Aches and pains - running injuries - deserve more attention than any other running related issue. After all, an injury can end your running career instantly. And when that happens, nothing else matters.
Let's say you start having knee pain, hip pain, or foot pain. If you are like many runners, you try to continue to run.
If you are like other runners, you go immediately to the doctor.
Or, maybe you take a route in between. You back off the running and ice down.
Is the answer A, B, or C? Unfortunately, it's very difficult to know the answer. It's not nearly that easy, and, of course, the right answer will vary.
One sure thing about running injuries is that they are often difficult to diagnose, and they are often misdiagnosed.
The one frequent scenario, a runner allows another runner to diagnose the problem. Unless the other runner is a professional, that's not a good idea. The other runner is only trying to help, and the other runner may be right, but the other runner also may be wrong.
When a runners tell me about an injury, an ache, or a pain, and they tell me the self-diagnosed cause, I worry. If that person assumes the problem began recently and is isolated, I worry about that diagnosis, too. Sometimes that's the case, BUT sometimes the problem started long ago.
For example, say your hip starts to hurt. The problem might be a hip problem, but it might go like this: You had an injury a year ago. Let's say you fell and experienced an injury to your back. Nothing was broken, and you were able to continue running. In a couple of weeks, the pain in your back went away.
But, in fact, during that two week period, you modified your gait, ever so slightly, subconsciously, to favor the injured side just a bit. Your body got used to running that way.
Oh, and because you modified your gait, you also altered your arm swing, also ever so slightly, also without realizing your were doing it, to offset the slightly different gait.
Turns out your left leg is now shorter than your right, too, not really shorter, but it measures shorter because you torked your torso, ever so slightly, to compensate. With everything taken together, lots has changed.
Now, the hip pain looks a bit different, from this long view.
Now, it's not really a hip problem is it? The hip is a problem, but it started long ago and not in the hip. Now, I'm not a doctor, and I have no experience in the medical field. This is only an example. I'm just trying to make a point.
Not being a medical professional, my chain of events, causes and effects, might not be a completely accurate example, and I apologize for that, but you get the idea.
I have had my share of injuries, aches, pains, etc. And I have heard the tales of many runners as they pursued diagnosis and treatment.
My point is just to take the long view. If you see a healthcare professional and that person doesn't ask questions about past injuries, then you should be sure to explain them. Sometimes it's been so long that you had forgotten - or almost forgotten - the original injury that, in fact, precipitated a whole series of physical changes that culminated in the current pain.
It's your job as the patient to make sure the healthcare professional knows the full story; otherwise, that person is at a disadvantage and may misdiagnose the problem.
Let's say you bake a cake, and the icing runs off of it and mostly ends up on the plate. Your mom comes over, and you say, "'What did I do wrong?' I followed the instructions in the recipe; at least I thought I did."
Your mom says, "You did everything exactly as it said?"
"Yes," you say.
Then, after a moment's more thought, you say, "Well, I did use 1% milk instead of whole milk in the icing. Hmmm. I guess that's it."
Your mother, having made thousands more cakes than you, suspects that is not the cause. Did you use the right kind of sugar?"
"Yes," you reply.
"Did you wait until the cake cooled completely before icing it?"
"Uh, well, no," you say, "I was running out of time. It was 5:45, and I knew the guests would be here at 6:30."
"Well, there's your answer," she says, "essentially, you melted your icing by putting it on a still warm cake."
Like your mom, your healthcare professional will probably ask the right questions, but if not, you must be sure to provide all the pertinent information. Otherwise, you'll ice the cake while it's still warm next time you are in a hurry, expecting a different result because you used whole milk instead of 1%.
Whether that healthcare professional is a physical therapist, massage therapist, chiropractor, podiatrist orthopedist or primary care physician, make sure that person gets the full story. If the healthcare professional acts like he/she doesn't want to hear it, you may need to seek out someone else.
Think about it; if the healthcare professional just treats the recent injury, and the problem originated in some other part of the body, then the problem is not fixed or any improvement may be only temporary; the real problem has not even been diagnosed, much less treated.
