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Anatomy of an Injury and Recovery

By Dr. Michael Cerami

It shows up without warning, it sneaks up on you, it ruins your season, and it gets almost everyone eventually. No, it’s not the latest horror movie preview for the summer blockbuster; it’s your running injury.

Most of the running symptoms I see at the office are (in order of most common) are knee, foot/ankle, leg and hips. The breakdown usually begins from a bio-mechanical weakness and then develops over time into a compensation that will cause soft tissue inflammation. If un-attended or covered up with medication the problem usually gets worse as the body starts recruiting alternative tissues, muscles and ligaments to try and stabilize the dysfunction. Long term damage can result in muscle or tendon tears and arthritis of the joint surface.

I believe the knee is the most common injury for runners because of the rotational loads put on it from two areas; the feet and the hips. 85 percent of the population has pronated (rolled in and down) feet, while it’s not always clinically significant, it does create an internal rotation of the 2 lower leg bones. This, along with the 3 dimensional bi-lateral movement of the pelvis, can create twisting in the knee joint from the top and the bottom causing pain throughout the leg and knee. In my experience, distortion of the kinetic chain or alignment of the lower leg can cause everything from a patellar tracking problem to IT Band syndrome, Achilles Tendonosis and plantar fasciitis.

If you are having running injury problems I suggest a 3 part approach with an honest self-assessment:

  1. How bad is the injury or symptom? What are the best and worst case options? Can you recover by just stopping running for a while? Have you been over-training?
  2. Specifics: Have you had the problem diagnosed it correctly? Have you researched the problem on Google, or YouTube and tried some stretching or exercises? Have you seen a professional? If so, what have you been told?
  3. Time: How long have you been having problems, what have you tried on your own? Do you have any options left?

Try and work though the details like you were problem solving something at work or at your house. For me; I’m going to try things on my own first and if I fix it, great; I feel proud of myself. I also recognize there is a time to call in the experts when I understand and realize that I can’t figure it out on my own. Whether it’s tools or expertise; sometimes you just have to call in a professional.

Do your research and ask around for a referral from friends or other athletes. You may need to see a few people to find one that works for you. Healing and repair of the body (unlike house plumbing) is not an exact science.

Finally, be positive but realistic. Make a commitment to follow through. In my experience there is almost always a solution to fixing running injuries fairly quickly whether you are 6 years old or 60 years old. BUT (and it’s a BIG BUT), you have to be willing to do the work and spend the time necessary to find and correct the source of the injury and give the body 2-6 weeks to repair.

Dr. Michael Cerami is an avid runner, cyclist and triathlete. He is available for a no charge consultation one Saturday per month at The Salt Lake Running Company (Salt Lake store) by appointment. He can be reached at 801-486-1818 or online at www.utahsportsandwellness.com

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