Thursday, April 9, 2009

Who you gonna call?

What do you do if despite your best efforts at doing everything right-- incorporating rest in your training schedule, not increasing your mileage by more than 10% a week, not overracing or overdoing speedwork and of course stretching properly (dynamic stretching before a workout static stretching after as mentioned in previous post) you become injured? We decided to consult some of the best runners and coaches/experts in the country for practical advice on what they would do if injured for a typical running injury such as a hamstring strain. Here were the 5 options we provided:
  1. Family Doctor/General Practitioner
  2. Orthopedic specialistHamstring/Piriformis
  3. Chiropractor
  4. Physical Therapist
  5. Do nothing, let it heal on its own

The majority of respondents in our unscientific poll said they would consult a physical therapist first for treatment. Interestingly, the second most popular choice and the top choice among those who have run for the most years was to do nothing, let it heal on its own.
Of course a competitive runner participating in an upcoming track or cross country season may not have the time for this option. Few of the respondents recommended either the family doctor/general practitioner and none recommended a Chiropractor. Some of the respondents also suggested a podiatrist as the best person to consult. Here are some of the responses:Former American Mile Record Holder Steve Scott

Steve Scott former US Mile Record Holder now head coach at Cal State San Marcos: "I would definitely send them to a physical therapist."

Former US national champion and running author Tom Osler who has been running for over 50 years and has run over a thousand races:" I would do nothing, let it heal on its own."

Bernd Heinrich, also has over 50 years running experience, and is an author and former world and US record holder in ultramarathon events: "I would let it heal on its own, usually after a couple of months I make an appointment to go see a doctor, but it has already started to heal on its own."
Greg Meyer, the last American to win the Boston Marathon, Set 10 American road racing records at the following distances: 8K, 10K, 15K, 25K, 10 Mile. Set two world records in the 15K and the 10 Mile now at Aquinas College: "If I knew what the hamstring injury was...stain or pull vs a tear...I'd try to go right to a massage therapist. If I thought I ripped it...and of course now Greg Meyer 1983 Boston Marathon Champwith the HMO's requiring a doctor's referal for PT...I'd need to go there first. For a hamstring I would also see a podiatrist. These injuries take a lot of time and I feel gentle Physical Therapy. Easy off."

Coach Roy Benson, national coach and one of the leading experts on Heart Monitor training in the country: "I'd probably see a massage therapist because I wouldn't consider that (hamstring strain) an "injury." However, if I wrenched my knee as I tripped on a root on a trail, I would see a MD, preferably an orthopod with Sports Medicine certification. But if I just tripped and Roy Bensonwrenched my back as I fell, I would see a chiropractor who has the confidence of the running community. In either case, if I needed followup therapy, I would then have them refer me to a Physical Therapist. If anything below the knee was bothering me,. I'd consult a DPM (Podiatrist)."

Gerry Lindgren, former US and world record holder (27:11 6 mile) and best US High School runner (8:40 2 mile, 13:44 5k) of all time: "I would turn to other runners who have had similar injuries, and try to treat it myself."Gerry Lindgren

Jonathan Beverly, national class runner, coach and Editor at Running Times: "I would recommend a Sports Physical Therapist.
Because all of my "serious" injuries have eventually been cured by one."

Dr. Avery Faigenbaum (EdD, CSCS, FACSM at The College of New Jersey and one of the leading researchers on stretching and strengthening in the country):
"I would recommend a sports Physical Therapist who has experience working with runners."

Keep in mind the acronym RICER-- it is often the best strategy is to try to treat most injuries as soon as they occur to avoid a possible chronic situation: Rest, Ice, Compression, Elevation and Referral to an appropriate professional such as a Physical Therapist familiar with runners for an accurate diagnosis to avoid the dreaded downtime.

Written by Jack Heath
Note: A recommended Physical Therapist in the South Jersey/Philadelphia area is Orthopedic and Sports Physical Therapy