Reading comments on the site recently has drawn my attention to many people struggling with persistent running injuries. In clinic I see a lot of patients for second opinions, many who still struggle despite long periods of treatment under several different clinicians. So I’ve decided to do a series of short pieces examining the question, “why am I not getting better?“…

If things aren’t progressing as you’d hoped the first question you might want to ask is, “have I followed the advice I was given?“. If the answer is, “no” you won’t be alone; studies suggest as much as 65% of patients don’t do their exercises as instructed. It’s also important to ask why you haven’t done it. Don’t feel guilty though, there’s no blame here you just need to be honest with yourself. Here are some common reasons;

  • I wasn’t sure exactly what to do
  • There was too much in the programme
  • I didn’t have the time
  • I couldn’t see how it would help
  • I’ve had conflicting advice
  • I did it for a week or two but nothing changed

These reasons are totally valid. Speaking from personal experience it is hard doing rehab and it can be a challenge fitting it all in. We all encounter hurdles in rehab, don’t be stopped in your tracks, work out a way over them! Speak to your physio/ health professional for guidance;

  • Have a Q&A session – make a list of questions and be honest about what you need to know and what’s realistic for you.
  • Clarify the finer points – e.g. exercise reps, sets, load and frequency – Does it really need to be done daily? 2-3 strength sessions a week can be very effective. Get written instructions and pictures if possible. If you have a smart phone ask your physio to video you doing each exercise and provide instruction and feedback.
  • Prioritise – in many injuries 3 or 4 key exercises can be sufficient to make a significant difference. While a comprehensive 20 exercise programme might make sense can you really fit it all in?
  • Remove the barriers – for example if your programme involves regular gym sessions but it’s always a nightmare to get there (or you hate the gym!) can your therapist give you exercises to do at home? Are there cost concerns, pain during the exercise, or simply lack of motivation? Discuss these with your physio to find a way over these hurdles.
  • Give it enough time – most rehab programmes need around 6-12 weeks to be effective. This can be frustrating but sadly there’s no magic bullet.
  • Plan a gradual return to running – a stumbling block here is the word ‘gradual’, to you this may mean something very different than your physio. Discuss how quickly to return and what to expect in terms of symptoms. Don’t rush back too quickly, this often causes setbacks.

There are no quick fixes with running injuries. In many cases it’s a question of modifying your training to a manageable level and building strength to increase how much running your body can cope with. As good as your physio is they can’t make you stronger, you need to do your rehab to achieve that. To get better you need to follow the advice and treatment plan provided and give it enough time…

…if you’ve done this and you still aren’t improving, maybe the treatment plan isn’t correct or you need a second opinion which brings us to part 2…

It’s not me, it’s you!…