Runners expect months of long runs and training schedules, coupled with dreams of personal records and lofty goals of new distances. Runners do not expect – or appreciate – the phrase "you need to stop running." Except, of course, that this is exactly what many are told by physical therapists as they start treatment to recover from running injuries.

Elena Sonnino

Recovering from a running injury often takes as much mental stamina as it does physical strength. The idea of not being able to lace up your shoes and go for a run can feel like a death sentence to a hardcore runner, but the reality is that for some injuries, stopping running altogether is the first step in the recovery process.

Treating a running injury with physical therapy

Physical therapy is a common treatment for running injuries that impact the illiotibial bands, knees, hamstrings, groin or adductor muscles and hips.

Andrew Parker, an orthopedic surgeon specializing in sports medicine who's based in Reston, Va., knows that recommending physical therapy to his running patients is often a more palatable plan than surgery, which can lead to long and even more difficult recovery periods. Physical therapy is a first line of defense to identify the imbalances and mechanical issues that can be the result of poor running form or strain from overtraining.

While some athletes prefer seeing a sports chiropractor to treat their injuries, Parker suggests that physical therapy is a good place to assess the "holistic issues of strength and balance." If the injury persists or pain continues, Parker suggests considering a team approach with physical therapy and sports chiropractic techniques like Active Release Techniques or Airrosti treatments for patients who want to exhaust all options before considering surgery.

The worst part – at least for me, as I treated my hip bursitis and illiotibial band injuries – was the instruction to stop all running. While some physicians will tell patients that it's OK to keep running, chances are good that your physical therapist will suggest the cessation of all running to reduce the variables that might impact recovery.

What to expect in physical therapy

A typical physical therapy plan starts with a thorough assessment of the injury as well as balance, strength and mobility. Treatments then include various techniques, such as manual therapy, that include massage, mobilization and manipulation where the therapist applies the stress or friction to stretch or massage the area. The goal of manual therapies is to work on the soft tissues and joints to reduce friction, which can cause pain.

Treatments also include more active exercises that address both strength and balance. Typical equipment used during physical therapy includes:

• Pilates reformers and chairs

• Stability balls

• Resistance bands

• Foam rollers

• Steps of varying heights

Keys to success in physical therapy

Although injured runners might wish there was a magic pill to treat a running injury, the process of treatment and recovery can take time – sometimes much longer than we would like. The keys to success in physical therapy are commitment, frequency, application of knowledge and patience. The first thing that I learned early on in physical therapy is that progress can be very slow and that sometimes pain gets worse before getting better.

Physical therapy can often involve two or three weekly sessions, in addition to daily practice of exercises and stretches at home. "Physical therapy requires commitment from patients. There is no quick fix or magic solution for an injury," says physical therapist Britta Gilbert, clinic director at Results Rehab and Fitness in Arlington, Va. Recovery happens over time when patients take what they learn during their physical therapy sessions about form and mechanics and apply it in their day-to-day lives.

While physical therapy takes time, persistence and patience, it's important to keep in mind that running and physical activity are long-term goals. Making the time to invest in recovering without surgery is an easy sacrifice to make if it means long-term health and strength – or, at the very least, it's an excellent place to start.

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