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Erkrankungen und Überlastungsschäden an der unteren Extremität bei Langstreckenläufern

Diseases and overuse injuries of the lower extremities in long distance runners


Der Laufsport ist einer der populärsten Sportarten weltweit, der Hunderttausende von Läuferinnen und Läufern aller Altersstufen zu Laufveranstaltungen lockt. Laufen ist ein effektiver Weg, seine Gesundheit zu verbessern. Es ist mit einem hohen Risiko für Verletzungen assoziiert. So berichtet jeder zweite Läufer über 1 Verletzung pro Jahr. Einige Verletzungen sind Folge eines Unfalls. Die meisten haben eine Überlastung als Ursache. Die häufigsten gestellten Diagnosen sind das patellofemorale Schmerzsyndrom, das Schienbeinkantensyndrom, die Tendinose der Achillessehnen, das iliotibiale Bandsyndrom, die Plantarfasziitis und Stressfrakturen der Ossa metatarsalia oder der Tibiae. Das Knie ist das am häufigsten verletzte Gelenk bei Läufern jeder Distanz. Bei den Oberschenkelverletzungen handelt es sich meist um eine akute Verletzung der ischiokruralen Muskulatur. Hüftverletzungen sind bei Läufern eher selten, aber komplex bezüglich Diagnose und Behandlung. Bei den Unterschenkelverletzungen kommen die Tibiastressfraktur, das Scheinbeinkantensyndrom oder selten das chronische belastungsabhängige Kompartmentsyndrom infrage. Unter Langstreckenläufern ist das Sprunggelenk das am häufigsten verletzte Gelenk. Das Übergewicht und die Anzahl der Laufkilometer pro Woche gelten als Risikofaktoren für eine Verletzung. Die Rolle von anderen Faktoren wie Schuhe, Dehnen und Biomechanik ist nicht klar. In jedem Fall sind eine genaue Anamnese und Untersuchung essenziell zur korrekten Diagnose oder für die Indikationsstellung einer bildgebende Diagnostik und einer Therapie.


Running is one of the most popular sports worldwide, with running events attracting hundreds of thousands of runners of all age groups. Running is an effective way to improve health but is also associated with a high risk of injuries. Up to 50% of regular runners report having more than one injury each year. Some injuries are caused by an accident but most are caused by overuse. The most frequent diagnoses are patellofemoral pain syndrome, tibial stress syndrome (shin splint), Achilles tendinopathy, iliotibial band friction syndrome (runner’s knee), plantar fasciitis and stress fractures of the metatarsals and tibia. The knee is the most frequently injured joint in runners at all distances. Hamstring injuries are typically acute resulting in a sudden, sharp pain in the posterior thigh. Hip injuries are less common but it can be more difficult to make the correct diagnosis and treatment is more complex. Clinicians confronted by runners with shin pain must distinguish between stress fractures of the tibia, tibial stress syndrome (shin splints) and chronic exertional compartment syndrome. Foot and ankle injuries are the most common injuries reported by long distance and marathon runners. Excess body weight and the number of kilometers run per week are high risk factors for injuries. The roles of other factors, such as shoes, stretching and biomechanics are less clear. A detailed anamnesis and physical examination are important for the correct diagnosis or the necessity for further diagnostic imaging and subsequent therapy.

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Correspondence to M. Tschopp.

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M. Tschopp gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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U. Müller-Ladner, Bad Nauheim

U. Lange, Bad Nauheim

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Tschopp, M., Brunner, F. Erkrankungen und Überlastungsschäden an der unteren Extremität bei Langstreckenläufern. Z Rheumatol 76, 443–450 (2017).

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  • Laufsport
  • Verletzungen
  • Kompartmentsyndrom
  • Nagelverletzungen
  • Risikofaktoren


  • Running
  • Injuries
  • Compartment syndrome
  • Nail injuries
  • Risk factors