#822 Minimal restrictive intervention is the goal with runners - DOC

#822 Minimal restrictive intervention is the goal with runners

Today on the Doc On The Run Podcast, we’re talking about how the minimum restrictive intervention should always be the goal if you’re a runner.

 

 

Today, we’re talking about a concept I’ve mentioned in a couple of other episodes that are a little more detailed. And this really is what you have to understand when you go to a doctor or you’re doing your own self-treatment, self-diagnosis.

If you’re a runner, you have a very simple thing that’s going on, you have an injury that is necessarily limiting your activity. Doctors who don’t really understand how important it is for you to get back to running tend to limit it more than necessary. They’re more restrictive than necessary and that costs you as a runner.

You lose more fitness, you get weaker, you get stiffer, you get neuromuscular changes that actually damage your running form, your coordination, the firing of the muscle units that makes you efficient. All of that gets damaged over the weeks that you’re not running. So, it’s really important that you maintain your fitness.

How do you do that? Well, you have to figure out what is the minimum restrictive intervention that you need at that point in your recovery. The big mistake everybody makes is how long do I have to stop running if I have a stress fracture, that’s a dumb question, really and truly.

So, everybody wants an answer. Six weeks, eight weeks, four weeks, three weeks, two weeks, whatever. We caan’t give you that answer. If you look at the largest meta-analysis ever done on this topic, the time to return to activity ranged from 4 to 52 weeks, that’s a month to a year.

What’s the difference? Well, the difference is all the other stuff that you do. It’s how bad it is. It’s how much you sleep. It’s how much you pay attention to your nutrition, how much you decrease stress and strain to the injured bone so they can actually heal. That’s true of tendon injuries, ligament injuries, whatever.

The most restrictive intervention is likely to heal the injury with the most probability. So, it’s also most likely to give you trouble later that also damages your running fitness. So, if you think about this, the most restrictive thing, what is it? It’s traction. We put you in a hospital bed, hook you up to a contraption that actually holds the bone in exactly the right position, take the stress off the injury in exactly the right way. But you don’t move until it’s healed. Well, obviously that’s going to cause a lot of problems.

A cast immobilizes just that one injured part, just your leg, just your foot, whatever. Bed rest doesn’t really immobilize as much but you don’t do anything, you’re just laying in bed. Then you have a wheelchair and then a little less restrictive as a fracture walking boot and a little less restrictive than that is crutches without a boot or a cast. And then after that, it’s just no running where you’re walking on it, you’re doing more normal stuff, but you’re not stressing in the same way. Or even relatively less running. You’re running just not as much and maybe you’re doing some things to take stress and strain off that tissue.

But you have to realize that you need a balance between the two. You’ve got the need to heal, and you have the need to stay fit if you really want to run again. So, if you want to understand how I figure that out, I have a thing that I put together. It’s called the Fast Track challenge. It’s just three days, you can even do it for free, normally have to pay for it. And the other people that have been through it have all paid for it. But you can do it for free if you go to www.docontherun.com/fasttrack.

It actually helps you figure this out. It shows you exactly how I would do it with you and it’s about figuring out what do I need right now? Do I really need crutches? Do I really need something to decrease some stress and strain to that area? Is it okay for me to do some exercise? Those are the things your doctor doesn’t discuss with you that you’ve got to figure out on your own. Again, you get it for free www.docontherun.com/fasttrack, so go sign up and I’ll see you in the challenge.