The Power of Listening: It’s Not Just a Running Injury

Before we even start our session I look over the new patient paperwork. When I read through it I can already tell that she has been dealing with her hip pain for far too long. She has been through the medical system ringer, tried everything she has been told, and far more with no results. She has attached a long, typed-out history of her issue in uncanny detail hoping to avoid telling her story to yet, another healthcare provider.

When I walk into the waiting room and introduce myself I can feel the uncertainty and see her hesitant smile. She was told by a physician to come see me, but she has no reason to trust me. Her experience in the healthcare system has been subpar over the last several months and years. I notice a shopping bag at her feet overflowing with running shoes and orthotics of varying types. She is hoping one of these shoes is to blame.

As we walk back to my office we pass a treadmill, pictures of runners completing races on the wall, magazine articles, a box of used running shoes to be donated, and several other patients. Each one dressed in running clothes exercising, working on running form, engaged in discussions with their PTs or leaving for the day.

Once she settles into her seat I sit down, face her and ask her to tell me her story. Immediately I can see the tears welling up in her eyes. I hand her a Kleenex, lean in, and let her know I am listening.

“I have seen four or five physical therapists, multiple doctors in multiple states, had MRIs, seen a chiropractor or two, a massage therapist, done glute exercises, foot exercises, stopped running, ran more and no matter what I do I am not better,” she says in a long, winded breath. She sits in front of me, shifting in her seat, tapping her foot nervously while she wipes away tears of frustration and anger.

This is a story I hear every week.

We spend the next 40 minutes of our 60-minute session talking. One of my mentors early on in my career told me that if you just listen, truly listen, your patient will tell you what is wrong with them. You have to train yourself to listen, not jump to conclusions or cut them off. When you master that you will become an expert. Through my several years of practice, I too have learned that there is so much to a person’s story.

A concept that we talk a lot about in running medicine is that stress is stress. Our body cannot differentiate between physical, mental or emotional stress. Without the story, you don’t learn about the other stressors that may be occurring in your patient’s life. Maybe their overuse injury is overtraining, but is it overtraining because they are doing too many miles OR because they are exhausted from working a demanding job, juggling family, and are under financial stress? What exercises do you give for that?

By the time we are finished talking, I can see her body has settled down and relaxed a little. Her breath is slower, she isn’t fidgeting anymore and the adrenaline of proving to another healthcare provider she is in pain is gone.

When treatments don’t work our healthcare system often blames the patient. Over time, the patient begins to believe there is something truly wrong with them, even if there isn’t. Or even if it isn’t a big deal. Patients may even feel like their symptoms are in their heads and they have to prove to someone that they are in pain.

This additional stress that is part of our healthcare system pushes the patient’s nervous system further into overdrive and they are constantly living on cortisol and adrenaline — no wonder they can’t heal. They can’t even get their body to drop into “Rest and Digest” where recovery takes place.

At the end of our physical therapy session, I give my patient her homework for the week:

• Go for a walk in the woods
• Stop thinking about every single aspect of her run or her movements
• Do something that is not running-related that makes her happy
• Breathe

After much explanation, citing research about the benefits of her homework and explaining why I am not giving her glute exercises today (though I likely will at some point), she laughs, gives me a hug, and says thank you. She is already on a better path.

Every patient is different.

Every story is different.

But, every patient is human, with a story that impacts how they heal, what motivates them, and how they process pain. This is how injuries can be approached with greater success.

On our next visit, we begin some traditional PT. I do manual therapy, teach some neuromuscular retraining, strength exercises and watch her run. I also continue to listen, to notice how she responds to the words I use, to make sure I explain everything we are doing and why. I don’t give her exercises and walk away, I make sure they are the right ones for her and she is confident in doing them. I don’t rush through the manual therapy I make sure that I provide her with what she needs- no less.

Over the next few months, I see her once a week. There are many ups and a few downs (that is how the body heals and I assure her of this physiological process) along the way, but each visit is an overall improvement. We work together to solve problems, change things that aren’t working and address her whole health. Some days her homework is meditating, getting 7–9 hours of sleep or sitting in the morning sunlight, other days it is doing squats, single-leg deadlifts and running drills. Her treatment is designed to address the cause of her hip pain — not just the pain in her hip.

It may have taken longer than she hoped, but eventually she is running again. This time she is stronger — physically yes (she has rock-hard glutes and knows how to use them!) but also mentally and emotionally. In her recovery she did more than glute exercises and stretch. She learned to address all the other aspects of her life that impact healing and recovery — to integrate her whole health including mindset, emotions, nutrition, knowledge, goals, sleep, strength, and the power of being heard.

Thank you for reading, XO Kate

Need a way to address all aspects of your health? Try RUNsource from Fast Bananas. I created it to fill in the gaps — to address what is missing in traditional healthcare.

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