When running injury threatens, here's who may have the answers

In the quest to avoid injury and layoff, a physical therapist might be your best friend

Injuries are the bane of every runner’s existence, aren’t they? This week, Amanda Loudin, a new friend of The Half Marathoner who’s written widely on running, fitness and health for Runner’s World, ESPN and Outside Magazine, had a great idea to write about the best person to turn to when we experience injury (that perhaps we wouldn’t think of) — a physical therapist. I’d love to know what you think/what your experience has been too! 👍 — Terrell

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Like many runners, Mimi Albert has had her share of injuries over the years.

From a layoff due to a lingering hamstring issue to a metatarsal stress fracture and several things in between, the 36-year old California-based director at Stanford Children’s Health has invested plenty of time and money looking for a fix.

After passing through a seemingly endless line of medical practitioners’ offices, she finally found a solution that worked for her: regular check-ins with a physical therapist.

Similarly, 42-year old Sam Snyder, a campaign officer from Anchorage, Alaska, has experienced his own list of injuries in nine years of running. Snyder has sat sadly on the sidelines due to IT band issues, a hernia, and other problems.

“I tried a variety of approaches for treating my injuries, but nothing really helped long term because they weren’t treating the root of the problem,” he says. “Finally I found a PT who took a different approach, and this is the first year I’ve logged with no layoffs.”

What Albert and Snyder have discovered is that physical therapists are experts in movement and for runners, they might just be your best offense for warding off injury.

Why a physical therapist?

Runners have many choices when it comes to aches and pains. From chiropractors to massage therapists and sports medicine doctors, all can play a role in maintaining a healthy body.

But well-trained physical therapists who regularly treat runners come armed with a thorough understanding of the human body and how it moves.

“A good PT understands the mechanics of running and how to determine the origin of pain,” says Ryan Smith, DPT, and co-owner of Recharge Modern Health and Fitness in Ellicott City, Md.

“PTs know how a nerve, tendon or muscle will present, because each is different. They also understand bio-mechanics of the kinetic chain, which is an important part of the puzzle.”

Smith says practitioners can address aches and pains in two ways, primary and secondary.

“If you receive treatments like ultrasound, e-stim, active release — those are all secondary and will feel good,” he says. “But primary treatment is a diagnosis and understanding of the demands placed on your body, along with a plan to progress.”

‘I tried a variety of approaches for treating my injuries, but nothing really helped long term… I found a PT who took a different approach, and this is the first year I’ve logged with no layoffs.’

For instance, if your Achilles is hurting, a good physical therapist will help you load it properly to push it along. This might include movement with body weight or additional weight that gets increasingly more challenging as the injury improves.

Perhaps the best news for a runner working with a PT is that rarely do they tell you to completely lay off your sport while you heal.

“The goal isn’t to have you stop running entirely, but to measure what you are currently doing, back it off and then ease you back in,” explains Smith. “The one exception to this is a bone stress injury. In that case, a PT will shut you down and you should take that seriously.”

When Albert found her current PT, she liked that she focused not only on her aches and pains, but her whole self. “She asked about my running goals, my history, and training,” Albert says. “Then she watched me run and analyzed my gait.”

This recipe, along with additional weight training, has worked for Albert, who has been putting more than her usual miles throughout the pandemic. “She’s given me simple exercises I can do at home,” she says. “This isn’t just fixing a problem, but a way to stay healthy.”

Snyder says he returns to his PT for regular check ins.

“She’s kept me running and taught me how to alleviate pain,” he says. “It’s been a matter of learning and understanding the process. That helps me avoid the fear spiral every time something hurts.”

Establishing a partnership

Smith says there are a few characteristics to look for when picking the right practitioner.

“Avoid someone who speaks in absolutes, because nothing is the same in every case,” he explains. “Be cautious of someone who suggests everything is tied back to glutes that don’t fire, for instance.”

He also recommends someone who has a good understanding of running, if not being a runner him/herself. “They may not be an avid runner but they should be able to walk the walk,” Smith says.

It’s also helpful to remember that it’s a two-way relationship. You can improve the treatment you receive by being curious. “Patients who ask questions and are open to learning will have better odds at injury prevention in the future,” says Smith.

Also get to the PT early in the pain process. “Show up when you feel things starting to develop and creep up,” Smith recommends. “That can go a long way to reducing how long it takes to return you to normal.”

This approach has helped Snyder immensely. “I know now that a little pain doesn’t have to be the beginning of a layoff,” he says. “I’ve learned that with a trusted PT, pain can be treatable and manageable.”

— Amanda

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Races you might love running

Urban Bourbon Half Marathon

Louisville, Ky. | Saturday, Oct. 17, 2020

The banks of the Ohio River as well as this famous Kentucky city’s downtown streets and parks are the setting for this race, which takes runners past Louisville’s Cherokee Park, designed by the legendary Frederick Law Olmstead. Organizers plan to limit the number of entrants to 2,300 and implement social distancing with a rolling starting line, with groups of 100 runners sent off every 5 minutes.

