Running Rehabilitation
A Novel Approach
In my experience with sports rehabilitation, I’ve found that an evidence-based approach is the most successful plan we can utilize. The following are my thoughts on this subject.
In my rehabilitation career, I’ve worked with athletes from all levels and backgrounds including the most elite. Before I moved to the east coast I practiced in the mountains of Colorado. There I carved out a niche in the running field of sports medicine and rehabilitation. As we lived at a higher elevation, our area attracted some of the most elite runners, particularly ultra-runners, in the country (probably the world as well). This allowed me to create a practice that focused almost exclusively on treating running-related injuries, as well as training and coaching runners for major competitions.
The running world is full of misinformed and mismanaged athletes not only in the general population, but at the highest levels as well.
Let me give you an example to better understand what I mean.
While working in Colorado, I had a high-level weekend warrior runner as a patient. They competed in the master’s categories for most races and typically finished top two rather consistently. The patient’s nagging hamstring injury was hindering their performance. In my initial conversation with the said patient, they described to me their previous history with therapy, training, and exercise in general. What this patient told me was that during their first few bouts of-of experiencing this hamstring ‘strain’, their typical recovery would include visits to therapy and rest.
The patient would get put on a hot pack for 15 minutes, followed by 12-15 minutes of ultrasound. After they would be directed on how to stretch, foam roll, and ‘strengthen’ their core. They would refrain from running during this period, then as the injury appeared to start feeling somewhat better, they would return to their normal training and hope they were fully recovered. My initial thought: ‘oh boy’.
How do I treat?
Treating each and every patient that I work with as if they were an elite athlete is what I pride myself on. I find myself frustrated to hear an approach like this when seeing an elite athlete. Why? Because they’ve were misguided when it comes to their health and performance. First of all, in order to have a good idea of how we want to treat an injury, we need to have a fairly good understanding of the underlying pathology going on. In the case of this patient, they were actually dealing with a chronic proximal hamstring tendinopathy. This is important as the way we rehab tendons differs quite significantly from how we rehab muscle strains.
Rehabbing an injury like this is being able to understand the mechanisms associated with this injury. The demands that the athlete is putting on their body consistently. For a running injury, this would include assessment of their running mechanics and general capacity test. The passive treatments we choose to utilize should be efficient and beneficial in aiding optimal healing. Here’s where a systematic approach to rehabilitation comes into play.
Now rehab itself can be as complicated as we want to make it, but high-quality rehab takes into account the basic understandings of anatomy, physiology, strength, mechanics, and psychosocial components combined. Utilizing these key principles allows us to efficiently and effectively treat the athlete in front of us, and here’s where I feel Greenwich Sports Medicine truly stands out from the rest.
A novel and evidence-based approach revolving around the foundation of three main stages of rehab:
- Deloading the area of injury
- Desensitizing the patient and their symptoms
- Reloading the athlete and returning them to play
We can fit in a number of modalities such as movement literacy, hands-on treatment, strength, and endurance. The proper understanding of how of to do so is of the important piece here.
With the new addition of our biomechanics lab, we can now understand loading mechanics and movement like never before. This helps guide our de-loading stage and show how we want to keep an athlete active and moving efficiently. This is a very important key to any good rehab program. We fully assess running gait to get a clear picture of how an athlete’s movement may contribute to ongoing issues. Greenwich Sports Medicine has some of the best in their field. They can effectively treat patients during the desensitizing stage. This typically involves hands-on treatment, injury education, and early stage rehabilitation.
Our therapy staff can properly address the reloading stage. This consists of therapeutic exercise, strength and endurance training, and return to play activities and measures. This is what makes a rehab program great. I feel that the care you’ll receive at Greenwich Sports Medicine is so far above the rest.
This is the most successful way at getting runners back to running and helping them perform at a higher level. A proper gait analysis and capacity test followed by guidance through desensitizing and reloading the area of injury prove this.