Monday, March 7, 2011

To Run or Not To Run.............

…..that’s the million dollar question I am frequently answering.

With years of experience treating orthopedic and sport related injuries as a physical therapist, years of training and racing myself, and coaching my own incredible athletes I am often helping coaches, athletes, and my own clients answer this question. Is it ok to still run?

Athletes invest a great deal of time, money, energy, sweat, heart and sole into following their dream and achieving their goals (if you haven’t noticed just signing up for Ironman isn’t cheap). When training catches up to you and your body starts to talk back in some way telling you with pain that it’s not happy, it’s hard to stop and interrupt the training. Athletes often push through the pain, keep training, ignoring the symptoms which often results in even more dysfunction.

Over the years I have developed some guidelines for my athletes, and clients in the clinic who find themselves in pain, injured or trying to train through an injury. I’ll share some of these generalizations here and you will see a lot of it is common sense, but when dealing with pain, the desire and motivation to keep training all rational thoughts and common sense is sometimes lost. My ultimate goal as a physical therapist and coach is to keep the athlete running or participating in their sport. However, there comes a time when resting is the smarter choice and will allow the injury to heal more quickly. When all conservative options, such as rest, ice, modifying training still results in pain, then use common sense and seek professional medical help to get some treatment. This will ultimately help speed up the healing and recovery process, and allow a quicker return to training.

Don’t Run When:

1 Obvious trauma: severe trauma resulting in exposure of bone, inability to contract a muscle or stand or walk. Laugh, but you’d be surprised! I’ve seen it all!

2 Limping or severe compensation: running with pain to the point where you are limping, significantly altering form, stride or foot placement to avoid pain. This will likely lead to tissue breakdown somewhere else only adding to the problem

3 Pain with ADLs: when pain (other than general muscle soreness) is experienced during normal day to day activities just walking, standing, sitting at rest; then likely running is not an optimal choice

4 Pain increases during a run: if experiencing pain and it worsens or becomes more severe and sharp while running, then stopping is recommended

5 Increased pain at night or when done running: this is your clue that you are dealing with some injured tissue and likely continuing to run without modifying the training or seeking treatment will only aggravate the condition.

Run When:

1 Pain decreases throughout the run: its ok to keep running when you start out
and feel pain or discomfort and after a short duration it diminishes and goes away, then it is ok to continue the workout. This may take 12-15 min. as the blood and oxygen circulates to all the muscles. Running for this amount of time will most often not worsen or aggravate a condition. If pain does not diminish during this amount of time, pain increases, or compensation/ favoring is occurring, then stopping the workout is the best option; when coming back from an injury sometimes you will feel it during the warm up. The injured tissue has to adapt to the stress of running again. As long as it doesn’t continue or increase then continuing the run is ok.

2 Injured tissue has gotten a rest/and or some treatment and pain has decreased: try the above option and see how the injury responds. If pain does not diminish or decrease during the warm up, then stop. Running for this short amount of time most likely will not set the athlete back.

3 Modifications have been made: sometimes injured tissue will tolerate running
at a slower pace, or decreased volume and still allow the healing to occur. If the symptoms are minor, then try slowing down and cutting back. If after trying that pain is still present then seek some professional help from a physical therapist, chiro, physio or medical person with some expertise to guide you through the injury and return to running.

Run Smart and Train Safe :)

No comments: