DOC » #368 Why runners should not start with prescription medications

#368 Why runners should not start with prescription medications

Today, on the Doc On The Run Podcast, we’re talking about why runners should not begin their treatment with a prescription medication.

 

This weekend, I was giving a lecture at a medical conference, and this is a conference where physicians and podiatrists and sports medicine doctors go to get their continuing medical education credit. I was giving a lecture that was specific to running injuries. In fact, I was giving three different lectures. But in one of these lectures, I was talking about a case where someone had had a lot of trouble for a long time. And then I came up with the right answer. 

Every time we come up with the right answer, meaning the correct diagnosis, the next most important part, of course, is to figure out what is the very best treatment for this particular runner with this particular running injury. And when I went into that discussion, I discussed all of the options that I had considered for this particular patient who had eluded diagnosis for so long.

And one of the best recommendations, most reliable and, in fact, most probable to actually relieve the symptoms was a prescription medication that you just take in pill form. And that’s not what I actually recommended for the patient. It was on the list, but I also thought about a number of other things, like just taking some pressure off of the injured structures, just trying to do some stuff to decrease the inflammation that didn’t involve medications. Trying to do some simple things, some running form readjustment. Some physical therapy that might help in a way to realign the biomechanics, and adjust the running form in a way that would put less stress on the structures that kept getting aggravated and inflamed over and over and over.

During the question and answer period, one of the physicians in the audience asked a completely valid question. She said, “Why wouldn’t you just begin with a prescription medication if you’re 100% sure that medication had the highest probability of reducing the patient’s symptoms?” Now, that seems like a reasonable thing to do, but my answer pointed out how wrong we, as physicians, often get it. Most of the runners I know really don’t want to be stuck taking a bunch of medications for a long period of time. And the fact is, many runners don’t need to take medications for these types of conditions where you get what amounts to an over-training injury from too much stress repeatedly applied to some specific injured structure that keeps getting inflamed.

What you really need is to try to do something to reduce the stress on that structure, and hopefully permanently realign your biomechanics in a way that reduces the stress that’s applied to that structure when you run. Because after all, if you’ve been running for many years and you didn’t get this injury, and then you develop compensation and a way of running that puts too much stress on one piece of tissue, and it keeps getting beaten up and injured, then that’s really the problem. Not the thing that will actually reduce the inflammation or irritation of the tissue, from a systemic, physiologic, medication standpoint.

And while I acknowledge that this was the most effective way to reduce the patient’s symptoms, I said I think it makes more sense with these kind of patients if we take something really simple, like reducing stress and strain, trying to alter running form, trying to do something to reduce the local irritation to the anatomic structure that’s getting beaten up when you run, and then see if you can run. In that case, of course, this is exactly what happened with that runner.

So you have to really be thoughtful about this and think about what would happen in the end. Because if you said, “Okay, we’re going to try to use some pads to shift pressure from one area of your foot to another. If we’re also going to have you try to adjust from one type of running shoe to a different type of running shoe and try to adjust your form. And we’re going to give you a medication that should really help as well.” 

If you do all of those things, all at the same time, and you improve and you feel better and you’re running, well, if you’ve been going for years with not getting the right solution and suddenly you’re pain free, you’re going to think then that you need the new type of running shoe, the pads to adjust your form, you need to try to adjust your form…and you need to keep taking the medication.

Well, in this case, we were able to find a solution without any medications, without any other kind of intervention that requires ongoing prescriptions or anything else. And that is what I think we should all hope for as runners when we get injured. 

If you think you’re injured and you’re not getting better, you need to come up with the key things that you can do right now that will actually help. If you really want to understand what your true baseline is and what you can do to try to figure out whether or not you can get on a faster track, go to docontherun.com/fasttrack and sign up for the Fast Track Recovery Challenge. It’s free. It’s going to help you. I’ll walk you through the process in three days. And it really will help you figure out what you need to do to get back to running sooner.

If you think you have a nagging injury, and you are trying to figure out whether or not you can run, you need to check out How to Fast-Track Your Running Injury in Record Time!

Give me 3 days, and I’ll help you figure out where you are are now, and how you can get back to running in record time. Get started for free right now!

Go grab your seat now. I’ll see you in the training.