One of my greatest pieces of advice for injured runners is to ALWAYS REMAIN CONSERVATIVE in managing any running related injury. In all the years I've been working with injured runners, a needle has never played a decisive role in expediting an injured runner's return to training and racing. Furthermore, in nearly all cases in which an injured runner has gone against my professional advice and opted to receive an injection, it has only made their situation worse while prolonging an otherwise timely recovery by engendering the false notion that it's safe to train simply because the pain may have subsided. I'm writing this post specifically because in just this last week, I have spoken to three runners, who elected to receive a corticosteroid injection and are still dealing with the adverse effects and sequelae of this intervention and still are unable to run. While favorable research by Gunter and colleagues does exist pertaining to the use of corticosteroid injections in managing symptoms associated with recent onset Iliotibial Band Syndrome (ITBS), this study only assessed runners at 7 and 14 days following the intervention so no definitive conclusions can be drawn. Although I fully appreciate that being sidelined by injury isn't fun, never opt for a needle as a viable fix to address a running related injury. Rather, take the time to connect with a running injury expert, who can systematically evaluate you and get to the root of the problem. In the event this message is getting to you late and you have already received an injection for a running related injury, please make sure to afford at least 4-6 weeks before you even entertain the idea of running considering the iatrogenic effects of an injection. My ultimate goal is to help you make better decisions to foster a healthy running career while protecting you from yourself. 

Growing up in Pittsburgh, Pennsylvania, I used to play a considerable amount of golf. When I wasn't playing a particular course, I used to live at the driving range or putting green in a never ending attempt to refine my swing and mechanics while incessantly trying to shave strokes off my score. Sometimes I would work my way through the entire bag of clubs while other times I would simply focus on one club during a session at the range. Through consistent and mindful practice, however, I managed to slowly but consistently improve my game and invariably ended up shooting lower rounds while becoming proficient at hitting nearly every club. 

Although I do not play much golf these days, I continue to apply several aspects of how I improved my game to the sport of running. Rather than simply go out and run at the same pace multiple times a week, I make sure to spend time working on various aspects of my running on an almost daily basis. This is analogous in many ways to hitting the range as a golfer. While it is undoubtedly fun to go for a run or play a round of golf, the only way you will improve is through deliberate and calculated practice. So if you are simply looking to enjoy a life of running or have specific performance objectives, it's time that you treat running as a skill that requires ongoing practice and refinement. Time to hit the range! 

Running is a repetitive plyometric activity that involves a specific set of performance demands. Therefore, clearing injured runners for a safe return to training following injury should be premised on such demands. In the event a rehab professional fails to adequately prepare a runner for a safe return to training, the runner will invariably blow up only to find themselves hobbling home. In an effort to safeguard against such a situation, I thought it would be helpful to share my criteria/checklist to help rehabilitation professionals return injured runners to training in a safe and timely manner. Hopefully this provides you with a simple and objective framework in helping injured runners seeking your services. 
                                     STRONGER - FASTER - TOGETHER

1. BASIC UNDERSTANDING OF PAIN SCIENCE 
2. NO SIGNS NOR SYMPTOMS OF INFLAMMATION
3. ABILITY TO FULLY WEIGHT BEAR THROUGH THE AFFECTED EXTREMITY 
4. ADEQUATE TOE DEXTERITY
5. ABILITY TO BALANCE ON EACH LEG IN A WOBBLE FREE MANNER
6. IDEALLY 30+ DEGREES OF ISOLATED EXTENSION AT THE 1ST MTP
7. ABILITY TO PROGRESS THE LEG OVER THE FOOT (>20 DEGREES OF DF)
8. TOLERANCE TO OPEN & CLOSED CHAIN LOWER EXTREMITY CONTRACTIONS
9. GOOD FRONTAL & TRANSVERSE PLANE CONTROL AT THE TRUNK & HIP
10. TOLERANCE TO FITNESS WALKING (3.5MPH)
11. TOLERANCE TO A PROGRESSIVE WALK-RUN ROUTINE
11. ABILITY TO HOP ON EACH LEG IN MULTIPLE DIRECTIONS