Recovering from injury can be difficult and time consuming, but from my point of view running injuries continue to interest and educate me. Running injuries are often the result of continued overload to an area over a period of time. Think about your job for example; if you can stick to your prescribed amount of work, leave on time and work within your job description you’ll feel pretty happy right? However, if your boss loads a little extra on your plate every day you can take it for a while without much annoyance, but eventually you will snap. Enough suddenly becomes enough and the enjoyment very quickly funnels out of work, leaving you tired and stressed.
Now imagine a part of your body, such as a tendon, going through the same process. A tendon that is overworked and under supported and its f telling you it’s fed up is through pain. Initially it gives a low level intermittent pain, eventually you notice an increase in pain levels and frequency, resulting in injury.
Look at the injury as a whole
It’s at the injury stage when the visit to the physiotherapy practice comes in. We help protect the area, preventing further injury. We reassure you and advise on likely causes and treatment options to get you back to running strong and pain free. But let’s go back to the tired stressed out worker, an initial period of downtime would be beneficial for their headspace and energy levels. The tendon is the same. Stop running for a short period to give the injured tendon a break.
A sore area or injured area is usually the result of a fault somewhere in the system. For a runner, that system is usually a long connection or chain of muscles running up the front, sides or back of the leg. That system also relies on your core, so following an initial short break from running, work with the physiotherapist to identify the dysfunctional link in your chain of movement to ensure the support network for that tendon is working at full capacity. Like the overloaded worker, you’re going to need appropriate support before you can take on the extra tasks. Full recovery of an injury requires the surrounding support network to be fully functional.
Unfortunately this is often where we see injuries reoccurring; the tendon itself took time off and healed but the fault in the support system was not identified and fixed. Look at the whole picture or better still, catch the problem before it progresses. A great quote that fits this is: “If you listen to your body when it whispers, you’ll never have to hear it scream.”
What not to say to an injured friend
How long before you can run again?
Even their medical team cannot be entirely sure about this question. As physiotherapists we work with the patient and scientific evidence to provide a guideline or framework for our patients with a graded return to running. But the body is not a robot and sometimes, in spite of our hopes, a person’s rehab may need to be modified depending on how the injured tissue responds. Asking “how long” to somebody puts them under pressure when so much of their recovery is out of their control. Instead, how about asking: “How are you feeling?”
Have you tried ice baths, orthotics, platelet rich plasma injections…
This advice is normally well meaning with their best interests at heart. But your injured friend is frustrated and possibly low in spirits. Offering general treatment options to them can be overwhelming, never mind possibly leaving them out of pocket and disappointed. Instead, ask an open ended question about their recovery plans giving them an opportunity to talk and maybe vent a little. Sports physiotherapists are constantly updating their treatment options and learning new skills. Each patient is treated as on an individual basis. Physiotherapists will discuss a variety of options for treatment finding the package that their body will respond to best. What may have worked for you is not guaranteed to work for your friend. That said, if your friend has been going to someone for weeks and seeing no improvement as expected, suggest that they consider changing their treatment approach.
Don’t listen to Ronan Keating, you will not say it best if you say nothing at all. If this is one of your running friends, recognise that they may miss meeting up with you and perhaps suggest that they join you in another form of exercise. Maybe this is the perfect opportunity to start some cross training or something you’ve wanted to do for some time. Cross training has the potential to build muscle strength to improve your running economy. Getting in some low impact exercise during the week is a great way to protect your joints.
Orla Crosse is a chartered physiotherapist and yoga instructor. She treats patients and teaches weekly sports performance classes in Limerick and Clonmel. For more information visit performanceyoga.ie