Understanding Relative Contribution Related to Running Related Injuries

If there is one thing that I've learned when it comes to helping injured runners overcome pain and/or injury, it's that tips and tricks simply DO NOT work. If you really want to tackle the problem, and help injured runners return to healthy running, it's essential to take the time to understand the relative contribution of potential impairments or drivers to their problem. Every runner will have different needs, which can only be determined by collecting a comprehensive intake and thorough evaluation. Several of the factors that I consider when performing a consultation with an injured runner are as follows...

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Perhaps one of the greatest mistakes that we can make as rehab professionals is to treat a runner, who is dealing with a pain problem, as if they have a tissue injury, when in fact they don't. Oftentimes, pain is more about sensitivity than it is true tissue injury. It is therefore critical to distinguish between the two if you hope to engender an optimal outcome. I'd also like to remind you that most runners are not chronic pain patients, but rather, highly motivated individuals, who have been mismanaged and are desperate to return to training to avoid an identity crisis.

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​In certain cases, runners will present with legitimate tissue injuries. For example, if a runner strains their calf or hamstring, we must honor healing timeframes to avoid over stressing the site of repair while progressively loading them to adequately prepare them to withstand the performance demands of running. Failure to correctly identify and treat a runner presenting with a true tissue will only prolong one's recovery and perhaps worsen their condition.   

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Understanding how to assess a joint is an important skill to master as a rehab professional. To highlight the importance of joint play, we need to look no further than a lateral ankle sprain, which is a common injury, that routinely goes untreated, and can lead to various sequelae. One of the residual effects of an ankle sprain is joint stiffness at the level of the talocrural joint, which can lead to a loss of ankle dorsiflexion and compensatory motion. Possessing the ability to assess and treat such an impairment is therefore critical to foster improved outcomes among runners. 

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Never overlook equipment issues. Fortunately, when it comes to running there are relatively few equipment needs beyond shoes, socks, shorts, and a t-shirt or sports bra. Even then, not all of these items are necessary. In the event that you elect to wear shoes, make sure to take the time to screen them for potential defects or premature wear. As you can see from the this pic, the left shoe lacks symmetry. Imagine if a clinician did not correctly identify this defect and started blaming a runner's complaint on some other factor that had no bearing on the situation?

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​If there is one thing that a recreational runner would benefit from, it's improving their comprehensive capacity. This is most easily accomplished through some basic resistance training, and taking runners out of the sagittal plane. The bottom line is that developing capacity is not only important when it comes to running, but also to get you through the day without issues. And please don't worry that you are going to bulk up from engaging in resistance training, as there is no evidence to suggest that this occurs.

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​One of the first questions that I ask ALL runners seeking my services is, "What do you understand your problem to be?" I never cease to be amazed by the responses I get. In the vast majority of cases, runners have subscribed to misinformation that only serves to make their situation worse. By no means am I claiming to have all the answers, though there is a lot of credible evidence that we should apply to ensure that runners have the "least wrong" understanding of their situation. Some great examples of misinformation relate to footwear, pronation, and foot strike pattern. 

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HABITS HABITS HABITS! This is the last and most important aspect to address in working with injured runners. Invariably training errors account for a large percentage of running related injuries. As the saying goes, "We live and die by our habits." The same applies to running. At day's end, adopting good decision making skills and healthy habits, particularly in the context of challenging times, lies at the heart of consistent and healthy running.