Diagnosis and Treatment of runners using treadmill as a tool
Many runners have injuries from the way they run, or by hitting an uneven surface on the road or on the trail which produces a painful problem for them. The most frustrating thing for them is to find a solution so they stop hurting.
When we evaluate people for running injuries, most of the tests we perform in office give us a good deal of information and the procedure is to evaluate, treat, challenge, treat and repeat. Unfortunately, insurance companies do not have an appropriate way for a doctor to appropriate an hour of their time to enable them to go through all the possibilities with a patient. I have done this often by taking care of them, having them run around the block a few times and then reevaluate to see if the problem we are taking care of resolved. It is still quite difficult using the insurance model to often give adequate time to fulfill the needs of a patient. Some doctors, like myself will schedule the patient at a time where they can give the time ( not reimbursed ) to adequately test out the problem until the patient finally feels relief on that visit.
More and more, people are now bringing in videos of them on the track. It allows me as the doctor to see how they are running and to spot possible problems that my other analysis would not see. Ultimately, the best tool to have is a treadmill, which I have in my home office.
This past weekend, I had a patient who was having a problem after stepping on something during a run that twisted her ankle. She stated that her calf by the knee was in pain after that. Her past two visits were helpful but she still had to stop running after a mile or so due to pain. I suggested she get on the treadmill after working on her problem. After turning up the speed, it was obvious her lower body stride was good but the upper body had much more rotation on one side than the other. I worked on a number of things and had her get on again, while I took care of her husband who had some other problems. I was determined to help her get through her race in two weeks, and time was not on our side. After working on her husband, she noticed that her calf began to get sore again but felt greatly improved, and on the treadmill, it was obvious her upper body was moving more appropriately. She also noticed she was not working as hard.
This is an example of treadmill diagnosis. I really could not see this problem unless I stood on the side of the treadmill and watched her carefully. I also looked at her symmetry in both the upper and lower body as her speed increased on the treadmill. Symmetry in runners is vitally important and a lack thereof will often cause injuries to occur. The worst part about this is that the treadmills they have in the running store would never pick up a problem such as hers because they focus on the feet hitting the treadmill from the back and nothing else. This type of problem in the upper body would surely have been missed without visually watching the person on the treadmill
Treadmills can be quite helpful in diagnosis of a problem. Perhaps, we may eventually put one in the North Brunswick office as well. It is a great tool to help us diagnose running problems that fail to resolve with our best efforts. All we need is time.
What do you think? As always, I value your opinion. Email me directly through the web site or at email@example.com