10 Rules to Running injuries

1. Running injuries are not an act of God

• They result from the interaction of the athlete’s genetic structure with the environment through training methods.

Essentially, you do not wake up one day with an injury.  Something happened.  You may have ignored certain symptoms or some alteration in your activity caused a result.  It just needs to be sorted out

2. Each injury progresses through four grades

• Grade 1: An injury that causes pain after exercise and is often felt only some hours after exercise has ceased.
• Grade 2: An injury that causes discomfort, not yet pain during exercise, but which is insufficiently severe to reduce the athlete’s training or racing performance.
• Grade 3: An injury that causes more severe discomfort, now recognized as pain, that limits the athlete’s training and interferes with racing performance.
• Grade 4: An injury so severe that it prevents any attempts at running.

If you ignore the symptoms at one grade, you may progress rapidly to a higher grade quickly.  It is best to address an injury at the earliest possible time.

3. Each injury indicates a breakdown point

This law simply emphasizes that once an injury has occurred, it is time to analyze why the injury happened.

When an injury happens, you must evaluate everything about your running: Footwear, surface, training, rest, nutrition.  Sometimes you have to dig deep to discover your breakdown point.

4. Most true running injuries are curable

Only a small fraction of true running injuries are not entirely curable by quite simple techniques, and surgery is required in only exceptional cases.

Most running injuries linger a long time or seem incurable because they are not accurately evaluated. Sometimes it just takes someone to listen and help figure out the problem.

5. Sophisticated imaging methods are seldom necessary

Most running injuries affect the soft tissue structures (tendons, ligaments and muscles), particularly those near the major joints. These structures do not show up on X-rays. As with any injury, a correct diagnosis requires a careful, unhurried approach in which the injured athlete is given sufficient time to detail his or her story and training methods.

In this day and age, most people want sophisticated imaging immediately to find out the problem.  With running injuries, they are most often diagnosed with a comprehensive history and logical thought process to figure out the problem.

6. Treat the cause not the symptom

Because all running injuries have a cause, it follows that an injury can never be cured until the causative factors are eliminated. Thus surgery, physiotherapy, cortisone injections, drug therapy, chiropractic manipulations and homeopathic remedies are likely to fail if they do not correct all the genetic, environmental and training factors causing the injury.

Conditions such as Plantar Fasciitis, IT Band Syndrome, Patellar Tendonitis, Hamstring Strains, Anterior Shoulder Pain are all conditions that typically have a separate cause than the painful symptom.  Treating the cause will provide relief to the symptom.

7. Complete rest is seldom the most appropriate treatment

Complete rest is unacceptable to most serious runners because running involves a type of physical and emotional dependence. Our advice to injured runners is generally to continue activity, but only to the point where it is safe.

An active individual will incur many psychological issues if they are required to not have any activity for an extended period of time. It is the responsibility of the medical provider to develop an overall treatment plan that allows for activity while the injury heals.

8. Never accept as final the advice of a non-runner

• Your adviser must be able to discuss in detail the genetic, environmental and training factors likely to have caused your injury. If the practitioner is unable to do this, together you will go nowhere.
• If your adviser is unable to cure your injury, he or she should feel as distressed about it as you do. It is patently ridiculous to accept advice from someone who is antagonistic or indifferent to your running in the first place.
• Your adviser should not insist on expensive remedies as most running injuries can be cured without recourse to expensive treatments.
• Your adviser should be a runner.

This is NOT saying that a non-runner cannot treat running injuries, but if the injury lingers or surgery is recommended due to the advice of a non-runner, it is advised to be evaluated by a runner, someone who understands the conditions of the injury.

9. Avoid surgery

There are only a few true running injuries for which surgery is the first line of treatment. Surgery may be the treatment method but only when all other forms of non-operative treatment have been allowed a thorough trial.

Please remember, surgery is irreversible.  All the other treatment methods can be reversed.  Make sure that all options are explored before surgery is considered.

10. There is little evidence that recreational running causes osteoarthritis.

The research points this out.  You may have osteoarthritis, but with or without running, you would have incurred this condition.  Do not feel you need this is a limiting factor to running.