Awareness. Man, that is a valuable thing.
Imagine if you had no awareness that there was a 100% chance for an ice storm to hit when you were halfway into a long run. Might you change your plans if you had this information?
Now let's talk chronic running-related injuries. These are those injuries that "just started for no reason". Or, maybe they coincided with an increase in training load or some other variable. But, consider if the injury is only on one side, you can probably rule out training as the root cause.
Let's up the ante and talk about the especially chronic ones. The kind that linger for more than a week, 6 weeks, 6 months, even years - despite doing all the things like rest, physical therapy, new or different shoes, cross training, injections, braces, compression sleeves, orthotics/shoe inserts, foam rolling, stretching, massage, strengthening... you get my point.
The annoying, frustrating symptom that you are experiencing is certainly providing awareness alright. You're acutely aware of the symptomatic area - it hurts!
But, here's the question: is the symptom located where the problem is located? The problem is the underlying cause of the symptom. Which would you like to address?
If you keep hitting your thumb with a hammer, do you want to address the symptom (and continue to hit your thumb) or address the cause?
It's a pretty clear choice, isn't it? But, with running related injuries determining the problem may not be as obvious.
In my practice, I rely heavily on the teachings of Gary Ward of Anatomy in Motion. He created something called the Flow Motion Model® that details the journey each bone and joint should experience during gait.
So, armed with the knowledge of what movement each bone and joint should be experiencing, we can simply check to see if they are or are not actually able to move in that way.
Personally, I've found time and time again that where the symptom is, the problem is NOT.
Here's a common and personal example:
I suffered a severe right ankle sprain when I was 15. After a few weeks, I was back running. No biggie.
For 20 years I was blissfully unaware that my ankle wasn't moving as well as it should be. And, I was also not aware that the rest of my body wasn't moving on top of that foot as well as it could be. I had nothing calling my attention to this underlying problem.
Then, at around age 35, I developed some knee pain that simply would not go away. It didn't respond well to rest (when I resumed running, the pain would return), strength training, nor any of the stuff listed above, including a course of PT. Plus, I wasn't interested in a band-aid solution.
A colleague performed an assessment and it started with a detailed history. What's happened to me in terms of traumatic injury or surgery? How did we get here?
- cut to right wrist age 5
- head impact w/ 6 stitches age 11
- right ankle sprain age 15
- inguinal hernia surgery age 21
That was as much as I could remember. Fortunately, not much else had happened.
As part of a thorough evaluation, he checked these areas to assess how they were moving. Sure enough, my ability to move that right ankle (the talus and calcaneous, specifically) was limited. Therefore, my ability to move my entire right leg was not up to par.
You know that thing where people say "it's all connected"? Here's how:
My talus bone was not able to move through it's ranges of motion. The talus bone sits directly beneath the shin bone and on top of your heel bone. So, the talus bone will directly influence the movement of the shin bone. The shin bone is half of your knee joint. So, the movement of your shin bone is extremely relevant to the movement of your knee. Again, the shin bone IS (half of) your knee! (And you can trace connections like this this directly up to your skull, if you like.)
Although I was able to cope with the limited ankle movement for quite a while - 20 years! - my body was telling me that time was up. The knee symptom was a yellow light on the dashboard that read: "you aren't moving well enough, please investigate."
Within a few days of practicing my assigned movements, the knee pain, which had annoyed me for over a year at that point, simply dried up, disappeared, and has never returned.
Remember that it takes access to EVERY joint movement in your body to be the ultimate efficient runner. So, if you've got an annoying chronic running related pain and have already seen a medical provider, consider that symptomatic spots scream for attention and they usually get it. Whereas there are areas of your body which are kicking back, hanging out, not moving, and thus, NOT drawing your attention. Let's identify and bring awareness to your problems - in this case, the areas of the body which aren't moving and encourage them to move.
One more thing...
Don't have any current symptoms? Feeling great? That is awesome. Does it mean you don't have any 'problems' as defined here? Hmm. Could it be valuable to assess the body to check for areas that don't move well? For 20 years I had a problem, but no symptom. Actually, I did have a symptom, but it was subtle - reduced efficiency. I don't know about you, but I’d prefer more efficiency, more ease of movement, and like my odds better if everything is moving as it should.
Please don't hesitate to contact me today to discuss your unique situation!