As a runner, it is almost guaranteed that you will experience some form of running related injury throughout your running career. The extent of severity of the injury depends on many things.

As I have mentioned before, runners are a very fickle and stubborn breed. We don’t ask for much in life, we only want to be able to run as often and as far as we want, without any pain or injury. You would think this would be a simple request that could easily be granted by the Running Gods…but, sadly, we all too often find ourselves taking time off from running, having setbacks, experiencing chronic pain, etc, etc, etc!!

Runners, particularly long distance runners, have exceptionally high tolerances for pain. It is a valuable trait to have, but is often times our “Achilles Heel” (pun intended). From the moment we start running longer distances, we just figure that “pain” is just par for the course…We are “supposed” to have little aches here, or muscle stiffness/tightness there…Nearly any runner you talk to will tell you that they often get out of bed and do the “3 step test”. This is where you get out of bed in the morning, stand up, take three steps forward to access what kind of damage has been done from the previous days mileage. This test will determine how you handle the rest of your day.

But, before you go assuming that runners are just a bunch of pain loving junkies, you must realize, it is not totally our faults.

You see, us runners just like to control the things within our capabilty and leave everything else to those “professionals”. We can control the shoes we wear, the miles we run and races we enter…We don’t really want to worry about the bicomechanics of the human body and all that other medical “mumbo jumbo”..WE JUST WANT TO RUN!!!!

But, as we all know, running comes with it’s overly eager to “wear out it’s welcome” baggage. If you run long enough, you will no doubt experience one or all of the following; soreness, stiffness, shin splints, knee pain, calf strain, plantar fascia…and the list goes on!

So, if all of this is the price to pay for running, why do we do it? Some run for fame and glory, others for weight control..some run to prevent boredom and to be a part of something…But, and this is just my opinion..I think we all run in search of that “PERFECT RUN”..The run where you go out there and experience not a single discomfort..where you feel like you could run laps around the globe as easily as you could run to the fridge and back. It’s what keeps us coming back..the joy of finding that perfect rythm and then being able to repeat it again and again.

Okay, so runners have pain and experience injury…Where am I going with all this?? Hold on, I am getting there!

So lets take Runner # 1 (we’ll call him Bob).

Bob has been a long time runner, has ran a number of marathons and numerous shorter distance road races over the years. Bob has had his fair share of aches and pains, but has never been setback for any significant injury. However, for the past week, Bob has been eperiencing an annoying dull pain in the back of his knee everytime he goes out for his evening run. He figures it to be no big deal and continues running through the discomfort. He takes his NSAIDS (Non-steroidal Anti-Inflmmatory Drugs…Ibuprofen, Aspirin, etc.), he goes home and ices his leg, does his stretches..But, the pain is still there. What is Bob to do?

For the most part here, Bob is doing the “right” thing (all the things he has heard his whole life)..Never once would it have occured to him that perhaps the knee pain is actually being caused by another troubled area. His knee pain could be caused by weak hamstrings or glutes..Perhaps one leg is shorter than the other…He may have muscle imbalance or weakness elsewhere, thus causing strain in his knee.

So, it isn’t really Bob’s fault that he is addressing the knee pain as a problem within his knee…He just doesn’t know otherwise and therefore is not able to get to the root of the problem.

Now, we have Runner # 2 (we’ll call her Jane).

Jane, has just recently started running within the past year. She has really started to enjoy it and even joined a really cool running group

She has been competing in weekly road races and has been peer pressured by her group to start training for a marathon. For the first time ever, she is consistently running 40+ miles per week..She is getting faster and just loves seeing those fast paces for every training run. She has 4 months before the upcoming marathon and just knows she is going to “crush” it..She is on cloud nine!

Then, all of sudden, she starts getting a weird pain in her shin…She has heard of other runners talking about the dreaded “shin splints” but had never experienced them before. Every single run, she is experiencing pain..but she guts through it because she can’t miss any key training runs.

She ices, she buys compression socks, she takes epsom salt baths and is doing every stretch imaginable..but, nothing is working..the pain just won’t go away. This goes on for several weeks when finally, she is forced to miss a day of running because the pain has become unbearable. Distraught, she makes an appointment to see a specialist. After an MRI, it appears that she has stress fractures in both shins and is told to take a substantial amount of time off.

As per the doctor’s orders, she stops running and starts “aqua jogging” and going to physcial therapy…After a few weeks, she is cleared to run again, but told to “Go Easy”!!

