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5 lessons from physical therapy


A few years ago, I battled a nasty case of IT-band syndrome after a particularly frustrating marathon training season. The irritation in my knee ran up along the side of my leg to my hip and kept me from running for several months. After a while, I grew hopeless and didn’t think I’d enjoy a pain-free run again, so I sought out physical therapy at the suggestion of a friend.

I went in for sessions 2 to 3 times a week for three months and slowly saw progress. I never became entirely convinced the physical therapy itself was making magic happen or if it was just the time off that allowed me to heal. Regardless, I got better; and I learned 5 important lessons through the process that have stuck with me.

  1. Warning signs are there for a reason. By the time I landed on the PT’s table, I had been struggling with pain and irritation for a couple months. Before the injury had become full-blown, I had little twinges or pains during my longer runs, which eventually happened sooner after heading out the door, but I ignored them. My physical therapist taught me that if that sign of symptom recurs more than a few token times, it’s a good idea to back off or seek help before tragedy hits. Had I stopped trying to run through the pain, I may not have irritated my IT-band to the point where I eventually required treatment.
  2. Strength and stability enhance training. A lot of my “issues” stemmed from muscular imbalances between my right and left legs — likely caused by a foot injury I had endured years earlier. At the time, I wasn’t engaged in any strength program. Through several weeks of targeted, one-legged squats, lifts, and presses, I did notice a difference in my running form. More generally, running alone is a good activity, but if you want to be competitive, you need to think holistically about your training. It’s key to address form before logging too many lopsided, injury causing miles.
  3. Stretching and rolling create a well oiled machine. I’m a get dressed, run, and shower kind of runner. I don’t make much time to warm up or cool down. I rarely stretch. My physical therapist taught me that we should treat our bodies much like how we treat our cars. Investing a little time in daily maintenance can keep those larger issues at bay. For me, rolling with a foam roller a few times a week helps keep my IT-band happy. Stretching informally or by heading to yoga is also helpful in keeping my whole body loose and ready for more running.
  4. Heat and ice are our friends. Depending on the issue, cold or hot compresses can make a big difference. Usually, and when swelling is involved like with acute injuries, cold is the way to go, as it “reduces blood flow, decreases swelling, relieves pain, and promotes better healing.” For example, the IT-band injury is caused by irritation and inflammation, so heat exacerbates the issue. For more chronic conditions, heat can help, but it’s tricky. Here are some additional guidelines from sports doctor William Roberts.
  5. Sometimes, rest is the best medicine. My physical therapist was honest with me. I could keep running and trying to push the limits of my injury, but continued running was slowing/stalling the healing process. My IT-band pain was all about inflammation from continued rubbing caused by running. We tried stretches, strengthening exercises, heat and cold therapies, electronic stimulation, and even pulsed cortisone. It all helped with immediate, acute pain, but a little time off my feet (aqua jogging, mostly) allowed these other therapies to knock out the root cause and finally get me back on the roads.

Have you tried physical therapy? What lessons has it taught you about running?

Written by  Ashley Marcin.

Related Physical therapy for runners