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Athletic development specialists dedicated to the art and science of excellence in movement

Prevention and Rehabilitation of Running Setbacks: Five Areas that Matter

Runners get injured for a myriad of reasons  However, too often our prevention and rehabilitation protocols focus on the wrong areas for that particular athlete's needs.  If you have a leak in your house, you call a plumber not a carpenter.  You may later need a carpenter to repair damage caused by the water, but the plumber has the most valuable skills for the problem at hand, which is to stop the leak.  For the best results in the care of athletes (whether yourself or others), consider multiple dimensions and align yourself with teams of professionals with specialized skills in each of the relevant areas.  Toward that end, a system to place runners into the appropriate buckets is indispensable for the delivery of the most appropriate corrective interventions. 

Dysfunction (aka, the Function bucket) - Movement dysfunction can exist at many levels from the infantile movement patterns through specific aspects of running form.  Our system to evaluate function centers on the Functional Movement Screen.  Unfortunately, most attention is usually focused upon form (if runners actually have the foresight to consider any type of poor movement quality as a source of injury...).  Form can play a role, but to reduce the issue to one of running form independent of general movement patterns will ignore major risk factors.  Expect more on this topic in the coming weeks.

Discomfort (aka, the Pain bucket) - Discomfort gets most of the attention of these five prongs, and rightfully so.  Athletic progress is difficult, if not impossible, without control of pain.  Unfortunately, pain is often dismissed as an occupational hazard that runners seek to control with pills and bags of ice.  The Selective Functional Movement Assessment (SMFA), the medical compainion to the Functional Movement Screen, is one example of a medical system to treat pain within the purview of dysfunction.  Even if a runner can gut it out, the body will respond in unpredictable ways as part of its deeply rooted subconscious pain avoidance mechanisms.   Just as the turning on or off of the "Check Engine" light in an automobile is not a definitive gauge of the car's functionality, the body's pain signals require interpretation of a skilled medical professional who can navigate the many dimensions of pain science.  Making the "Ouchies" go away is a critical first step for recovery, but recovery does not end there.

Damage (aka, the Structural bucket) - Injury is often tied to damage, but not always.  In fact, some "damage" such as poor soft tissue quality might not rise to the level of injury.  Interpreting the source of damage must occur with a full consideration of all the possible causes.  For anyone to say "You did too much" and just leave it at that (or worse, "Running is bad for you"), invites a relapse of the problems and constrains people to a level of training and achievement below their max potential.  Furthermore, even if damage is not painful other areas of the body must compensate for the impaired tissue.

Design (aka, the Training plan bucket) - Poor training plan design can provoke injury.  The natural impulse is to focus on the "how much", but a full understanding requires a careful analysis of the "how."  As we have written before, misuse is frequently more provocative than overuse.  Any number of problems within a training plan can contribute to injury, but rarely is the training plan alone the source of malady.

Details (aka, the Support system bucket) - Details include shoe selection, training surface, nutrition status, and sleep.  None of these will make someone faster than they actually are, but a deficit in these areas can inhibit the full expression of one's ability.  Even if someone is stellar in each of the other areas, something like improper footwear or running too much on hard surfaces can bring everything else down.  Conversely, the magic shoe or a wonder-food will not make up for weakness in the other areas! 

Summary

Positive outcomes are not only the result of the methods being employed but also whether the athlete is where they should be when they should be there.  Someone with movement pattern dysfunction might have a perfectly good training plan but break down because of their movement impairments.  Likewise, someone who good movement quality may need to reshape their approach to laying out a training plan if they are chronically injured.  We give ourselves the greatest chance for favorable outcomes by putting athletes in the right places at the right times, which means finding providers with the appropriate skill set for that particular athlete's needs.  Finally, although we have laid out the buckets as discrete entities, do note that these buckets interact with each other on many levels.  As such, a team approach to providing what the athlete needs is paramount.   

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