Something I am asked about often is how I stay injury free. While I am certainly not an expert on this, two of the things I do the most that have helped me the most are Shockwave & Active Release Therapy. Both were things I tried as a “last ditch effort.” Aka at the end of my rope, I’ll try anything, I’ve gone to every other doctor. Both have been things that have been integral to keeping me on the road.
My first experience was with Active Release Therapy. I had a very cranky IT band, which I had run on and really pissed off over a number of weeks. It took about 10 weeks of visits to get me back to completely normal, and then I spaced it out to 2 weeks between visits, 3 weeks, ect – now I go every 6 weeks (or more if needed).
So what is Active Release Therapy?
“ART is a patented, state of the art soft tissue system that is movement based.
The technique is used to treat problems that involve the muscles, tendons, ligaments, fascia, and nerves.
ART uses the examiners hands to apply the technique. The main goal is to reestablish proper motion between muscles and fascia while reducing fibrous adhesions. Ultimately myofascial (muscle and fascia) and neural (nerves) glide is reestablished allowing for proper function.” (Source)
The way it was explained to me by my doctor is that you build up almost like a scar tissue (adhesions) when you are using your body and the muscles and nerves are gliding and moving the correct way. So for example, if you have a weakness in your hips, which allows your knee to collapse in while you run, your body builds up scar tissue to try to correct and balance out this imbalance.
I have also had ART treatments for plantar fasciitis, my sciatic nerve & my hips. My hip joints used to swell up to the point that I couldn’t walk comfortably after running 15+ miles. I now feel no pain in them when (or after) I run, or even race a marathon.
(In a lot of pain in this picture, but not in my hips LOL.)
The next treatment I tried was Shockwave Therapy. Thankfully, my ART doctor has a Shockwave Therapy doctor (his wife!) right in his office. My ART doctor and I had been working on my right foot weekly. I had a stress fracture back in February of 2016, and although it had healed, it was still giving me trouble. The sesamoid bone in my foot tends to swell up – this happens especially if I wear high heals to work – and then running or even walking too much can aggravate it. I was sort of maintaining it by going to my ART doctor every week (which was cost prohibitive) and sleeping with my ice pack on my foot. He suggested trying Shockwave Therapy to see if we could get a better maintenance solution.
How does Shockwave Therapy work?
“The application of shockwave therapy creates capillary micro-ruptures in tendon and bone increasing growth indicators; eNOS, BMP, PCNA, and VEGF.
This stimulates the growth and remodeling of new arterioles. The new blood vessels improve the blood supply and oxygenation resulting in faster healing of both tendon and bone.
As a result of the increased collagen production these new fibers are forced into a longitudinal structure producing stronger tendons.
Shockwave therapy is also known for breaking up calcium deposits found in calcific tendinitis of various joints including the shoulder.” (Source)
The way my doctor explained it to me is that it is kind of like lifting weights for your tendons and bones. When you lift weights, you create tiny tears that have to heal themselves. This creates tiny ruptures in your tendons and bones, which then promote healing and new growth of tendon/bone fibers. Additionally, they grow back correctly – so they are stronger than before.
When I get a Shockwave Therapy treatment, the doctor moves the “wand” thingy (you can see a picture here) over and around the area that is bothering me. When she gets to the part that needs treatment, it “lights up” in terms of pain. Meaning the shocks don’t really hurt until they get to an area that they are needed. They are also more painful around areas where there is just skin and bone (i.e. the top of the foot).
One thing that I really love is that Shockwave Therapy helps prevent stress fractures by strengthening the bones.
I’ve largely had Shockwave Therapy for my foot, but I’ve also had it for hamstring issues and those huge knots you’ll get in your calves sometimes.
I cannot say enough what a huge difference these two treatments have made in my running life. I would recommend them to anyone with any injury, and also for preventative measures. The moment I feel a twinge of any kind, I call the ART/Shockwave doc. You can find an ART provider here. For a Shockwave Therapy provider, you are going to have to do some web searching for your location. I’d start with asking your ART provider and go from there.
Overall, some things to remember and questions I’ve been asked:
- Consistency is key. You can’t just go once and expect to have your problem fixed. For all of my “big issues” it took 6-10 weeks of weekly appointments or even 2-3x weekly. If you can find someone in your location, that is ideal. The treatments don’t take long, but being able to go a couple of times a week really spend up the healing process.
- Is it expensive? Yes. Both treatments cost about $90 for a 15 minute session.
- Is it covered by health insurance? It depends on the doctor and your health care plan. In my opinion, it is worth it even if its not covered. Some offices will let you get a plan or a bundle of appointments to help save money. If we didn’t have a way to afford it, I would start driving for Uber or Lyft LOL. Not kidding.
- Does it hurt?
- ART – It is kind of like a really intense sports massage. So, its not comfortable. If you are having pain in a particular area, its not going to feel great. But the more you can get done while you are there, the more beneficial it is. I always figure I can handle a lot of pain if it is just for 15 minutes. When I first started going, I would have pretty gnarly bruises on whatever body part they were working on. Could have cared less, because it actually works.
- Shockwave Therapy – Yes, it does hurt, but like a 5/10. All the websites say it shouldn’t hurt that much. It shouldn’t hurt to the point where you can’t handle it, your doctor should be working with you on that. Again, if you can handle more pain, the more work you are getting done. The top of my foot hurts like crazy when I get this treatment, but there is also a lot of work to be done there. Additionally, there is no padding on the top of your foot – its just skin right over the bones like I mentioned before.
- My doctor has always told me NOT to train, foam roll or do too much stretching on the evenings I get this done. I always do my run/lift/whatever before the appointment. Then at night I just take it easy instead of the normal foam rolling while I watch TV. If you are someone that does doubles, I would recommend making your second work out swimming or something low impact on the day you get this done.
- Drink a lot of water on the days you have appointments – this isn’t written anywhere, but my doctor has mentioned its helpful to by hydrated, which I have a hunch is just a good health recommendation overall.