“If it hurts then stop doing it.”
That is the phrase that every physical therapists will repeat throughout their career. Whether we are referring to exercises in a home program, basic ADLs, or part of a patient’s normal routine at the gym, that phrase is the disclaimer that we use to make sure our patients are not taking a step back in their recovery. However, there is one patient population that will never listen to this phrase…..our crazy runners. We say, “You need to stop running,” they think we are just another health care provider who doesn’t understand them. Here is where you prove them wrong. Being a “crazy runner” myself, I know that if someone told me to stop, I would smile nicely and act like I was totally on board with everything they were saying. In my head, I would be thinking, “yah right, I have a wedding in 3 months and I have to fit in that dress! Running is the only way I can maintain my weight, so I am not stopping for anyone.”
Before you tell a patient, especially a runner, that they have to completely stop doing the one thing that they love, you better come up with a backup plan. Believe me, you will gain a lot more respect from your patient and their compliance with your plan of care will significantly improve! Giving your patient options will set you apart from the other health care professionals they have seen. Their physician told them to stop running and go to therapy. The patient has probably continued to run right up until their appointment with you. Now, you have done your examination, discovered their deficits and attempted to explain to them why it is so very important that they stop running. But, you have forgotten to address the most important part, what they can do in place of running.
Rowing machines are all the rage these days and although many people associate them with the 1980’s, they are a great way to get your heart rate up while minimizing the impact on your joints. And, if it is done the proper way, it can be really intense.
Swimming. So many people dislike getting in the pool because it is such a hassle, but what they don’t realize is that it is just as good, if not better than going for a long run. The major difference is that you do not feel yourself sweating, so you don’t think you are burning as many calories. Wrong.
Cycling. Although not the best choice for everyone, depending on their diagnosis, it is still another great low impact choice that if lead by the proper instructor, can be very challenging.
And last, but not least, if you are lucky enough to have access to one (and I am) The Alter-G Antigravity Treadmill. For those of you who haven’t seen one, this overpriced piece of cardio equipment allows patients to off load themselves and run with as little as 20% of their body weight. It is great for nursing injuries as well as working on speed training.
Always, always give them some type of return to running program before you cut them loose. You need to make sure that they are able to log a few middle distance runs prior to discharging them. I like the University of Wisconsin- Madison program which can be found on their web site, http://www.uwhealth.org/files/uwhealth/docs/sportsmed/SM_Runners_Training_Tips.pdf
So before you say those words that no dedicated runner wants to hear, provide your patient with some options to get them through the next few weeks while you address their deficits. They will leave not only with an appreciation for our profession, but for you as the health care professional who didn’t make them stop doing what they love.
- Cara McInerney, PT, DPT, SCS, CSCS