Another week passes and Jane’s shins are feeling great and she is feeling strong. She jumps right back into 40 mile weeks and is cranking out track intervals, tempos and weekend long runs…She had a setback, but is off and running again…Jane so happy!!! Three more weeks go by and Jane is still cranking out the intense training and loving every minute of it…But, the morning after a hard track session, she starts to experience the same shin pain again.

In the end, Jane ends up battling back and forth for months with this ongoing shin issue..Ultimately, she misses the marathon she had planned in the fall and is devastated.

So what did Jane do wrong here?

Jane was so caught up in her new found love of running and her continued success in the sport, that she never really allowed her body to adapt properly to the new workload. She developed shin splints, but rather than correct the root cause of them, she merely took a little time off, then came back full force, only to end up injured again.

So, if we are having knee or shin pain, we shouldn’t address the knee and or the shin? Not necessarily! Sometimes the area of pain is also the cause..but often times, the area of pain is just the tip of the iceberg…the underlying problem is usually something entirely different.

This is where the Dry Bones lyrics come into importance

“The toe bone connected to the heel bone,

The heel bone connected to the foot bone,

The foot bone connected to the leg bone,

The leg bone connected to the knee bone,

The knee bone connected to the thigh bone,

The thigh bone connected to the back bone,

The back bone connected to the neck bone,

The neck bone connected to the head bone,”

Like a finely tuned engine, all the muscles, joints and bones of the body work together as one to allow us our movements. It goes without saying that most of us do not have an extensive background in anatomy, physiology, or biomechanics…Therefore, we pretty much only know the basics of how all of the components of the body work together.

What the hell is a Psoas, a piriformis or a sacroiliac joint??

A psoas, as it turns out, is not a Greek God..but in fact, it is a muscle that is mostly responsible for the flexion and rotation of the hip joint. I guess this would be important to runners, huh?

What is a trigger point? Hint, it has nothing to do with firearms!

“Trigger points, also known as trigger sites or muscle knots, are described as hyperirritable spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers.^[1] Trigger point practitioners believe that palpable nodules are small contraction knots^[ambiguous] and a common cause of pain. Compression of a trigger point may elicit local tenderness, referred pain, or local twitch response. The local twitch response is not the same as a muscle spasm. This is because a muscle spasm refers to the entire muscle contracting whereas the local twitch response also refers to the entire muscle but only involves a small twitch, no contraction.”

If you don’t get trigger points addressed and or taken care of, they can lead to some serious injury, muscle imbalance and impeded performance and functionality of the muscles and joints.

Modern Sports Medicine has come a LONG way over the past several years and much of the past “sound medical practice” has since been debunked. In the past, it was common to hear a doctor to tell a runner to “stop running” once they were experiencing pain somewhere.

Now days, we are starting to learn much about many new practices that can correct, fix and alleviate sports related injuries and trauma. Practices such as ART (Active Release Technique), Graston, Myofascial Release, Deep Tissue Massage, Aqua Therapy, Dry Needling, etc, are now becoming more main stream and more understood. Some of these practices can have an injured athlete up and performing again in no time, with very minimal set back in training.

Because of medical professionals who have “thought outside the box”, the rest of us are now discovering new ways to get healthy and stay active..WITHOUT PAIN!!

Below, I have included some links to some good reading material. These various articles address in more detail some of the practices I discussed above.

As an advocate for pain free running, I want to remind you all how importance it is to take care of your body and to have routine and scheduled maintenance done. By maintenance, I mean, getting regular massages, doing hot/cold therapy on tired muscles, getting chiropractic adjustments from time to time…In the same way that your car needs to be taken in for it’s scheduled maintenance..So does the human body. Take care of your body and it will in turn take care of you.

AS A DISCLAIMER: If the above stories about Jane or Bob sound very familiar, please do not think I was picking on YOU…Just so happens, many of you reading this can relate to Jane and Bob…LOL!

http://www.medicinenet.com/sacroiliac_joint_pain/article.htm

http://www.pponline.co.uk/encyc/sports-injuries-understanding-your-bodys-trigger-points-what-they-are-and-what-to-do-about-them-287

http://www.aidyourtendon.com/index.php?REF=GTENDContent

http://www.grastontechnique.com/

Also, I know of some great practitioners of the above mentioned practices. If you would like more information on some recommended massage therapists, ART, Chiropractic and Myofascial professionals, please let me know and I can put you in contact with them. Many are covered under your insurance policy.