[Physio Discussed] From struggles to strides: mastering running injuries with Dr Rich Willy and Brad Beer
Nov 6, 2024
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Rich Willy and Brad Beer, both experts in running injuries, delve into the complexities of managing conditions like proximal hamstring tendinopathy and bone stress injuries. They emphasize the importance of personalized recovery approaches and educating athletes. Footwear’s role in injury prevention is explored, revealing that design and history matter more than expected. Additionally, they discuss recognizing energy deficiencies in athletes and balancing exercise with bone health. Insights into technology’s impact on injury management provide a holistic understanding of modern running care.
Proximal hamstring tendinopathy and patellofemoral pain are highly challenging injuries to manage due to individual variability and prolonged recovery timelines.
Footwear plays a multifaceted role in injury prevention and treatment, requiring individualized assessment based on the runner's unique biomechanical needs.
Screening for relative energy deficiency in sports is crucial for assessing injury risks in endurance athletes, highlighting the need for a collaborative care approach.
Deep dives
Challenging Injuries in Runners
Proximal hamstring tendinopathy, patellofemoral pain, and bone stress injuries are identified as particularly challenging injuries to manage in runners. Proximal hamstring tendinopathy tends to persist and is difficult to treat, especially in athletes with additional loading from sports like triathlon. Similarly, patellofemoral pain, the most common running-related injury, exhibits high recurrence rates, complicating effective treatment due to individual variability in symptoms. Bone stress injuries, although sometimes seen as simple to manage, present a complex challenge involving multifactorial risk factors, particularly in runners with a history of repeated injuries.
Expectations and Recovery Timeframes
Setting realistic expectations regarding treatment timelines is crucial for managing injuries such as proximal hamstring tendinopathy and patellofemoral pain. Athletes may need up to six months for recovery from proximal hamstring tendinopathy, particularly if they have a long-standing history of the injury, as self-management attempts can complicate healing. Recovery from tendinopathies often requires clear communication that the healing process can be gradual, with some cases extending beyond the typical recovery timeframe. Understanding individual variation in symptoms and treatment responses also plays a critical role in how practitioners set recovery expectations.
Role of Footwear in Injury Management
The role of footwear in preventing and managing running-related injuries can be complex, as it varies significantly among individual runners. While some argue that footwear contributes to injuries, others view it primarily as a tool for managing load during rehabilitation. For example, while lower drop shoes may exacerbate anterior knee pain, higher drop or rocker bottom shoes may help mitigate loads at the foot and ankle, illustrating how footwear can influence treatment. Ultimately, practitioners should focus on footwear as one part of a multifactorial approach, considering the runner's unique biomechanical needs along with their injury history.
Recognizing Energy Deficiency
Relative energy deficiency in sports (RED-S) is a significant consideration when assessing injuries in athletes, particularly those involved in endurance sports such as running. Screening for indicators of RED-S should be a routine part of the assessment process, as it relates to a higher risk of various musculoskeletal injuries, including tendinopathies and bone stress injuries. Clinicians are encouraged to look for signs such as poor performance, menstrual irregularities in female athletes, and changes in body weight or mood. Establishing a collaborative approach with sports medicine professionals, dietitians, and psychologists can significantly enhance the care provided to athletes with potential energy availability issues.
Impacts of Technology on Injury Management
Technology offers both benefits and challenges in the management of running-related injuries, with tools like GPS watches providing valuable data on training loads and patterns. Utilizing apps and wearables can help clinicians better assess athletes' running volumes and elevate gain, which is important for injury prevention strategies. However, clinicians must also be cautious about over-reliance on this data, as many athletes may underestimate their training loads or overemphasize specific metrics, potentially masking underlying issues. The integration of technology must be balanced with a holistic understanding of the athlete's overall health and psychological well-being.
Introducing our new, longer form podcast, Physio Discussed, where 2 expert guests and our host explore everything you need to know about your favourite topics!
In this episode, we discuss running injuries and the running athlete. We explore:
Most challenging injuries to manage
Importance of education and load management within treatment
Footwear and its role in the prevention and treatment of running injuries
Screening for relative energy deficiency in sport (REDs)
Bone stress injury in this population
Role and limitations of current technology
Dr. Rich Willy is an Associate Professor in the School of Physical Therapy, University of Montana (Missoula, MT, USA) and the Director of the Montana Running Lab. He received his PhD in Biomechanics and Movement Science from the University of Delaware and his Masters of Physical Therapy from Ohio University. Dr. Willy has been a clinician for over 20 years specialising in the treatment of the injured runner.
Brad Beer is known for his expertise in treating running and triathlon related injuries. A physiotherapist with over 17 years experience, Brad is an APA Titled Sports & Exercise Physiotherapist, Exercise Scientist, and former Head Physiotherapist for the Super League Triathlon Series.
Want to learn more about running injuries? Dr Rich Willy has done a brilliant Masterclass with us, called “Restoring load capacity in the injured runner” where hegoes into further depth on this topic - https://physio.network/masterclass-willy
If you like the podcast, it would mean the world if you're happy to leave us a rating or a review. It really helps!
Our host is @sarah.yule from Physio Network
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