Sometimes running hurts—and not in a good way. Thankfully common sense (not running “through” an injury) combined with proactive treatment is often enough to prevent an annoying niggle from morphing into a mandatory rest period. Long gone are the days when physical therapy and body work were only for professional athletes. New treatments and affordable pricing make self-care and body maintenance important tools for every runner. The challenge is determining where to start. Considering these treatments are hands on and can be intense, finding a good practitioner is the first step. Once you find a second party you trust, talk to them about a recovery plan.
Eric Hayne, DC, at Aspen Sports Medicine in Aspen, Colo., suggests looking for a practice offering multiple treatment options to address many types and stages of injuries.
“If the only tool you have is a hammer, everything looks like a nail,” Hayne says.
Related: The Basics of Foam Rolling
A common misconception is one visit will turn into dozens. Problems don’t have to be chronic and a good practitioner will help you return to running and give you tips to stay healthy. In my experience, they would much rather see you happy and running on the trails than grouchy and on their table.
The following is a list of the top six treatment modalities Hayne recommends for runners.
Active Release Techniques (ART)
Practitioners use hands-on therapy to feel muscle, tendon and ligament movement and determine if scar-tissue buildup is the root of your pain. Affected areas are treated with a combination of targeted pressure to isolate the problem zone and specific movements to break up scar tissue and restore range of motion. When you’re in the midst of a treatment, it may feel like your practitioner is digging his thumb or fist into your Achilles/hip/knee while slowly moving your leg in intricate patterns. Your involvement comprises relaxing, breathing and providing resistance when asked. For those who don’t think they have scar tissue: If you have plantar fasciitis, Achilles tendinitis, shin splints or ITB issues, think again!
When To Use: ART breaks up scar tissue from chronic injuries. It’s also a good place to start with injuries, as the physical therapist must get “hands on” to determine the source of the pain and problem. It also allows a PT to determine range of motion and limitations.
Also used in instances of scar tissue and restricted fascia, the curved, stainless-steel, Graston Technique instruments look a bit like torture devices. The instruments are designed to work with different curvatures of the body, to penetrate deeply into larger muscles (the “belly” of a muscle, according to Hayne) and to cause less stress to the practitioner’s hands.
When To Use: Graston is best for getting to any knots and scar tissue in the belly of certain muscles—think: calves, hamstrings and quads. Graston would be too intense for areas like the Achilles tendon, which isn’t as meaty. In such instances, hands-on manual manipulation is more effective.
Dry needling, a Western procedure, is similar to acupuncture in the application of fine needles to affected parts of the body. Dry needling is used to affect musculoskeletal issues, and acupuncture affects the flow of chi within the body. The term “dry needling” refers to the fact that doctors usually use needles for purposes of injecting or withdrawing medicines and fluids. The filament needles used for treatment involve no fluids. Instead, the needles are inserted into affected muscles and trigger points to relax and reset inflamed muscles and areas to their resting state.
When To Use: Do not use within 10 to 14 days of a serious injury or major trauma. Let the injury settle down a bit first.
Soaking in a cold or ice-filled tub, or sitting in a chilly river after a run may not be your favorite thing to do, but it’s effective for reducing inflammation and promoting muscle repair, especially after hard efforts.
“People are afraid of ice baths,” says Hayne, who recommends taking a 10-minute chill session after hard workouts. “It’s simple but effective.”
Add cold water to a large bucket or bathtub, toss in some ice if you want, set a timer and soak whatever body parts are injured or stressed. The initial shock is always the worst. Professional runner Megan Lund-Lizotte will often sip on a post-run recovery drink while bearing her icy soak.
When To Use: Ice bucket or bath soaks help with injuries and reduce swelling in healthy tissue after workouts. They can also be beneficial after manual therapy, like ART, to calm muscles. Although heat treatment might be more pleasant, it actually inflames the tissue, especially if you have any type of joint involvement.
Functional Movement Systems (FMS)
Practitioners observe patients as they move through seven specific strength and mobility exercises. The goal of the assessment is to observe for irregularities to identify issues before they lead to injury. This process may also give practitioners an idea of how to treat patients with various symptoms.
When To Use: Testing can be done on someone who is injured. It can also be done prophylactically to look for irregularities and work towards preventing injuries.
Popular with track and field athletes, painless electromagnetic currents are applied to the skin to ostensibly promote healing, reduce inflammation and lessen pain. Devices exist for home use and sometimes prescribed by doctors. Either way, it’s always a good idea to talk to a professional before trying at-home therapy options.
When To Use: This can be helpful for something like a hamstring tear. It’s especially popular among track athletes.