Running injured: when giving up is not an option

If you were surprised to suddenly discover the joy of running during lockdown, you’re not alone. The combination of gym closures, home-schooling, and the prospect of waiting in for that next supermarket delivery, prompted many people to don their trainers, take to the streets and let off a bit of steam.

In short, recreational running enjoyed a mini boom during the pandemic. Some estimates say it increased by a third, as people found new ways to energise body and mind. Runners talk about the meditative quality of putting one foot in front of the other, and the calming effect of getting some space from work and family. Two years after lockdown ended, it seems the enthusiasm hasn’t abated.

The trouble is, the surge in the popularity of running has also led to a rise in injuries, according to Dr Robin Chatterjee, Consultant in Musculoskeletal, Sport & Exercise Medicine at the Institute of Sport, Exercise & Health (ISEH) and The Lister Hospital both part of HCA Healthcare UK.

"Rather than tell my patients to stop exercising," says Dr Chatterjee, "I try to understand any underlying conditions that might be making them more susceptible to injury." As well as treating the knee or ankle injury itself, Dr Chatterjee takes what he calls a 'macroscopic' look at their overall physical and mental health. 

"Whereas some doctors see a swollen Achilles tendon as a simple ankle problem," he says, "I look at the whole person, including any lifestyle or medical factors that brought upon this pain. At least half of my patients are actually experiencing a non-musculoskeletal issue manifesting in physical pain and injury, so we explore lots of different areas. It’s a very holistic approach."

For some patients that might mean treating a medical condition that may be causing a foot and ankle pain. For others it might mean adapting the training regime to reduce the amount of stress on bones, tendons and ligaments, choosing more supportive footwear, a better balance between exertion and rest, or addressing emotional factors.

"If a patient arrives with an injury from running three times a week for the past three months to deal with anxiety and depression, of course I'll start with an ultrasound of the heel itself. But I’ll also go beyond the tendonitis diagnosis to see how we can support the underlying anxiety, so that running is not their only resource." Dr Chatterjee says that might include referral to a psychotherapist or psychologist, stress relieving techniques, mindfulness, breathing and so on.

Dr Chatterjee’s practice is multidisciplinary – meaning he works regularly with other clinicians, including physiotherapists, podiatrists, nutritionists, psychotherapists, psychiatrists, gynaecologists, endocrinologists, haematologists, orthopaedic surgeons and rheumatologists. "I’ve got access to a huge amount of expertise, not only within my clinic, but across the whole HCA UK network," he says.

With a background in general practice, intensive care medicine and anaesthetics, Dr Chatterjee’s professional journey took him to the USA to do a fellowship in functional medicine, a systems-based approach that looks at the root cause of illness and injury. "I suffered from joint pains for many years that turned out to be intolerance to certain foods that was causing early wear and tear of my joints," he says. "The cause was missed for a number of years, so I fully understand what patients go through when they’re not treat holistically."

"Exercise is good for you!" he says. "It’s good for your heart, your muscles, and mental health. What’s key is to find the right way to exercise for you as an individual. And to know your limitations." And the best way to do that? "Get advice from a sports and exercise doctor or physiotherapist before you start," he says. "With a sound exercise plan that’s right for your body, your needs, your lifestyle, you’ll be much less likely to suffer injury."

Dr Chatterjee’s holistic assessment and diagnostic approach includes:

• Weight – – too much load through the joints increases the likelihood of injury. We explore any weight issues, including emotional, dietary or medical causes.
• Nutrition – dietary habits have an effect on pain and injury. We ensure the patient is getting the right intake of nutrients and minerals.
• Sleep – rest and recovery are critical for healing, but sleep is often hampered by pain, so we look at sleep hygiene.
• Physical activity – we consider type and frequency of exercise, as well as technique.
• Mental health – if the patient is running to manage their mental health, we look at how we can help them address their mental and emotional issues.
• Gynaecology – the menstrual cycle and menopause can affect pain, increase flexibility of tendons and ligaments and promote weight gain, which increases stress on the body. In turn, over-exercising can affect the periods. 
• Family history – heel and ankle issues can sometimes be genetic.
• Medication – medications and medical conditions can also affect pain and make the body more susceptible to injury. 

Find out more about our services for acute injuries or to book an appointment, contact us on 0203 733 5966