#191 Top 3 reasons doctors hate treating runners - DOC

#191 Top 3 reasons doctors hate treating runners

Today on the Doc on the Run Podcast, we’re talking about the top 3 reasons doctors hate treating runners.

For about 15 years now, I’ve been teaching other doctors about running injuries. Every time I speak in a medical conference now, I ask doctors why they don’t like treating runners. I know some runners are actually surprised to hear this, but if you are a runner, yourself, and you’ve been to the doctor and you’ve had some doctor look at your intake form or some nurse look at your intake form, and said something like, “Do you really eat that many servings of fruits and vegetables? Do you really run that much? Why do you exercise so much? Are you obsessed? Are you some kind of exercise addict?” Well if you’ve heard any of these things, you probably understand that not all doctors like to see runners. But when I am at medical conferences, I always ask doctors, “Why is it that you guys don’t want to treat runners? What’s your problem with them? Why is it that you think it’s difficult to treat them? Do you think they’re unreasonable? What is it?”

After years and years of asking doctors in the audiences at medical conferences these same questions, here are the top 3 reasons doctors say they don’t like taking care of runners: 1. They say runners read on the Internet. Okay, well my take on that is that’s a good thing. And as I explained to doctors at medical conferences in the audience, I say, “Look, that’s to your advantage, right? Part of your complaint with runners is that they read on the Internet and then they want to take a lot of your time in clinic, and you feel like you only have a little bit of time to spend with them. So if you only have a little bit of time to spend with each and every patient throughout your day, it is to your advantage if a runner comes to you pre-educated because they already read about their suspected condition on the web. I think that’s a good thing.”

Obviously, that’s why I do this podcast. I try to help runners understand what’s going on with their running injuries, how they can treat them themselves, and in most cases, it’s getting better without seeing a doctor. But in any case, when they actually do go see a doctor, when you have a problem that you can’t fix on your own and you go see your doctor, and you already understand all of this stuff, you’ve already tried all these different things, it actually makes the doctor’s job a lot easier. 

To me, when a doctor says they don’t like the fact that a runner goes and tries to figure out the condition and become sort of acquainted with that condition on their own, that doesn’t make any more sense to me than an accountant who says they don’t want anybody to come to their office if they already know math. Let’s face it, accountants don’t sit around trying to teach their clients how to do simple math. They expect that you already know how to do that, or they can speak your language.

It’s the same with doctors. Every time you listen to a podcast episode like this, you learn something that could help you treat your own injury, and then prevent that injury later, and hopefully, communicate with your doctor better. That’s the first thing is that a lot of doctors just say they don’t like treating runners because runners read too much stuff on the web, and when they come in, they want to try to explain to the doctor what they think their condition is, and that’s actually a good thing. That’s one thing you have to be aware of is that a lot of times, the doctors are afraid that because you come pre-educated, you’re going to take up a lot of their time, and that is not usually the case. It’s usually the opposite.

The second reason doctors said they don’t like treating runners is they say runners think they know everything. Well, if you are a runner and you listen to podcast like this, you read articles about how to treat running injuries, you read articles about stress fractures or Achilles tendinitis or how to change your running form to decrease stress to those structures when you’re recovering from a running injury, well, if you listen to all podcast episodes, all the ones that I’ve created for you about the particular thing that’s bothering you, if you read articles that are related to that condition and you’re a runner and you want to get back to running, you’ll probably know more than about 99% than doctors anyway. I understand that may insult their egos a little bit, but doctors don’t know everything. And in many cases, when runners are educated and experienced about how to run with a particular injury, what actually helps heal a particular injury, well you may actually know more than the doctor yourself. But the doctor has some very specialized knowledge that may help you shift the healing process and get better sooner. 

Of course the flip side is true when you go see a doctor, you understand some things about running that the doctor, in all likelihood, does not understand. You can combine your two knowledge bases and then get better and get back to running a lot sooner if you can just respect each other’s knowledge. That can be very helpful on both sides. 

I tell doctors they have to understand that runners already know all these things about biomechanics, about the healing process, about physiology, about nutrition, and all of those things are helpful to the healing process. I always tell doctors not to discount the knowledge that you runners have, but you have to be aware that some doctors are just afraid that you’re going to think you know more about them given your particular injury. And in some cases, you may actually know more than them, but that doesn’t mean you can’t get useful advice from them.

