When 50-year-old Liz McHutcheon was prepping for the Boston Marathon this year, she visited her chiropractor once a week, her massage therapist just as often, and her PT as needed when a niggle (a common name runners give to minor aches and pains) reared its head and concerned her. In her words, the practitioners were all essential, because “nothing was going to keep me from running Boston.”

While the Massachusetts-based blogger/entrepreneur might be on the extreme end of regular professional maintenance, most runners find that having a Rolodex or contact list full of PTs, massage therapists and the like comes in handy. And these days, many runners will turn to any/all of the above before visiting a doctor.

There are a bevy of professionals serving up body work from which to choose. Different runners tend to have their favorites in the mix, and are often vehemently dedicated to their practitioner of choice. There’s no one-size fits all prescription, but the common thread is that most runners find they can bang out the miles more consistently if they have some sort of regular treatments in their tool kit.

The Options

McHutcheon says that at her age, having run off and on her entire life, maintenance is essential.

“When I get up into higher mileage as I do marathon training, I have imbalances that rise to the surface,” she says. “Getting professional help allows me to minimize the damage and continue training as I like.”

David Colafranceschi, a 48-year-old investment specialist from Ontario, Canada, is also a fan of this approach. He typically runs 70 to 100 miles or more per week, and says such body work is essential to remain at that level. “I use three practitioners and, on occasion, a fourth,” he says.

Every other week, he visits a chiropractor for an adjustment.

“I believe this keeps me balanced and is sometimes a good indicator of stresses in the body I’m not aware of, things that might lead to something significant if not checked,” he says. “My chiropractor was a former marathoner that broke the three-hour barrier after 60. I take all of his advice to heart and find him to be a great source of information and inspiration.”

Like Colafranceschi, most runners find that working with a professional who is also a runner can be helpful. Michael Conlon, PT, and CEO of New York City-based Finish Line Therapy, says that about 80 percent of his clientele is made up of runners and triathletes. “I’m a runner myself and as my business evolved, we zeroed in on this niche,” he says. “Word gets out in the community.”

Asking fellow runners for recommendations is often the best course of action when seeking some sort of treatment or assessment. Otherwise, the path to finding the right practitioner can sometimes be frustrating. “I spent a long time trying to find someone who understood runners,” McHutcheon says. “I finally found my massage therapist through PT and coach recommendations.”

When to Call a Doctor

Most runners will tell you that they will check in with a PT, massage therapist, chiropractor or even an acupuncturist before seeking out the opinion of a traditional MD or family physician. Whether it’s to cure a relatively minor ache, pain or soreness or just for preventive maintenance, it’s often easier and more effective to seek out a sports medicine professional as a first step.

“I have to be pretty desperate to see a physician,” McHutcheon says. “I believe I can figure most things out with my other go-to professionals.”

This is also how 58-year-old Mike Fronsoe, a longtime runner and owner of the Fleet Feet Sports store in Monroe, La., goes at it.
“I think most running-related injuries are preventable with sensible training and some rehab work to deal with imbalances,” he says. “An injury is usually the result of some piece of the chain being out of balance, and a PT, chiropractor or good trainer can address it before you need to see an orthopedic [doctor].”

Fronsoe admits he doesn’t find too many physicians who are as well versed on runners and their common injuries as other front-line professionals. “Physicians like to fix things,” he says.

Colafranceschi concurs. “I find that they are not in touch with runners’ issues,” he says. “The diagnosis is not as accurate and the treatment options are usually slow.”

There comes a point, however, when sometimes an orthopedic physician is the only option.

“Having a primary care sports (non-operative) medicine specialist on the list would be wise,” advises Matt Sedgley, MD, a sports medicine physician with MedStar Ortho and Sports Medicine in Baltimore. “Often these physicians can refer patients to PTs and the like who are experienced with runners. And if an injury doesn’t respond to a conservative approach, the physician will also know surgical specialists who would share the runner’s goals.”

In most cases, runners are looking for a practitioner who will let them continue some level of training as they pursue treatment.

“We’re rarely going to tell you not to run,” Conlon says. “We are movement specialists and we’re going to look for the root cause of your injury rather than treating just the symptoms.”

It’s this philosophy that keeps McHutcheon returning to her crop of professionals rather than a physician. “I haven’t found a doctor yet who is in line with my core beliefs and values,” she says. “They might say stop running, which isn’t an answer to me. All the practitioners I saw before the marathon had the same goal in mind: get me to the starting line.”