Physical Therapy for Runners: Keep Runners RUNNING
As a runner and a physical therapist, I am a bit biased to believe that runners need specialized care to overcome running injuries. However, with injury incidence rates reported as high as 85% in runners (Krakouris et al. 2021), it is likely that a majority of runners will experience an injury at some point, unfortunately.
The tricky aspect of running involves believing that running is a strategy to “get into shape.” Alternately, it is important to be in shape to run, especially when we realize the Achilles tendon and knee experience multiple times our body weight in force with each step. Multiply that by the thousands of steps we take every run and this force adds up. Our muscles and tissues must be able to tolerate these forces.
As a result, runners truly need specialized care from the medical field to understand the stressors involved with running, the biomechanics and the treatments that can be utilized to increase load. So if you are a runner dealing with an injury, make sure you receive the quality care you deserve and be sure that your treatment involves the following.
Thorough Assessment
Any process begins with thoroughly understanding the problem and contributing factors. Assessment should include a detailed subjective examination to understand your unique thoughts and experiences with the injury. Then, a detailed objective examination should seek to find the impairments that tie into the subjective information.
The body acts as a chain, so we must assess the whole chain and not just the injured parts. This will allow a better understanding of the injury as well as key contributing factors to understand the root cause and problem of the injury. Only then can we ensure to address these issues and properly restore the body.
Many runners face the fear that they will be told they cannot run as a result of an injury. Understand that it is never the goal to take a runner fully out of activity. We must always rule out red flags signs and symptoms that point to it being dangerous to continue running. Ultimately, it is essential to seek out experts with running injuries as they will often have a better understanding of the safety of returning to running.
Reduce Irritation
Once an understanding of the problem exists, steps must be taken to reduce irritation, inflammation, and pain of the involved tissues. This exists with more acute injuries where inflammation may inhibit tissues from tolerating the load of running.
Many strategies and modalities exist to reduce irritation, but often the answer is pain-free movement. As the body is resilient, finding ways to move and remain active in a pain-free way will allow faster healing and better maintenance of a runner’s cardiovascular fitness. For a large number of runners, running is a great way to continue this movement, but for a smaller number of runners, working with a running specialist to find strategies that work for you will remain essential.
Proper Loading
Proper loading is an absolute MUST when returning from a running injury. I have often seen physical therapists underload patients and runners, which ultimately, is a disservice. We must load our muscles and tissues effectively to increase our tissue’s strength and capacity to allow better tolerance of the demands of running.
This loading can then be applied to an effective strength training routine after the injury to allow our tissues to maintain their strength and capacity. Overall, as a runner, make sure that you are lifting heavy weights, working on proper form with lifting, enhancing single-leg strength, and receiving a proper progression into plyometrics.
Return to Running
A ha! Now we have made it to the point of returning to a runner’s previous level of running. Specialized care for runners should include a safe, effective, and organized progression back to the runner’s original volume and schedule before the injuries. Runners should learn how various surfaces, hills, and intensities affect this return.
Utilizing a strategic and individualized program will allow a safe return to running to effectively progress, build fitness, and decrease the chance of injuries. Ultimately, runners should be advised to progress frequency, then duration, and finally intensity of runs to safely return to their previous level.
Communication + Education
The last piece of the puzzle centers around proper communication and education. Going through injuries will always be stressful, especially when goals and races play a role in the picture. As a result, runners should find a provider that can properly communicate the entire process and teach them the strategy and goal of rehabilitation.
Empathy plays an incredible role as runners should be taken care of and feel as though their provider and medical team understand their fears, goals, anxieties, and views of the injury. When you feel heard and understood, it allows a much easier process to return to injury.
In closing, running offers unique demands to the body. As a result, runners deserve specialized care from clinicians who truly understand running and empathize with runners.
If any runners are ever looking for specialized running care, know that you can always find it at BioEndurance PT & Performance. It is always our goal to keep runners running and allow them to advance towards their goals and new PRs!
References:
Kakouris N, Yener N, Fong DTP. A systematic review of running-related musculoskeletal injuries in runners. Journal of Sport and Health Science. 2021; 10: 513-522. https://doi.org/10.1016/j.jshs.2021.04.001
