跑过了，没理由一天不到6迈的慢跑啊。
偶瞎说一下，估计是肌肉不太用，退化了，运动一下锻炼起来，这样那样的小痛感就会
消失了，也就是run through吧。跑后多做拉伸，不要长时间坐着不动。多活动一下。。
【在 A***u 的大作中提到】
: 14天统计的.
| A***u
发帖数: 3714 | 5 跑8迈的时候，开始时痛，后面就没感觉。
我没有时间天天跑，所以加起来才30迈。
。。
【在 d******0 的大作中提到】
: 要不试试路程长点，你全麻都跑过了，没理由一天不到6迈的慢跑啊。
: 偶瞎说一下，估计是肌肉不太用，退化了，运动一下锻炼起来，这样那样的小痛感就会
: 消失了，也就是run through吧。跑后多做拉伸，不要长时间坐着不动。多活动一下。。
| d******0
发帖数: 22800 | 6 如果是这样，估计可以run through的。偶现在腿脚也是不跑就会酸痛。
【在 A***u 的大作中提到】
: 跑8迈的时候，开始时痛，后面就没感觉。
: 我没有时间天天跑，所以加起来才30迈。
:
: 。。
| g*2
发帖数: 658 | 7 有点像anserine bursitis。也可能啥事没有
诊断
Diagnosis — The diagnosis of anserine bursitis requires:
Local tenderness
A negative valgus stress maneuver (indicating an intact medial
collateral ligament)
Normal x-ray of the tibia (no underlying bony pathology)
体检
Physical examination — Patients should be examined for tenderness at the
medial tibial plateau, along with a thorough examination of the knee and an
analysis of the patient’s gait.如图
治疗
The goals of treatment are to reduce the pain and swelling in the bursa and
to identify and treat any underlying cause of abnormal gait. Activity
restriction, knee protection, and ice are the treatments of choice for acute
bursitis. When anserine bursitis is the primary cause of knee pain,
glucocorticoid injection is the preferred initial treatment. When bursitis
complicates one of the articular disorders of the knee or ankle, treatment
should focus upon the primary condition.
急性期
Acute therapy — After a thorough examination of the knee to rule out an
underlying cause of bursitis, we recommend the following:
Eliminate squatting and direct pressure on the bursa (with a pillow
between the knees at night).
Avoid crossing the legs.
Limit repetitious bending.
Apply ice for 15 minutes every four to six hours to relieve pain.
An NSAID can be used to control inflammation; however, oral medications
may not concentrate well in this relatively isolated bursa.
如果症状持续的话：
Persistent symptoms — Patients who have persistent symptoms for six to
eight weeks despite the above may benefit from glucocorticoid injection (
figure 1).
The patient lies on the back with the leg extended and externally
rotated.
The tibial tubercle, medial joint line, and midline of the medial lower
leg are identified and marked.
Ethyl chloride is sprayed on the skin. A 22-gauge needle is inserted
perpendicular to the skin and is directed slightly upward toward the
concavity of the medial tibial plateau. It is passed through the
subcutaneous fat until the subtle resistance of the conjoined tendon is felt
. Local anesthetic (0.5 mL) is injected for comfort. Then the needle is
gently passed an additional 3/8 inches to the firm periosteum of the tibia
and is immediately withdrawn 1/8 inches to avoid injection into the medial
collateral ligament. The bursa is located between the medial collateral
ligament (MCL) and the tendon, and 0.5 mL local anesthetic plus 0.5 mL
methylprednisolone (80 mg/mL, Depo Medrol) is injected. Injection should be
free flowing with little resistance; pressure on injection usually suggests
improper position (too deep).
Injection aftercare is critical to the success of glucocorticoid injection.
The patient should be advised to:
Rest for three days, avoiding all direct pressure, squatting, kneeling,
repetitive bending, and unnecessary standing and walking.
Use ice (15 minutes every four to six hours) and acetaminophen (1000 mg
twice a day) for soreness.
Protect the knee for three to four weeks by limiting pressure,
repetitive bending, squatting, and kneeling.
Begin straight leg raising exercises for the quadriceps muscle on day
four 如图2
The injection can be repeated in six weeks if swelling recurs or persists.
Consultation with an orthopedic surgeon can be considered if two consecutive
aspirations and injections fail to eliminate swelling and if the patient
still complains of weightbearing pain. However, bursectomy is rarely
required (less than 1 percent of cases).
以上摘自uptodate
【在 A***u 的大作中提到】
: 距离上次全马14个月了,这期间我几乎就没跑过. 那次Race结束后,我就发现右膝盖外侧
: 痛,尤其是下楼痛. 这2周以来,我加强了拉伸, 左腿已经彻底没感觉了. 倒是原来不痛
: 的右膝盖内侧开始痛了,我想多拉伸会好,但是跑了30迈了,还不见得好.就是前2迈,尤其
: 是速度慢到3.89mph, 15min/mi,这种非常慢的跑时痛, 速度到达5.31MPH 的时候,倒不
: 痛,但是跑结束静息状态上下楼的时候会痛.
: 这种状态有10天了,我担心要不要看医生? 请大家分析一下..
: 谢谢
| d******0
发帖数: 22800 | 8 谢谢版医图文并茂，偶也跟着学习了！！
偶琢磨着能不能把版医给诊断给出可能治疗的整成一个合集。大家有伤痛，都可以查查
有没有对应的诊断治疗。不光是造福一个人，而是一堆大家伙儿。 | h*******t
发帖数: 2679 | 9 ITBS.
拼命roll就好了。
【在 A***u 的大作中提到】
: 距离上次全马14个月了,这期间我几乎就没跑过. 那次Race结束后,我就发现右膝盖外侧
: 痛,尤其是下楼痛. 这2周以来,我加强了拉伸, 左腿已经彻底没感觉了. 倒是原来不痛
: 的右膝盖内侧开始痛了,我想多拉伸会好,但是跑了30迈了,还不见得好.就是前2迈,尤其
: 是速度慢到3.89mph, 15min/mi,这种非常慢的跑时痛, 速度到达5.31MPH 的时候,倒不
: 痛,但是跑结束静息状态上下楼的时候会痛.
: 这种状态有10天了,我担心要不要看医生? 请大家分析一下..
: 谢谢
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