Why Runners need to take a page out of their automobile maintenance manual when it comes to running injury prevention.
Tissues have limits. They are like a tire, they only have so much tread on them before they show pathology. But like a tire, it takes time for a wear pattern to show up enough to make the tire wobble or the axle to pull the car mildly towards the ditch. Take a spinal disc, it has a certain number of compression and load cycles before it begins to desiccate, especially in the higher load / transition zones of the spine. Cartilage has a certain number of cycles before it begins to desiccate and crack/fissure and flake. Osteoarthritis then begins its slow sneaky onset. Tendons and ligaments have the same “limited lifespan” especially if loaded imperfectly with strained joint loads. Just because someone is pain free doesn’t mean they are safe. The abnormal load on an ITB band doesn’t begin the moment that pain presents itself. The problem brews in the background long before there is pain. Pain and injury represent a failure point in the mechanism. At this point it is too late. Being in medicine, we would be just like all the others if we crisis managed every athlete that walks in the door. So, we are in the game of prevention. We know our biomechanics, we know our orthopedics, physiology and neurology as good as the best out there. And so , we are well positioned on the front lines to identify problems before they ensue, and pick up on that aberrant wear pattern on the proverbial “tire” long before the pattern of wear is so bad that an injury is immanent and a foregone conclusion. So, this bodes the bigger question, just because you are injury free for many marathons and decades, doesn’t mean you shouldn’t take your car in , have its tires rotated, lug nuts snugged up, and alignment tweaked so that your car’s life will be maximized. Remember, unlike a car, we get one set of tires. We cannot replace bolts, we cannot remove the rust or put in a new oil or air filter. All we can do it make sure our “car” , our body, is working as best it can with the anatomical parts it has.
We do not think anyone would disagree that leaving alone and ignoring a 99% stenosed artery in the heart’s “widow maker” artery is a good idea just because someone hasn’t had a heart attack yet. Checking the body for malfunction early can prevent some unpleasant problems down the road. Pain or tightness is the dashboard’s “check engine” light. Regular check ups should keep that light off and reduce the sudden anxiety that comes when it turns on.
In summary, we take our cars in for tune up maintenance 2-3 times a year. And usually we drive away without the car driving too much different. But, we are at ease knowing it is in tip top shape and can go another 6000 miles before it might show signs of wear. We should do the same with our body and our gait mechanics and fix and change the little things that are sneaking up on us that could trigger that “check engine” light. By the time it comes on, it could be too late and require major repairs which just might keep your “car” off the road for awhile while repairs are made. No one likes to hear from the mechanic, “well Mr. Jones…….if we had checked up on this earlier before it was a big problem, we could have prevented this expensive set back on the sidelines.”
Our bottom line, even if your running is pain and injury free for years on end (which would make you a rare bird as runners go), it should make sense to you that improving biomechanical deficiencies isn’t likely a bad thing for the long term. Rather, it is probably the smartest of choices to keep you on your journey down the road, around the next bend, one efficient step after another.
“An ounce of prevention is worth a pound of cure”. -Ben Franklin
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