It's Just a Step To The Left...

No, this isn't doing the "Time Warp!" I'm more interested in my runners who come in complaining about foot, ankle, shin, knee, or hip pain ON ONE SIDE. Here in Houston, TX we have major drainage issues, so all of our streets are banked.

So when runners come into my office, they have done online searches and have a million reasons why they are hurting. They have bought all sorts of supports and liniments to make them feel better...but they don't seem to work. They come in complaining of their IT band hurting, or some shin splint pain on one side and expect me to run a whole barrage of tests to tell them in a high-tech way why they hurt and how to solve it. Then, after I listen to them, I ask the most important question:

What surface are you running on?

Invariably I'll hear an answer that they're running on the side of the road, or another similar uneven surface. I watch as they brace to hear a lecture on how "asphalt is a terrible surface" or "never run on concrete." Instead I ask my next question:

Where on the road do you run?

This is a loaded question...I know pretty well that they're not running in the middle of the road (if they were, there would be bigger problems than limb pain). They're, of course, running harmlessly on the side of the road. A-ha!!

When someone runs on the side of a banked surface, like the local Houston roads, they are essentially creating a leg length difference. This will cause the two feet to function very differently. One limb is going to compensate by attempting to lengthen and the other is going to shorten. A significant imbalance will result and can cause a variety of pains. My great wisdom for these runners?

Take a step to the left...

That's all? That's what they came in for? Well...yes. Sometimes a simple change makes a huge difference. By running on a more even surface, it allows for a more stable and even base and doesn't overwhelm the mechanics. My advice is to not take time off. Nurse the injury with ice and some anti-inflammatory medication, and be more aware of where they're running. I ask them to call me in a week to tell me how they're doing.

The results are amazing! A small adjustment like this causes the lower extremity to even up and makes a huge impact on the biomechanics. The pain gradually improves with essentially no time away from training!