#875 Your goal tells me how chronic your running injury - DOC

#875 Your goal tells me how chronic your running injury

Your goal that you have right now could tell me how chronic your running injury really is. Don’t believe me? Well, that is what we’re talking about today on the Doc On The Run Podcast.



One of the first things I do with any athlete when somebody signs up for a series of coach coaching calls or one specific second opinion call where we talk over webcam, the very first thing I ask them is, “What is your goal?”

Just a couple of days ago, I was lecturing at a medical conference in Wisconsin where I was doing a whole morning session on running injury talks and diagnosis of subtle fracture patterns in athletes. And what I told them is like, you have to ask the athlete, “What is your goal?” That is what determines your timeline.

In of the question-and-answer periods, one of the doctors asked me a question about what would you do with this particular scenario and I said, it depends on the athlete’s goal. Their goal is number one, you have to figure out what the goal is and then figure out what you can do to make that goal happen. That is your job as a physician, it is not to fix the thing or make it look better on an Xray. It is to get them to achieve their goal.

Let’s go south when you have had a long-term running injury, let’s say that you are an Ironman triathlete. This is a real example. This guy was an Ironman triathlete, he had been doing Ironman races and he started having this weird foot pain on the outside of his foot, but he thought it was plantar fasciitis. He thought it was a couple of other things. He got a couple of opinions that did not really help him, at least the treatment that he tried for those things that he was told might be the diagnosis, they did not help him.

So, what happened? Well, the same thing that everybody happens. It happens with everybody who gets these kinds of injuries, you run a little less, you run a little slower, you keep sort of dumbing down your training goals, and you get slower, and you get weaker, and your foot does not hurt less. And so, it just gets worse and worse and worse and worse.

When I finally saw him, I actually asked him, “What is your goal?” And he said, “My goal is to walk to the bus stop without stopping because of the pain.” The bus stop was less than a block. It was about half a block down the sidewalk from his front door. This is an Ironman triathlete, and this guy said his goal was to walk to the bus stop. It is like, well, unless the bus stop is 140.6 miles away, I do not know why that would be your goal. And so, I said, “Look, we got to shift this. You need to do something different.”

The short story is he did have a very serious injury. I had to do surgery on him. The surgery was a success. It helped him luckily, and frankly, I knew there was a high risk that it might not help him, but it did. And then a couple of years later, he posted this huge thing on social media where he talked about how much it helped him and that he couldn’t believe he did another Ironman again and that he remembered that there was a time when he couldn’t even imagine walking to the bus stop.

If your goals are I just want to walk without pain, I just want to walk to the bus stop, I just want to be able to go the grocery store or the farmers market and it is not centered around a race, I know your injury has been going out a long time. You’ve tried a whole lot of things, and none of those things have been helpful, and now you’re demoralized because nothing seems to be working so you stopped believing that it’s possible for you to run a marathon anymore, or a half marathon or an Ironman or whatever it is that you want to do.

You have to realize that there is always a way. You just have to find out what the way is that will work for you. And if you have not found it yet, then you have not looked in the right place. Get another opinion, talk to somebody else, but you have got to figure out what the issue is so that you can get back to training, get back to running and do the stuff that is meaningful to you.

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