The third reason doctors say they don’t like taking care of runners is that runners never follow directions. I think nothing could be further from the truth. But what I tell doctors at conferences, I say, “Look, runners are used to following directions. They create training plans, and they follow them. They hire coaches and they follow their coaches’ advice. They do what they’re supposed to do. They understand delayed gratification. They understand putting in hard work now to get a result later. Runners will understand a treatment plan and follow it the same way they will follow a training plan.” 

I think that you just have to basically explain to runners that this is sort of your training plan, not your treatment plan, because you have to get back running. The goal is to get you back to running. I know that any runner listening to this is capable of figuring out what they have to do to heal and get back to running and then follow that plan.

It’s absurd when doctors tell me that runners never follow directions. But what I have seen is that a lot of runners will take things too far. I saw a guy one time who had plantar fasciitis. In his case, I knew if he did a simple set of stretches, literally, 10 seconds of stretch, 6 times, 3 times on each side, that this thing would just completely go away. A couple of weeks later, I saw him again, and he had Achilles tendinitis. What he told me was that he felt like if he held the stretch for 10 seconds that it would be helpful, but if instead if he just held it for 1 minute straight, then that would be significantly more effective. He’s right that it would be more effective in stretching out the tissue, however, he stretched it too much. As a consequence, he got Achilles tendinitis. 

We know also that runners sometimes we are prone to doing a little more than we should. We run a little faster than we should on our long runs. We maybe do a little bit more heel work than we really planned on. Sometimes, we overdo things just because we want to get fit and strong faster. That’s one thing that doctors are afraid of. They know that you’ll follow directions to some degree, but they’re also afraid you’re going to start doing activities sooner. You have to try to express to the doctor, in some way, that you’re on board, that you will follow the plan if they’ll give you clear directions and clear limits, but that you want to work within those limits and recover as fast as possible, and be able to communicate when you feel you’re ready to advance ahead of the plan. That’s the key.

You have to let the doctor know that the doctor may be in charge, but that if they follow your plans since you’re a healthy young athlete, you may actually heal a little bit faster than some of their other patients. If that happens, you want to know how can you get in touch with them and communicate with them so that you can move ahead to the next step in the process. If you explain that to them, they may be a little more amenable to working with you and they might be a lot more cooperative with you.

I know a lot of runners think it’s crazy that doctors won’t want to work with them just because runners are healthy, they’re interesting, they’re athletic, they should heal faster, but it’s no joke. These three reasons – runners reading on the Internet, runners knowing everything, runners not following directions – this is what doctors cite as the real reasons doctors hate working with runners. If you understand where they are coming from, you will be better equipped to extract the expertise and advice you need from those doctors when you do need help because you got an overtraining injury.

Remember those things. Remember that it is good for you to read about your condition before you see the doctor. It is good to know as much as you can about the condition before you see the doctor. And it is good to be prepared to follow the doctor’s plan, but have some way to alter that plan and move ahead of schedule when you do start recovering sooner so you can get back to running faster. It would also may help you to think of your doctor as your coach. This is your injury coach. He’s the one who’s going to get you back to running. If you put it to them in those terms and you explain to him, “Look, I have a coach. I have someone that’s going to train me when I get back running, but I need somebody to help me get back to that point,” that may actually reframe the doctor’s opinion and approach to you that will be a little more beneficial to you.

You just have to realize that doctors are busy. They think that they’re going to get held up if they have somebody who has big goals and big aspirations. But if you just explain to them that you’ve already learned a lot about the condition, that you don’t know everything, that you will follow directions, they will be on your team. If you have a doctor who’s on your team just like your coach, you definitely will get back to running sooner. 

If you have been told you need a fracture walking boot, you need to think about how you can accelerate the process and get out of the boot quicker. 

Here are the 6 Questions to ask your doctor to help get you back to running faster.

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If you have a question that you would like answered as a future edition the Doc On The Run Podcast, send it to me, and then make sure you join me in the next edition of the Doc On The Run Podcast. Thanks again for listening!