South Florida Sun-Sentinel (Sunday)
It’s running season. Here’s how to battle shin splints, other injuries
Running season officially has kicked off in South Florida with Turkey Trots and 5K fundraisers, and now come the injuries associated with the sport.
People already are showing up at sports medicine clinics with shin splints, tendinitis, runner’s knee, plantar fasciitis and stress fractures.
Whether you’re training for a marathon or walking in your neighborhood, injuries are challenging to avoid, but the right diagnosis and treatment makes a difference in how quickly you get back on your feet.
Medical research shows the most common causes of running injuries are increasing distance too fast and ignoring pain that interferes with movement. If your knees, ankles or hips are swollen or you feel a tear, crack or pop you need to get help.
“The main thing is getting a very specialized look at what is contributing to the problem you are having and treatment for the problem,” said Tina Schmidt, a physical therapist and general manager for Fyzical Therapy & Balance Center in Palm Beach County.
In many cases, running injuries can be treated with conservative methods such as rest, ice, compression and elevation. But when the injury is more serious, sports medicine specialists say newer treatments offer runners more options.
When Raquel Alderman of Coral Springs tore her hamstring training for the New York marathon she experienced overwhelming pain. “I didn’t stop when I should have stopped. I will never do that again,” she said.
Alderman said her doctor used platelet-rich plasma to speed up her healing process. PRP, as it is known, relies on injections of a patient’s own platelets to relieve muscle pain.
“You heal your tendons with your own cells,” she said. “It’s a last resort and it’s not covered by insurance, but it works.”
Dr. Michael Swartzon, a primary care sports medicine physician with Baptist Health Orthopedic Care, says platelet rich plasma has become more widely used for sore tendons, ligaments, muscle and joint injuries — conditions like hip bursitis and chronic hamstring and Achilles tendon problems. The treatment uses a patient’s blood cells to speed up healing in a specific area and decrease pain.
“If we can’t heal through conservative treatment, we need to jump
“The main thing is getting a very specialized look at what is contributing to the problem you are having and treatment for the problem.” —Tina Schmidt, physical therapist and general manager for Fyzical Therapy & Balance Center in Palm Beach County
start the regenerative process,” Swartzon said. “With ligament and tendon injuries, PRP can be very effective.”
Swartzon said his practice also uses another option called dry needling in combination with physical therapy to treat planter fasciitis and other muscle injuries.
“It’s like acupuncture and goes directly on the area and uses a small amount of electricity,” he said. “It’s mainly for tendons and muscles.”
For bone injuries like stress fractures, Swartzon said, “rest is a non-negotiable treatment.”
“Bones heal well with time,” he said. “Stress fractures have a good prognosis. It’s more about modifying your activity so you can still do something.”
For general pain and soreness, runners are turning to a device used by physical therapists called a vaso pneumatic compression sleeve.
“It slides on the leg from the ankle to the thigh and provides compression and release to help with swelling and pain and generalized soreness,” Schmidt, whose FYZICAL Therapy
and Balance Center use the device. “Even one use can bring you comfort and relief but most people do it a few times a week.”
Schmidt says starting physical therapy at the early stages can prevent an injury from worsening. “Right when you first feel pain you want to get ahead of it before it feels worse.”
Pain doesn’t have to put a full stop to your routine, she said. New equipment such as an anti-gravity treadmill allows therapists to help runners in pain continue to exercise by reducing pressure on their joints.
Dr. Alexandr Aylyarov, a sports medicine surgeon with HCA Florida University Hospital in Davie, said his patients do well with plasma-rich platelet injections, but he also uses ultrasound therapy as one of his tools to treat soft tissue injuries and reduce the healing time.
For Achilles tendinitis and cartilage tears, Aylyarov also uses stem cells. The treatment, called Bone Marrow Aspirate Concentrate (BMAC), is an outpatient procedure. A small amount of a person’s bone marrow is extracted and injected into their damaged tissue. “It’s not new but it has been studied and it has a better effect than we used
to think.”
Surgery, particularly for knees and hips, has become the last-resort option.
“We try to treat injuries conservatively but sometimes we have to offer surgery if someone is not getting better,” Aylyarov said.
Experts say runners can prevent some injuries by ramping up their distance and speed gradually and stretching well before and after their workout. At the first sign of pain, Aylyarov recommends decreasing your speed and distance. “You will need to gauge carefully if the pain gets better.”
Good shoes, he said, can be critical to runner’s avoiding future surgery. You might need to try different styles until you find the best fit for your foot anatomy and the terrain where you run.
“People who run love it, so I would say don’t quit,” Swartzon said. “If you get hurt, talk to someone with expertise to find out what the problem is and come up with a plan.”