Phoenix physical therapist Dennis Schepmann, of Jackson County Physical Therapy, watches Medford runner Gina Jones do a plank exercise to strengthen her core. - Photo by Denise Baratta

Fixing the weak link

The human body is like the chain that is only as strong as its weakest link, and runners are notorious for pushing the body beyond its current level of strength. When a link breaks, some runners look to the West to find a path back to health, some look to the East, some look both ways.

Physical therapy, a structural approach from the Western world, is one way to repair and strengthen that weak link. Acupuncture, an energy approach from the East, is another.

"In physical therapy, we work on stretching and strengthening," says Justin Carson, a physical therapist with Jackson County Physical Therapy. "We start off with video analysis of the running form. Is there excessive hip or knee rotation, pronation? Video can identify weak areas for muscle strengthening."

"In traditional Chinese medicine, the intent is to move stagnation," says Clark Zimmerman, co-owner with his wife, Ann, of Middleway Medicine in Talent. "Trauma causes stagnation of chi and blood. You see it as swelling, water retention, pain."

A runner is often referred to physical therapy by a foot and ankle doctor, or podiatrist. The doctor may fit the patient with a custom shoe insert — an orthotic — to address genetic biomechanical problems, like a difference in leg length.

Patients often come to Carson after damage to muscle and connective tissue. The most common problem he sees is plantar fasciitis.

"If you stand a lot at work, have tight calves or are overweight, you're at risk for plantar fasciitis. High-impact sports, like running, can trigger it. Walking barefoot makes it worse," Carson says.

The plantar fascia is the muscle layer that connects the calcareous (heel) bone to the toes. When the calf is tight, the plantar fascia tear away from the heel, causing heel pain. The first indication of this condition is usually pain with the first steps out of bed in the morning or after running.

The solution, says Carson, starts with stretching the plantar fascia themselves.

"Push the toes up (toward the shin) for a count of three, then release for three and repeat. Do this before getting out of bed," Carson advises. He also suggests using the "Power Step," a soft, over-the-counter, full-length, shoe insert with flex arch support that acts as a shock absorber. Alternatively, try wearing soft rubber sandals — like Tevas.

The purpose of all these suggestions is to prevent further tearing of the fascia while they heal.

Even bone injuries may benefit from physical therapy, as Gina Jones learned.

The 29-year-old Medford woman was training for a marathon and increased her weekly mileage rapidly. She began to experience sharp, localized pain while climbing stairs.

"I had stress fractures in both tibias (shin bones). I went to an orthopedist, but I wasn't getting better. I thought something might be wrong with my gait," Jones says.

After she healed a bit, she went to Jackson County Physical Therapy for a gait analysis.

"They focused on my form. One arm swung out, one hip dipped. I had weak (hip) abductors," Jones adds. She was given a series of exercises, including toe raises and "side planks" — leg lifts performed while lying on the side to strengthen the hip abductors.

"Now I only run on trails and the track (they're softer than roads), every other day," Jones says. "Last weekend I ran my fastest 10-miler ever."

Eastern medicine presents a completely different approach and can offer runners rapid results.

"Six months after an auto accident, I saw no improvement (going to a doctor)," says Mike Davis. The 49-year-old Talent runner decided to try acupuncture for relief of injured stomach muscles and found his way to Middleway Medicine in Talent.

"I went at my wife's suggestion. She'd had success for neck and shoulder pain. I noticed a difference after one treatment. With three treatments in the first week, I had 90-percent improvement," Davis recalls.

In Chinese medicine, "chi" is a vital, electric form of the life force that travels throughout the body along fixed meridians. By placing acupuncture needles at key points along these meridians, the flow of chi can be enhanced and unblocked, says Zimmerman.

"Acupuncture excels at reducing and stopping pain," he says. "For runners, it's especially effective for soft-tissue injuries. We may also use Chinese herbs. That reduces swelling, moves chi and blood and can expedite the healing process with no side effects."

Chinese herbal formulas are unlike Western drugs: they have no side effects, says Zimmerman.

Acupuncture can speed up healing and reduce pain. Physical therapy can prevent the problem from reoccurring. They make a powerful combination for treating running injuries.

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