Drug-Free, Surgery-Free Pain Relief for Trail Runners?

How do you deal with running pain without resorting to drugs or surgery? We’re looking for options beyond the obvious such as rest, ice, and traditional physical therapy – an option that many, though probably not enough runners consider … or at least not soon enough. We’re look to hear what else you rely on to rid yourself of running induced pain!

  • Do you regularly get massage therapy?
  • Do you go the acupuncture route?
  • When the aches come on do you reach for an herbal salve?
  • Do you roll on some tape before your runs?
  • Do you get PT that works something seemingly unconnected to the injured spot?
  • How about putting magnets in your shoes?
  • Does some other drug-free, surgery-free treatment get rid of your pain and back on the trail?
  • What about any that you’ve tried that failed epically?

I had intended to publish a discussion piece along these lines in tandem with another story, but the concept has surrounded me of late so I figured it was time. iRunFar contributor Meghan Hicks has been getting chiropractic adjustments to relieve back tightness with success… despite her skepticism. I noticed Anton Krupicka has been getting acupuncture for his knee. I also recently learned that the key to getting rid of my plantar fasciitis long-term might reside with restrengthening the very distant gluteus medius.

KT Tape - plantar fasciitisWhat really drove home the possible validity of alternate therapies was my recent experience with KT Tape, a brand of kinesiology therapeutic tape. I’ve been wearing it for two months, but have never been sure whether it was helping my plantar fasciitis… and then I didn’t wear the tape for two and a half days last week. That lapse combined with a few easy miles was enough to irritate the fascia. All it took to end the irritation was to reapply KT Tape. A few hours later the irritation eased and I’ve been better since. (See my handy work to the right.)

Before the PF first came on last autumn I started mixing in some cycling. Oh boy, were did those cycling specific support muscles get sore! I tried Salus Muscle Relief Gel – a blend of arnica, capsaicin, aloe, menthol and essential oils – and was impressed with its light analgesic effect. That effect is not all that surprising considering the product is a “drug” in the US due to the inclusion of menthol and the claims made for the product.

That brings up the interesting point that many “herbal remedies” are drugs by another name. There’s no need to shun the products, but they often contain the same active ingredients or work based on the same biological or physiological principles as pharmaceuticals. Likewise, many “alternative” invasive or manipulative therapies bear likenesses to western therapies or bear similar risks.

As a finale, I feel it prudent to comment that I am neither anti-drug nor anti-surgery. There are surely times when pharmaceuticals (over the counter or prescription) or surgery are the prudent course of action to ease a runner’s pain. I occasionally take a short course of non-steroidal anti-inflammatories (NSAIDs) to nip the recurrence of an old injury in the bud or to stop a new one in the tracks. I do not and would not recommend chronic use of NSAIDs as a crutch to keep running through pain. If you have a chronic problem, it’s time to treat the cause, not the symptom.

Comments?
Feel free to respond to any of the comments I posed with your own experiences with drug-free, surgery-free running pain treatments? Also, feel free to comment on any of our later thoughts.

[Uuuuuh, I’m not a medical professional of any sort so none of the preceding should or can be perceived as medical advice. I’m just trying to start a conversation. Medical professionals of all sorts should feel free to chime in on their own behalves.]

There are 16 comments

  1. Anthony

    I have heard good things about Active Release Techniques (ART), many chiropractors are getting certified. A lot of Triathletes seem to like the results.

  2. J

    I am, in general, highly skeptical of "alternative therapies" like chiropractic, acupuncture, magnets, etc. While they may show some effect in small uncontrolled trials, they show little or no effect in well controlled randomized, double blinded trials–in short, the more rigorous the research, the less likely one will actually get a therapeutic effect.

    Many of these therapies "work" because of the placebo effect–this is common when outcome measures are based on the subjective experience of pain (or mood) rather than bio-markers. For instance, fake acupuncture (needles randomly placed rather than placed in meridians) has the same effect as "real acupuncture." Sugar pills create the same effect size as herbal and homeopathic "cures." Unfortunately, the sport I love is laden with pseudoscience. Stick with the basic (and well researched) methods: rest, ice, and science based therapies.

    No, I do not work for big pharma or the medical establishment. I just don't think we should spend millions (or billions) of dollars a year on snake oil.

  3. DM

    Great topic! I have been using the 830 Laser on many trail runners with great success. It works best on acute tendon and bursa inflammation, but will work on plantar fascia inflammation as well. (When used with an overall look at the foot for flexibility, strength, arch height, shoe choices, running surface, etc.)

    Another tool that my patients have found helpful has been the Gait Analysis program – a two hour comprehensive look at how one runs, complete with a report of strengths and weaknesses, and a DVD review of gait patterns.

    (Check out http://www.archerpt.com to learn more.)

  4. Sarah

    I'm thinking about trying Rolfing for a glute/psoas/hip flexor problem I've been having for the last 6 months. Has anyone tried Rolfing before?