One time, years ago, I had a severe pain in my foot at the base of my big toe. I kept resting it for weeks at a time, but each time I went back to running, the pain got worse and worse, more and more intense, until I had to stop. Eventually, I took several months off. Still, the pain came back when I ran.
I gave in and went to a podiatrist. He told me he was sure it was a broken sesamoid bone and that I would need a cast. I said, "Well, it's been 9 months, how could it still be broken?"
He said, "Because you have never immobilized it."
Anyway, he said I needed a cast from my knee to my toes. I said I would agree, but only if we verified that I did definitely have a break. So, he sent me for an MRI. Guess what? No break. So, he suggested prescription orthotics. I ordered them. No relief. I went to a different podiatrist. He gave me a shot of cortisone. No relief. I went back for another shot of cortisone. Still no relief. By then it had been a year since the injury, and it was no better when I ran.
I was chatting one day with the cross country coach at the school where I taught. He said, "You know, I'm not much for vitamin supplements and such, but when I was having so much knee trouble that I had to ride a bike while my team trained, someone at a health food store recommended glucosamine. I started on that, and what do you know? It took about a month of taking the glucosamine, but the pain in my knee went away."
I tried the glucosamine, too. Guess what? The pain in my toe finally stopped, and I have been running ever since without that pain ever returning.
Now, don't get me wrong. I don't think glucosamine is a panacea that will help everyone. I don't sell it, either. I told this story just to show you that sometimes the solution is not what you expect. I have been to other podiatrists since then, and they were much more helpful, and did not lead me to treatments that did not work. I don't want to give the impression that I don't like podiatrists because I think they are important to all runners; however, it would be a good idea to always seek out medical professionals who either are runners, or who have the attitude that their goal is to help you continue to pursue the sport you love.
Sometimes you'll need to see more than one healthcare professional, too, but don't give up. The point is to be very open-minded, accept that the injury might be hard to diagnose, and keep at it. Don't give up on running.
If you don't know who to see, here is a tip: Ask other runners for recommendations of healthcare professionals. If you need knee surgery, for example, ask around. Make sure you find a doctor who has successfully treated many people in your local running community. Another idea is to get advice from the runners at your local independent running store.
Remember to always listen to your body and if you get an ache or a pain, pay attention to what you did differently that day or for the last few days before that. Did you just get a new pair of shoes? Maybe the problem is that you need new shoes. Have you recently started running on a different surface? Did you just begin doing speedwork? Did you just increase your mileage?
How about cross training? Did you change your cross-training routine? Sometimes, I think runners experience injuries and assume they are running related, when, in fact, they were caused by something else.
That, by the way, is what caused my toe problem. The day before the toe pain began, I had worked in the yard, digging a new flowerbed, and I was pushing on the shovel with the forefoot of that right foot, . The next day is when the pain started, and I did a real stupid thing, perhaps one of the dumbest things I've ever done.
I had dropped off my car for repairs that morning at a shop 8 miles from my house, planning to run home. I needed to run that far, anyway. After about a mile, though, the pain started. I should have called someone to pick me up, but I was stubborn and did a run/walk all the way home, despite the pain.
In that case, it was quite clear to me what caused the injury, but often you will find yourself unable to identify any cause of the pain. That's when you may find yourself playing detective.
This is one reason it is so valuable to keep a running journal. Make notes of any twinges. Make note of when you change shoes, training, gear, terrain, mileage, cross-training activities, etc. These notes can be valuable if you end up playing detective and can help you get to the root of the problem much sooner.
Sometimes it will take a while and visits to more than one healthcare professional, but don't give up. If you persevere, you will likely be able to get back on the road, running better than ever.
Running injuries are a pain, both literally and figuratively, but as I frequently point out, running teaches us many lessons. One of them is patience, for sure. Looking at the big picture, making wise treatment decisions, and exercising patience will help you recover sooner and get back to your running routine faster.
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