What does running mean?
How painful actions give us clues when designing a treatment plan
“Honestly, I’m very surprised,” said my client, an orthopedic surgeon. – I did not expect that after just one session I would feel so much better. I thought that massage gives only a temporary effect, and to consolidate it you need to go through a whole course! After you, the very next day I woke up, and the pain somehow did not happen. I am so pleased!
“But I’m surprised,” I answered. – Could you explain more precisely what it means – “pain as it never happened”?
The man thought for a moment, and then began his story.
– Before I came to you, my hip hurt almost constantly. I was worried that I had arthritis or something like that. It was very painful for me to get up after I sat for a long time somewhere. The most severe pain occurred while running – because of this, I stopped doing it. In the afternoon I have a lot of things to do, and I liked to run in the mornings in the park – and in the form of support yourself, and tune in for the day. I really missed these times! After the session, everything went right away.
Before starting a new session, I asked my client to sit on a massage table so that I could examine his middle gluteus muscle – it was with her that I was going to work. Palpating the same area of this muscle as a week ago, I found a focus of tension in the tissues.
“Wow, this place still hurts,” he said. – Even very much – did not expect! I thought that the whole problem was solved in the first session, because the pain that I complained about initially went away. What is the matter?
– Firstly, I want to assure you that this is how it should be – I am not at all surprised. Just because the pain that worried you every day is gone does not mean that the damaged tissue has completely recovered. We still have a lot of work to do.
“But why, when you touch this muscle, it hurts, and during the day nothing bothers me?” – he asked.
– It is worth noting that the absence of pain does not indicate that everything is in order. It’s all like in family life – if the husband and wife do not discuss the problems out loud, this does not mean that they are happy in marriage. Real health (both physical and relationship health) is a much more subtle and deep thing. So, let’s continue. When you said that the pain was gone, did you mean that you were able to return to running again?
“Actually not, it still hurts me to run,” he admitted. – A couple of times I tried, but I had to stop after a kilometer – the hip began to hurt. I would not want to reduce all our progress to nothing. I am very grateful to you that I felt better, but I really want to run again. Well, and if this is impossible – well, you have to find yourself a new sport.
– In no case! I will not let you quit running. Let’s do it – running without pain will be our main goal. When you can run again, we will realize that the treatment was successful.
– Well! How do we achieve this? My client asked.
– So, you have a certain problem with the tissues, the main symptoms of which appear during running – therefore, we need to pay attention to the biomechanics of this action. Whatever injury or illness caused this pain, during the run the tissue overstrain very quickly reaches the extreme point. Problems of this nature are much easier to solve than those that manifest themselves only after prolonged engagement in any kind of physical activity. The sooner the symptoms pop up, the easier it will be to determine the cause.
“Do you think the problem is that I am running incorrectly?” – I doubt it very much. You told me that you’ve been running for several years and you haven’t encountered such pain before. In addition, if the cause was in the wrong mechanics of movement when running, the pain would manifest itself over long distances, but certainly not in the first kilometer. Of course, I won’t say anything right now, but we will leave the study of your running mechanics for later. Please tell me, does the pain occur when you take your foot forward, transfer your body weight to it, or when you push your foot off the ground, leading it back?
“It hurts the most when I run my foot forward and lean on it, carrying body weight,” the client answered, showing me this movement.
“Two muscles are responsible for carrying the leg forward and supporting the pelvis while transferring body weight to this leg – the tensor of the broad fascia of the thigh and the small gluteus,” I explained. – Let’s examine these muscles.
Palpating them, I immediately realized that these muscles were overstrained. I devoted the whole session to their study.
A week later, I met again with this client and, as it turned out, since our last meeting he had been running three times in the morning! Of course, he gradually increased distances, starting with small ones. Very soon, he will be ready to run the same way as before!
Remember that the more specific the discomforting action, the more it can tell us about the true cause of the pain. Our task is to turn this “story” into a therapy strategy.