Runner, Protect Thyself!

Hi, Friends & Fellow Runners:

Did you know that the annual injury rate among runners is an astounding 80% or thereabouts, more than in any other sport?  That means you could pick 100 runners completely at random and feel reasonably certain that over the course of a year they would suffer roughly 80 mishaps of greater or lesser severity. 

Perhaps as disturbing is the fact that the prevalence of injuries in our sport has remained a relative constant over at least the past decade.  This has been true despite significant advances in the design and construction of running’s most important piece of equipment – the running shoe – and despite comparable improvements in other products such as orthotic inserts, knee straps and braces, self-massage tools, and sports tape.  Conclusion #1, therefore, is that the “right” shoes and equipment are simply not enough to keep us out of harm’s way.

As well, an increasing percentage of injuries occur or get worse after medical intervention.  The reason is that doctors, chiropractors and therapists frequently focus on the symptoms of an injury rather than the cause -- or they misdiagnose the problem in the first place.  Conclusion #2, therefore, is that the specialist we visit can potentially do more harm than good.  

Underlying this depressing scenario is what I’d call the “law of unintended consequences.”  The shoe manufacturers spend millions to incorporate motion control, stability or additional cushioning features into their products.  They do it all with the best of motives.  But in the end what they seem to accomplish, more than anything else, is to shield us from our own shortcomings.

If our basic problem is poor biomechanics, for instance, and that problem is not addressed, it will sooner or later manifest itself in an injury.  The progression over time can often take on a certain inevitability if and as we become increasingly serious about our running and demand more from our bodies.  We start with the best shoes we can find for our feet, then later we add orthotics, then we resort to physical therapy, and, finally, in a worst case, we undergo surgery.   And the progression is speeded up along the way if a well-meaning medical professional masks the root of the problem by prescribing an anti-inflammatory and rest – or by telling us we have a pulled muscle when in fact we have a stress fracture.

In the interests of full disclosure, I should point out that I’ve had two serious injuries over the past several years, both of which were originally misdiagnosed by medical professionals.  I  was told in the first instance that I had a groin strain and, as a result, underwent physical therapy and exercise in the weeks leading up to the 2007 Niagara Falls International Marathon.  As it turned out, I actually had a hernia condition and wound up crossing the finish line of that race in excruciating pain, while holding my swollen stomach in my right hand.  I underwent surgery two weeks later.

In the second instance, I went to a doctor with pain in my left foot.  The diagnosis was a stretched tendon in the foot and, once again, physical therapy and exercise were prescribed. Unfortunately, the tendon was not stretched; it was ruptured – which meant that the therapy and exercise were only worsening the condition.  Here again I required surgery and, as a consequence, missed an opportunity to participate in the 2009 World Masters Games in Sydney, Australia and to run in the Boston Marathon the following year.    

Timothy Noakes, author of the seminal book on our sport, called “Lore of Running,” states simply and succinctly that we should never seek treatment for a running-related injury from a medical professional who himself is not a runner.  And Runner’s World magazine has offered a “runner’s checklist” for determining whether a particular specialist is the best person to solve our running problem.  Here are some of the questions that the magazine suggests we ask him or her:  Do you have a specialty in Sports Medicine?  Do you run?  What should we bring to the appointment?  (The “correct” answer would include our training log and running shoes.)  And, finally, how much time will you spend with me?  (Expect it to be at least 30 minutes.)

Let’s cut to the quick here.  We must recognize, first and foremost, that we and no one else are the first line of defence against injury.  And this means, among other things, that we should appreciate that stress and recovery are the yin and yang principles of effective training, ensure that our running form is as good as it can be, engage in strength training on a regular basis, and respond promptly to any unusual aches or pain that might signal the onset of injury. If, despite such precautions, we still wind up a part of an 80% injury statistic, then at least we won’t have to second-guess ourselves.

Coach Stephen