This past summer, I had the fortunate opportunity to be a guest at the Oiselle Northeast Bird Camp up in New Hampshire. For those not familiar with it, it is a three day running camp for women of all ages, abilities, and backgrounds. Over the course of three days these women not only run together, they become a close knit community while attending educational seminars, sharing meals, working out, bonding and laughing. The weekend is centered around becoming a better, healthier, happier runner and person.
I was asked to come to share information on a topic I am very familiar with; running injuries and running injury prevention. In addition to lecturing, I was able to lead a group of 158 women in an introductory RUNstrong Class out in a beautiful field in the hills of NH. As expected, the participants were very excited, involved and eager to learn more about improving their running and decreasing their risk of injury. One focus of this session was increasing glute strength. And believe me we did some #birdbunsofsteel exercises!
After the lecture and group class I had a chance to spend some one-on-one time with 37 of the participants. This was a great opportunity to address personal questions and concerns about running shoe selection, injuries and pain, or assess running form. With this opportunity to talk with and evaluate so many similar women, I noticed some patterns and similarities among the group:
#1. Women WILL NOT stop running unless it will lead to death or dismemberment.
#2. Most of these 37 women have been misdiagnosed by several healthcare practitioners and not provided with the education and guidance needed (and deserved) to properly address their issues. Running injuries are hard enough to treat, and when you add the slightly more challenging mechanics of the female body, it gets even more challenging. We as healthcare practitioners need to assess them properly, listen to them carefully, and treat them non-judgmentally in order to have a shot in helping them reach their goals..
#3. Many of these women are mothers and as with many postpartum women, have had a difficult time regaining their body’s health and fitness after delivery. What I have found in my 20 years of practice treating postpartum runners is that deficits tend to show up 1-3 years after giving birth. This is the time when most women acclimate to parenthood and are more free to dedicate time to work on their own health and fitness. When activity levels increase, those underlying deficits that originated during pregnancy, such as instability and weakness, begin to culminate into more serious injuries. The chronicity of these injuries becomes much harder to address because they have become ingrained in day to day patterns and compensations have taken over. Finding these issues sooner after delivery is paramount.
In addition to this, the determination, motivation, and sheer will of these women to push through to regain a sense of self can sometimes lead to poor training decisions. They will ignore and overlook aches and pains that are a sign of something more serious. Well we all know if we ignore and do not acknowledge an issue it goes away right? WRONG! A good assessment of the body, the person, the lifestyle, the job, the duties, and the attitude is needed to overcome and succeed.
#4: The occurrence of high hamstring/gluteal pain was significantly high (almost 50% of the 37 women). This is a common injury among all active people, especially women. I’ve heard many stories that weekend and over the years of women battling to find the cause and the resolution to this “pain in the butt”. Story after story involves the suggestion from the medical world to “just stop running” and, offering medication and injections as a solution. Time and time again these women were casually told NOT TO RUN, without the realization from the health care practitioner that running is a vital part of their lifestyle: a mental, emotional, and physical necessity for them. If one is to make this recommendation one needs to be ready to offer specific reasons why, and better have ideas for alternatives/cross training, and better have a good timeline and longterm plan. Rest is not always the answer to the problem.
Though this can be a difficult area and injury to diagnose and treat, with time and patience it can be done. The resolution is not “one size fits all” because the contributing factors can be so varied. Including: abdominal weakness, pelvic instability, lumbar instability, sacroiliac joint instability, weakness, hormonal influences, posture, flexibility, foot mechanics…and the list goes on.
#5: As a husband, father, son, and brother, I have witnessed many women in my life overcome obstacles and roadblocks greater than I could imagine. I’ve learned through experience that “you cannot keep a good woman down” as they say. We in healthcare and fitness are here to educate, empower and guide these women to help them achieve their goals and attain better health, function and performance.
It’s weekends like this that remind me how valuable our relationships with our patients are and how important it is to listen, not judge, and look at our clients beyond the injury to truly help them. These interactions are what keep me motivated and inspired each day to do the work I love.
Michael Silva, MS, PT, CSCS