During the coming months I’m going to have a few articles on running related injuries
and their treatment from a podiatrist’s point of view. My hope is to provide the reader
with not only what the problems are but how you yourself can try to treat them. Sort of a
“Running Repair Manual.” These articles aren’t meant to replace your sports medicine
specialist and if you have significant pain or a problem that is over a week old and not
improving look for one the specialists outlined below.
Over the next few months you can perhaps do as I do and tear out the pages and have
them available for future use. My goal is to see you on the roads rather than needing to
see you in my office.
Running Injuries – Who Should I See?
You have begun to train seriously for that special race…Mile, 5K, 10K, marathon… and
it happens. The aching in the knee or heel, shooting pain in the midfoot or shin, lower
back pain… whatever. You read Runner’s World and you have every running book ever
written on your shelf. But even after doing the recommended RICE (rest, ice,
compression, elevation) routine, decreasing your mileage/speed and changing your shoes,
it still hurts. Now what do you do?
Whether you decide to see a podiatrist, orthopedist, chiropractor, acupuncturist or Voo
Doo doctor, there are a few things you should look for and avoid when seeking treatment.
Things to Know About Your Doctor
1. What do other runners think about him? Perhaps one of the best ways to find
out about a doctor is to ask other runners that have had injuries and see who they
liked. If you look in the yellow pages, you can see “Sports Medicine Specialist’s”
galore. Also, being a member of a sports medicine board does not mean they are
qualified…it just means they paid their application fee and maybe took a test. Ask the
other runners at your local Y, the running store, or perhaps call the local Track Club.
The runner’s grapevine is a pretty reliable source
2. Does he run? I recommend that the doctor you see have some experience with
running. He does not need to be a sub 2:20 marathoner but I feel that runners are
generally more empathetic and knowledgeable regarding running related problems.
Things Your Doctor Should Look At
You have finally selected a doctor. I am a firm believer in not being passive in the
treatment process. If he/she does not ask you, maybe you should have him look at or
1. Your running log. Overuse injuries are some of the most common I see and
they are frequently associated with changes in mileage or speed, surfaces you
run on, or number and frequency of races.
2. Your running shoes (training and racing). He should look at wear patterns
and ask how many miles you have on them. He can also determine if they are
appropriate for any biomechanical related problems you have.
3. The way you…stand, walk, run. By just looking at someone in a chair you
cannot fully appreciate what happens when they are standing or in motion.
4. Previous injuries. Even though you may not have had the exact same injury,
many injuries are related to biomechanical abnormalities and may be
associated with an overall larger problem that can be addressed.
Things to Avoid
1. Surgery. With athletic people, surgery should be a last resort. Almost every
injury seen has a surgical solution and some surgical solutions give a quicker
result than conservative treatment, but surgery has many drawbacks for
athletes. Most conservative treatment programs allow the runner to continue
to be somewhat active. Surgery dramatically slows the runner down, keeping
them off the roads or track. Also, a surgical complication in a runner – and
even the greatest surgeons have them – is devastating. The same complication
for a non-active person has a much reduced effect on the person. If your
doctor recommends surgery, I would get at least one second opinion from a
doctor who runs.
2. The non-listening doctor. Doctors are busy people. That does not give them
the right to dismiss your problems as insignificant. One of my professors in
podiatry school told me that the two toughest groups of people to treat are
runners and teachers. They take up too much time by asking questions and do
not want to slow down. (By the way, I have been both.) But remember, if your
doctor does not have the time for your problem, find one who does.
3. The “quit running” treatment plan. I am not talking about the short term
cessation from running, I am talking about the doctor who says “if it hurts to
run, then stop running!” If your doctor recommends some time off, he should
give you some alternatives such as water running, bicycling, or rehabilitation
exercises. If he tells you to stop for good, look elsewhere.
You are armed with the information, now it is your turn. Just remember, if
you do not ask questions and offer information, you may not get the answers
you need. I will see you at that special race and hopefully we will be toeing
the line healthy and ready to race.
Bill Johncock, DPM
Carolina Podiatry Center
Dr. Johncock is a podiatrist who has been running for over 25 years and
became involved in his profession through his own running related injuries.
He has completed over 50 marathons including a 2:34 P.R.