By Blair Gorsuch, MS, Wellness Director/Exercise Physiologist, OSF IPMR

Every day millions of Americans run. From the elite athlete-in-training to the casual jogger, runners hit the roads, trails, the track or the treadmill for fun, sport, and health. Running is relatively safe and usually results in enhanced health. Some runners have bodies like machines that are perfectly designed for running. They can run over any terrain, in any type of shoe, and never seem to get injured. That’s their good fortune. Others do seem to be injured, or waiting to be injured, more often than swimmers or walkers. It’s practically unavoidable, but most of these injuries are readily treated and often preventable.

Most running injuries don’t occur out of the blue. Most injuries are related to how you run and how that affects your body. There are many factors that can enter in; imbalances in muscle strength, overuse/over training, training technique, gait issues, and/or faulty shoe wear. When a running injury occurs, a runner can’t continue training as usual. Running injuries shouldn’t be taken lightly because even the slightest injury can become a major problem. It’s never a good idea to try to hobble through an injury, even if it seems like one that will clear up soon. Changing stride length to compensate for one injury can potentially cause a second more serious injury.

Also, when a runner continues to run by using an anti-inflammatory, either over-the-counter or prescribed to control the pain, they need to understand that taking this medicine to feel better is not the same as actually getting better. Anti-inflammatory medications mask the severity of an injury and allow it to get much worse if you keep on running.  Using medication for pain and inflammation and continuing to run on an injury can only make matters worse.

The development of virtually all running injuries is a gradual process. With very few exceptions, the runner has a fairly long warning period. It is during this time that the clever runner should begin to analyze why their particular injury developed in the first place. The runner may be able to self analyze and correct the cause.

With an injury, something has to be changed. It can be a matter of reducing mileage and/or intensity; it might involve adding some stretching, strengthening, or core exercises to the runner’s overall program; it might be getting different running shoes;  it might mean putting corrective devices (orthotics) in one (or both) of your running shoes.

The injury should be addressed before it becomes too severe. The less severe the injury the faster the recovery and the sooner one can return to running. The longer a runner continues to run with an injury, the more severe it will become, and the longer it will take to return to pain-free running.

Running injuries become gradually and progressively more debilitating, typically passing through stages of severity. Questions the runner should ask themselves:
1. Does the injury discomfort decrease the farther I go?  
2. Does the discomfort stay the same as I progress in the run?
3. Does the discomfort increase the farther I go?
4. Is the injury so severe that it prevents any attempts at running?

If the answer is yes to the first question, a runner can back off their normal routine, reduce mileage, and try running easy runs every other day. Gently try and stretch the area. If it’s getting worse, or if the answer to question #2 or #3 above is yes, then it might be time to take a rest from running while you get medical advice. However, if the runner is at #4, there is no improvement with time off, or the pain persists during normal daily activities, definitely seek professional advice. Also, if the pain causes any alteration in running stride/form, then a runner should seek professional help.

Sometimes a skilled professional is needed to help identify running “dysfunctions”, manage the injury, and supervise the runner’s injury recovery program. A professional helps identify the root cause of the problem by providing a thorough musculoskeletal assessment examining running history, training methods, training surfaces, and running shoes for fit, wear patterns, and function. A gait analysis can be done on a treadmill to examine stride length and foot strike to see how it relates to the injury. The cause of the injury needs to be identified and treated. Otherwise the runner may continue to have the same issue when they return to training.

The running specialists at OSF IPMR and Illinois Neurological Institute are knowledgeable about both running injury treatment and injury prevention. Treatment and prevention of running injuries are closely related and the specialists use best practices for identifying, evaluating, and treating running injuries. The treatment is not a one-size fits all model. The program is individualized, both diagnosis and treatment.  If a runner comes in with an injury, our physical therapists will explore the causes of the problem, develop a course of treatment, assign exercises, and make sure they are done correctly, and develop a recovery plan to get the individual back running. Only a small fraction of true running injuries are not entirely curable. The desired outcome is to have the runner emerge on the other side running better than they did before. Running is the chosen activity of many and it is our goal to assist the runner in the pursuit of the sport.

Our Running Clinic physical therapists are specialists who provide care that is covered by insurance. With the affiliation of OSF HealthCare and IPMR, you now have a greater choice of locations for your physical therapy needs.

If you need help getting an order for therapy, OSF IPMR Direct has appointments available now! With OSF IPMR Direct, a Physician Assistant will provide a rehabilitation evaluation and recommend next steps to help you get better. To get started, call 309-692-8670, go online to osfipmr.org/direct, or contact Illinois Neurological Institute at 309-624-8575.

^{Photo courtesy of OSF IPMR}

Running Clinic Services

• Physical Therapy Running Evaluations
• Running Performance Assessment
• Running Clinic Screen
• Sports Nutritional Counseling
• Body Composition
• Heart Rate Training
• Running Community Youth Education
• Shoes 101