$75 and up | Sign up here

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End of the Road Half Marathon

Waterfall, Pa. | Saturday, Oct. 24, 2020

If you’re a fan of the 2009 movie The Road, the landscape here in this tiny town in central Pennsylvania will be familiar, as it was used as a filming location. You’ll run along a portion of the old Pennsylvania Turnpike that was bypassed by interstate highways in the late 1960s, through a pair of tunnels “and miles of road untouched by traffic for nearly 50 years,” organizers say. The race will be limited to 250 entrants, and will feature morning and afternoon starts.

$82 and up | Sign up here

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PNC Atlanta 10-Miler

Braselton, Ga. | Sunday, Nov. 1, 2020

Thanks to Covid, Atlanta’s annual fall 10-mile race moves north of the city to Michelin Raceway Road Atlanta, where you’ll get to run on hills and along a track normally reserved for race cars. You can also run the race virtually, or if you’re not up for 10 miles, the Atlanta Track Club (which organizes the race) also offers a 2.54-mile run.

$65 and up | Sign up here

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Wild Vine Trail Half Marathon

Charlotte, N.C. | Saturday, Nov. 7, 2020

One of a series of running events that take place along the woodland trails at the U.S. National Whitewater Center, this race features stretches through the woods along the Catawba River — around the whitewater training areas, the man-made rapids that also serves as the official Olympic training center. You’ll also run deeper into the woods past lakes and ponds and through the wilderness, along mostly single-track trails.

$55 and up | Sign up here

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Hoover Dam Half Marathon

Boulder City, Nev. | Saturday, Dec. 12, 2020

The desert landscape of southern Nevada — combined with majestic views of one of the most awe-inspiring man-made structures anywhere in the world — are both on display at this late fall race, which unfolds along a combination of paved roads and portions of the River Mountains Loop Trail. You’ll also run through a series of small tunnels along the trails, which were used in the 1930s to ferry men and materials back and forth between the Hoover Dam and nearby Boulder City. The dam’s distinctive pale curved arch will be visible as you approach it from the Nevada side (you’ll be looking over into Arizona once you get there), taking a series of switchback trails up to the overlook — one of the most stunning sights anywhere in the country.

$80 and up | Sign up here

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Great running reads

This is interesting: a pair of shoe companies have recently released plans for fully recyclable running shoes that you subscribe to, rather than buy to own (and throw away). Check out On’s Cyclon shoe here and Atrey Running’s shoes here.

“The company says Cyclon is 100% recyclable, made largely with a bio-polymer derived from castor beans. Also, you won’t be able to buy Cyclon — you can only subscribe to them as a $30 monthly service.”

Running the First-Ever Virtual Bay to Breakers Is an Exercise in Letting Go. It’s difficult to imagine any race you must experience in person more than San Francisco’s Bay to Breakers — as this writer says, “each time grateful to have found myself amidst gaggles of cloaked queerdos, creatives, and outcasts.”

“The subliminal messaging was clear: You're kind of on your own on this one, but you'll be running with people in spirit.”

Your Running Shoes, While Comfortable, May Be Making Your Feet Weaker. If the toes of your shoes curl upward, they help you spring off the ground more easily — but also may make your more prone to conditions like plantar fasciitis down the road.

“It stands to reason that if the foot muscles have to do less work, then they’re probably going to have less endurance given that many thousands of times a day you push off on your toes.”

Out There, Nobody Can Hear You Scream. In this moving follow-up to her 2018 article “We’re Here, You Just Can’t See Us,” journalist Latria Graham talks about the response she’s received on the challenges of being Black in the outdoors.

“I cannot protect you. But there is one thing I can continue to do: let you know that you are not alone in doing this big, monumental thing. You deserve a life of adventure, of joy, of enlightenment. The outdoors are part of our inheritance.”

Runners Mobilize By the Thousands for 2020 Voting Initiatives. Organized by famed runners like Alison Désir and others, thousands of runners are using virtual races and relays as a way to get their friends involved in voter education and registration drives.

“The election is not the end. It’s really the beginning. So it’s about building power and about showing that when we come together, we can tackle these really massive, scary issues. This is a practice in collective action.”

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Words to run by

“Understanding habits is the most important thing I’ve learned in the army,” the major told me. “It’s changed everything about how I see the world. You want to fall asleep fast and wake up feeling good? Pay attention to your nighttime patterns and what you automatically do when you wake up. You want to make running easy? Create triggers to make it a routine. I drill my kids on this stuff. My wife and I write out habit plans for our marriage. This is all we talk about in command meetings. Not one person in Kufa would have told me that we could influence crowds by taking away the kebab stands, but once you see everything as a bunch of habits, it’s like someone gave you a flashlight and a crowbar and you can get to work.”

— Charles Duhigg, The Power of Habit