Injuries: Symptoms/Treatment

Content Courtesy of:

Rachel Miller, PT, OCS, Certified Running Coach
Owner of ProAction Physical Therapy
11820 Parklawn Drive (Suite 120) Rockville, MD 20852

Injuries happen - it's just a fact. But with proper treatment and techniques we can work to prevent them. 

I. Recognize "good" pain (or expected pain) vs. "bad pain"

A. Expected pain:

  1. Soreness that lasts less than 24 hours
  2. No redness, swelling
  3. You are not limping

B. Bad Pain:

  1. Soreness that lasts more than 24 hours
  2. Redness, swelling
  3. You limp when you walk or your running form has changed

POINTER/PALM Test: If you can take your pointer finger and point to where your pain is, that is a "bad" pain sign. If you can take your whole palm to indicate where your pain is, it may be an expected pain sign. However, the palm can turn into the pointer to describe where the pain is -- turns into a "bad" pain sign. Your pain basically becomes localized.

II. What to if you are having pain:

A. Ice: Use ice pack, frozen peas or bucket or bath of ice water (this is best!) for 10 -- 20 minutes 2 --3x/day for the first 48 hours.
B. Modify your training program: Talk to your coaches about your problem. If you are hurting for more than a day or two, you should skip the long run and any hard runs for one week. Then go back the following week to the schedule but you may have to do 75% of what you were going to do -- meaning, wean back into the schedule.
C. Cross Train: Do painfree alternatives to running, such as aqua jog, swim, bike, elliptical. And do equal time: if you were going to run for 40 minutes, then cross train for 40 minutes.
D. Check your shoes: Are your shoes too old? Not the appropriate type?
E. Don't overstretch: When you stretch, you should NOT feel pain.

III. How to avoid injury:

A. Address your pain appropriately and swiftly.
B. Wear appropriate shoes and change them every 250 -- 300 miles.
C. Core and hip exercises: Good to perform throughout the year. Since it may be difficult to fit in all your miles AND strengthen, I recommend taking 4 -- 6 weeks prior to your training for a race to focus on these exercises. 
D. To Stretch or not to Stretch: Personal approach. I recommend holding stretches GENTLY for 30 -- 60 seconds AFTER your runs. To stretch/warm up before your run, run 30 -- 35 seconds slower than your planned pace for the first 1/2 mile -- that is your dynamic stretching.

IV. Physical Therapy:

A. What We Do: Physical therapists evaluate your posture, strength, flexibility, muscle imbalances, footwear, walking and running gait, training log, among other factors to determine the source of your pain. The goal of physical therapy is to restore your body's biomechanics to enable you to run, as well as to perform all other activities, painfree.

B. Do you need to see a physician first? NO. However, your insurance may require a prescription -- we call call your insurance company to determine if that is necessary.

Many injuries are not easily diagnosed and can mask more serious injuries such as stress fractures. If pain lasts more than a few days, see a health care professional who has experience treating runners.

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