Don’t Run With Pain

An Excerpt from Healthy Running Step by Step

by CEO Robert Forster, PT

When describing how challenging it can be to find the source of a runner’s pain, my physical therapy mentor liked to say: “The human body is famous for hurting where it ain’t hurt,” because without a complete diagnosis to find the cause of the pain; treatment will produce only temporary results. Runners who suffer an injury need to focus on four things:

1) Attaining the correct diagnosis immediately

You can’t fix an injury until the damaged and pain-provoking structure is identified precisely. It should become the focus of treatment techniques and protective measures designed to prevent further irritation and damage. Various clinical testing and skillful and thorough palpation techniques are the tools of success when it comes to finding painful structures. Only then can the right treatment techniques can be applied.

2) Detecting the mechanical cause of the injury

My physical therapy mentor, John Papalia, PT, is fond of saying, “The human body is famous for hurting where it ain’t hurt.” Meaning, the pain associated with an injury is not always experienced at the injury site, but instead can be referred to various areas remote to the injury.

Additionally, the most common causes of injury are mechanical problems near or distant to the pain. Any mechanical asymmetry in what’s known as the “kinetic chain,” which includes the joints of the ankle, knee, hip, pelvis, and spine, can cause an injury far from the dysfunctional area. Detecting these mechanical deficits is absolutely essential as the first step towards resolution. This is our specialty.

3) Getting the right treatment

Many clinicians who claim to do sports medicine will sell athletes on laying on a table and receiving passive treatments from “fancy black boxing,” which is supposed to work to miraculously heal injured tissues. Be wary. Although we use fancy therapeutic modalities like ultrasound, electrical stimulation, and icing, these do nothing more than help suppress the symptoms while we actively rehabilitate the injury and fix the cause. The operative word being “actively.” We make every injured athlete an active participant of their rehabilitation, and never a just passive recipient of care.

The body is a mechanical structure and therefore requires mechanical treatment. As such, stretching, strengthening, cross fiber massage, and ergonomics adjustments are the critical active therapeutic measures that will resolve your injury.

4) Maintain Fitness

When a runner suffers an injury right before the competition, the clinician must not only immediately identify the inured structure and find the cause of that injury, but they must work with the athlete and coach to find a cross-training activity to maintain fitness. Water running is the best cross-training activity for inured runners. The bike, elliptical, and other aerobic modalities might be appropriate if the injured structure is well protected against re-injury and aggravation of symptoms.

The progressive return to full training is a journey wrought with pitfalls and roadblocks. The experienced staff at Forster Physical Therapy have done this thousands of times with elite and recreational athletes alike, and we are able and ready to help any inured runner get back on the roads and across the finish line in good form.

If you, or someone you know is inured, you have to act quickly and decisively to resolve the injury and find the cause while you maintain your hard-earned fitness. This is our specialty and the reason that Forster Physical Therapy has been the “go to” spot for injured athletes for over 35 years.

All registered L.A. Marathoners qualify for a free injury assessment at Forster Physical Therapy, and you don’t need to see a doctor to get started. Also, the PHASE IV exercise physiologists and nutritionists are standing by to dial in your training, improve your running gait, and create the nutrition and hydration plan that will set you up for success come race day.

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