  5. Max King

    ART has been great for soft tissue issues for me and others I coach provided there isn't something "up the chain" structurally that will cause the problem to reappear. 2-3months of 1/wk ART treatments took care of my plantar fascia for good while still running 100+mi/wk and workouts in spikes.

    If you do have structural issues as well (re-occuring injuries in the same leg popping up as different symptoms such as plantar fascitis, achilles tenodonitis, IT pain, etc) a method called MAT (muscle activation techniques) has helped me tremendously. It's a long slow process but well worth it. For me a lot of it stemmed from weak and inactive glute muscles.

    1. Bryon Powell

      Max,

      Don't you have a NACAC championship that your should be celebrating?! Congrats!

      Anyway, thanks for your insight. I'll have to check into whether there is anyone practicing ART in the nearby Sierra foothills. This PF drives me crazy. I wouldn't mind if it killed me, but I'm held at bay by the fear of a relapse!

      I've just started some glute activation exercises and was shocked at how weak they were. I thought I had a well muscled lower body… it turns out that musculature is pretty selective and out of balance. Time to get working!

  6. Martin

    This is a great column, Bryon! For those of us who don't do it, where do you find correct taping technique?

    Personal history, let's see….

    1) Shin splints — solved with rest

    2) Sciatica — solved slowly, and by foregoing any toe-touches

    3) Plantar fasciitis — solved with better insoles

    4) Iliotibial band syndrome — solved by rest and never repeating runs on the same off-camber surfaces

    5) Metatarsalgia — not solved yet :( but helped by staying off all concrete sidewalks

    That doesn't make me a doc or a medalist, but neither have they haven't kept me from running. Just a few lessons learned:

    1) If you know the problem is going to come back, rest until the pain is ALL gone. Make it Job #1. You actually have two weeks before your body begins losing its conditioning, so don't freak. Take the time to figure out what you were doing wrong and how not to repeat the same mistake. Besides, your next run will feel awesome.

    2) Get the shoe support you need, but don't go overboard. A gait analysis will probably tell you stuff you didn't know. Yes, you pronate, but you're not a heel-striker, you don't have flat feet, and you don't need Dutch clogs to make sure you're planting your foot correctly. By all means, make the trip to Roadrunner Sports for the gait analysis AFTER you take a long run, to make sure your feet are reacting well to what they're being put into. More important: Shock absorption isn't all you need in a shoe. More subtle things like how badly exaggerated the arch is in the shoe will make the difference between finishing your long runs comfortably and finishing with numb feet. Finally, the right insoles are God. (I think you've convinced me to try tape, too!)

    3) "Dynamic stretching" is the way to go. Google it. It will really cut down the number of runs in which you leave the gate feeling fatigued. These days, a good warm-up or warm-down is between 60-100 leg kicks. The NYT's "Well" blog had a nice article a while back on dynamic stretching. The same blog had a great report on alternative ways to build your "core" that don't put your back at risk while doing them.

    4) Two aspirin are pretty harmless AFTER a run, according to nearly all MDs. Anti-inflammatories are a very bad idea BEFORE a run, says the latest controlled research. (Also check the NYT Well blog for that cite.) Also, there's no evidence that BenGay and other such remedies have any medical effect.

    1. Bryon Powell

      I, too, avoid anti-inflammatories before a run. Even if two NSAIDs might not cause kindey/liver issues during a normal run, I want to feel my body's own pain feedback system!

  7. Adam

    I had to train barefoot for a few months last summer to strength my feet. I couldn't run more than 5k with brutal shin splints. I'm up to ~70+k per week an no pain and running ~12-13km/hour. I can run with shoes now but I use my old squash shoes and rip out the insole and tie them up loose. No pain and no injuries in the last 10 months. I had to go through some muscle pain while my body adjusted to not having shoes but it was more like pain from a good workout instead of pain from an injury.

  8. DavidH

    A few things I have explored:

    – Sore No More Salve: I have used this for knee tweaks and periformis issues. I feel it has helped at times. My wife has also used for a muscle strain and headaches.

    – Foot log – This has helped for tight tissue on the bottom of my feet. I use it every morning on wake up and before bed. Goofy site but the thing works. My feet just feel good after using it.

    – Acupuncture – Knee tweak prior to Boston marathon and the discomfort was mostly gone after one session. It seemed to help.

    – Chiropractor – For knee tweaks and general maintenance. I have had some success.

    – Supplements – Tissue Rejuvenator type products. Honestly not sure if helped or not.

    – Far-Infrared heat – A friend of mine has had great success with an Achilles issue. I have used for any area that could benefit (ex: Achilles and knees) for additional blood flow after inflammation has gone done. I feel it has helped in the recovery process.

    – Eating quality fruits, vegetables, proteins, and fats – I can't see how this can't help.

    – Homeopathy – Arnica for inflammation. I seem to have had some success with this.

    – Mental imagery – Focused thought to a specific area of concern.

    – Stress reduction / management – Again, I can't see how this can't help.

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