Treatment plan to training plan

A common occurrence in our office is a runner in pain getting ready for a race.  Not only are they hurting physically, but they are also generally feeling the time crunch.  Sometimes the pain can be scary, but it’s always frustrating.  Most commonly, the problem is the well-known IT band syndrome.  You can read about it here.  To briefly summarize, friction from repetitive contact with leg bones has inflamed shortened muscles on the outside of the knee.  This has generally distorted normal motion at the hips and low back, as well as the ankle.  Fixing it requires that we normalize movement at the joints, lengthen the muscles, and retrain the body to run normally.  If necessary, we will also need to reduce inflammation.

We begin with adjusting the dysfunctional joints and using Active Release Technique to lengthen the muscles.  If necessary, we will have the patient ice several times a day for inflammation, and when it is reduced, I will start the patient on rehabilitative exercises to train normal movement.  If inflammation does not require direct treatment, I will have the patient out running short distances very early in the therapeutic process.  While this is not always true, the body is generally designed for the normal motions to reinforce the healing process.

Once the patient is running again, the trick is to return to the training plan without re-irritating the IT band.  To do this, we slowly decrease the treatment frequency as the mileage is gradually increased.  The continued adjusting and Active Release Technique helps to encourage the normal motions of the body to reinforce the healing process, while also allowing the return to the the training plan.  The other piece to the process is education about good training habits.  In my experience, most runners want to run to warm up, run to run, and run to cool down.  A more effective sequence is the use of dynamic stretching to warm up before the workout, and static stretching to cool down after.  Consequently, I gradually introduce these training approaches and stretches as the treatment process progresses.