Does this scenario sound vaguely familiar?
You’re training for an upcoming race, building up your miles, or maybe you’re simply increasing your weekly mileage for fitness’ sake. You feel great, unstoppable, and ready for the race of your life. Suddenly, you have a pain in your foot. It only hurts after you run, not during, so you ignore it. Then, it hurts while you run, but only the first two miles—again, you ignore it. Then, your foot feels like it’s being stabbed with the power of a thousand hot daggers while you run, walk, sit, and sleep. You Google your symptoms, ice the affected area, buy a fancy brace, YouTube how to tape it, add in cross-training, and you even go as far as resting for what you feel is a sufficient amount. A miracle occurs: the symptoms fade and you are back out there running.
In my field, I constantly see the same trend over and over again, especially amongst my running friends. They have a running-related injury, they seek my advice, semi-rest it, and do 85% of what I suggest they do. More often than not, they decline to follow the most important advice: seek formal physical therapy treatment.
Why is physical therapy treatment so essential? Because most injuries will appear to heal with some initial rest, when the inflammation decreases, but will then reappear days, weeks, or months later if the underlying cause is not addressed. This is where physical therapy makes the difference between an acute injury (a few days or weeks) and a chronic one (a few months or years).
Perhaps many runners avoid formal physical therapy because they are afraid the therapist will insist that they stop running. Believe it or not, we want you running almost as much as you want to. But there may be a brief period of time that we strongly suggest you either back off on miles or pace, switch to a softer surface, or stop altogether until we can help calm the injury down. This period of time will be critical to make sure the treatment we are supplying you with is working. We can’t judge if ultrasound, dry needling, cupping, and strengthening are actually effective if you’re pounding out 10-milers after you leave our office. So yes, there will be a brief rest period. But unlike while you were resting the injury, we are now providing you with the treatment and tools you need to actually heal the injury and prevent reinjury.
Physical therapy has plenty of other benefits to consider as well. Ultrasound will get deep heat into injured tissue at the cellular level to increase blood flow for healing. Dry needling will break down scar tissue and create a healing inflammation response to injured tissue immediately. Instrument soft-tissue mobilization and cupping can also increase blood flow to injured tissue and decrease restrictions in the muscle or tendons. Electric stimulation coupled with heat or ice will decrease your acute pain without having to rely on NSAIDs (nonsteroidal anti-inflammatory drugs, like Advil and Motrin) that can upset your stomach with long-term use. As you can see, we have quite the array of tools at our disposal.
But perhaps the key portion of physical therapy is the actual physical part. We will educate you with strengthening exercises and monitor you while you complete them to ensure they are being done properly and at the correct pace and progression. Sure, you can Google your symptoms, decide you have plantar fasciitis, and begin a bunch of random (often ineffective) exercises. But what if your problem is stemming from your hips rather than your actual foot?
The physical therapist is trained to diagnose the cause of your injury and address it as a whole. That might mean zeroing in on your weak hips/glutes to prevent your foot, knee, or back from taking the brunt of the impact. Your foot injury might be stemming from a weak core or an old injury that was never properly tended to. Your best course of action to keep running is to let us determine the best approach to fix the problem.
Lastly, going to formal physical therapy gives the runner peace of mind that they are in control of the injury. For many, an injury that interrupts a training schedule or appearing at the starting line of a race they have dreamed of being at for months can feel like their world spinning out of control. By seeking physical therapy, you’ll feel like you’re being proactive in your best possible care while also doing all you can to keep it in control.
Most of my running patients walk into physical therapy with a wild, glazed look in their eyes. I can almost read their minds: “Please don’t tell me I can’t run anymore. Please don’t tell me to buy a bike.” I won’t. I want you running just as much as you want to. I want you running without a recurring injury and a smile on your face when you walk out of the clinic.