Runners Push Past Injuries to Reach Boston Marathon
Two years ago, Jennifer Elton set her sights on the finish line of her first marathon. For many, that's a lofty goal, but for Jennifer running mile after mile at an 8:30 pace was achievable. Her finish time in her first marathon was so fast she qualified for Boston. The only hitch was a pain in her foot that she describes like running on a rock in your shoe. “It just started being tender at the bottom of my foot when I would run,” Jennifer explains. “And then afterwards it would be fine, wouldn’t hurt me the rest of the day.”
That was six months ago, but as the calendar closed in on the Boston Marathon, the pain got worse. Six weeks before race day her foot was so bad all her running had to be done in the deep end of a pool. She was referred to Center for Diagnostic Imaging for help.
Treating Long Distance Runners
“We generally have a glut of people who come in around the time when they’re training for the Boston Marathon and then the runners who are inspired by the Boston Marathon and want to run afterwards,” says Dr. Joel Newman, a CDI radiologist in Boston who specializes in musculoskeletal imaging. Often those runners come in with stress fractures of the foot. That’s when Dr. Newman says an MRI gives patients a leg up. The MR scan helps him diagnose stress fractures earlier than he could with an X-ray.
Stress fractures fall into the category of over-use injuries says Dr. Kathryn Grannatt, an orthopedic surgeon in Needham specializing in sports medicine. She also treats a lot of chronic muscle strain, hamstring injuries and arthritis in runners. But when it comes to stress fractures, she says the combination of intense use and low bone strength can cause problems, especially for female runners. But it doesn’t always stop them, especially when it comes to the Boston Marathon:
“People run it no matter what, I’ve found.” –Dr. Grannatt
It’s common for a stress fracture to come with a diagnosis of osteopenia or, in more severe cases, osteoporosis. Low levels of the hormone estrogen can be to blame. “Women that train intensively may produce abnormally low levels of estrogen, which in turn, may lead to weakened bones,” reports the Running Times. Because of weakened bones, Dr. Newman says extremely fit female athletes can injury themselves repeatedly. “Their bones are actually more brittle due to the weight loss and some of the hormonal issues that occur.”
The best way to prevent the loss of bone density can be weight-bearing exercise, but that can present a problem. “In a long distance runner or athlete,” Dr. Grannatt says, “They may not be consuming enough nutrients to make up for the fact they are putting so much stress or pressure on their bones, so the bones don’t have time to repair and regenerate.”
Back Up and Running
Taking the time to repair and regenerate isn’t easy for many runners. Rest can lead to anxiety and depression because they can’t do what they love says Dr. Grannatt:
“Mentally it is very important for them to keep training and so they are uncomfortable with not running.”
Nobody knows the essence of time like a marathon runner who pushes through every second of a race that can last more than 3 hours. Try telling an athlete like that to take 3 months off training. Catching and treating injuries early is key. “My goal is to get them back to doing what they want to do as quickly as possible,” says Dr. Grannatt. “But depending on what kind of injury it is, they may need a certain amount of downtime.”
Downtime doesn’t translate very well for Jennifer, who has an approach to recovery that is almost as aggressive as her training schedule. While she’s injured, she finds alternate ways to train and says there’s no way she’ll miss the Boston Marathon. Instead, her plan is not to run it “very fast.” Jennifer admits some people don’t understand her attitude:
“Oh they say I’m crazy all the time.”
But among athletes, her drive to compete is the norm. “When we’re hanging out with all the people who do what we do, I don’t feel crazy at all,” Jennifer says laughing. “It feels totally normal. But I’ve always been a competitive and highly driven person anyway so to me it’s normal.”
With an Ironman competition on her calendar this summer and plans to someday qualify for the ultimate Ironman in Kona, Jennifer tries to balance her hopes of healing and her long-term goals. Dr. Grannatt says that’s important for any injured athlete. Rather than thinking about the downtime, she suggests focusing on what it will take to get back to a sport long term. For injured long distance runners, that means the most important race to win is the road to recovery.
About Dr. Newman:
Joel S. Newman, M.D. is a board certified body imaging and musculoskeletal radiologist at Center for Diagnostic Imaging (CDI) in Massachusetts. Read his full bio here.
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